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Holmbom M, Andréasson F, Grundström H, Bernild C, Fålun N, Norekvål TM, Kikkenborg Berg S, Strömberg A. Young Spouses' Experiences of Having a Partner With Heart Disease and Adolescents Living at Home. Health Expect 2024; 27:e14129. [PMID: 38970211 PMCID: PMC11226407 DOI: 10.1111/hex.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 06/02/2024] [Accepted: 06/19/2024] [Indexed: 07/08/2024] Open
Abstract
AIM To describe the life situation of spouses having a partner with heart disease and adolescents living at home. DESIGN Qualitative inductive design. METHOD Participants (n = 22) were included from three Scandinavian countries. Semi-structured interviews were analysed using thematic analysis with an inductive and latent approach. RESULTS Three themes were derived. 'Being in spousal and parental role transition' described how daily life had been affected and parental responsibilities had been doubled due to their partner's heart disease. 'Living with unpredictability and insecurity' included how the unpredictable illness trajectory caused worries and affected the well-being of the family. 'Managing a challenging life situation' highlights how spouses coped with their partners' heart disease and adapted to a new life situation. CONCLUSION Young spouses' life situation was greatly affected by their partner's heart disease, resulting in increased responsibilities and double parenthood. Having a positive attitude and mindset towards life was used as a strategy to cope with the changed life situation and find a new way of life. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE All family members are affected by heart disease. Spouses needed additional professional support and guidance on how to involve the children when a parent is ill. IMPACTS This study highlights how young spouses, with adolescents living at home, experience their life situation. The life situation is unpredictable due to the partner's heart disease, as they must handle both caring for their partner and taking on double parenthood. Research involving family members can improve person- and family-centred care and treatment outcomes in health care and society. REPORTING METHOD COREQ checklist was used preparing the manuscript. PATIENT OR PUBLIC CONTRIBUTION Data collection included interviews with spouse. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: By highlighting the spouses changed life situation due to heart disease and the importance of including them in health care.
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Affiliation(s)
- Matilda Holmbom
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | | | - Hanna Grundström
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Obstetrics and GynecologyNorrkopingSweden
- Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Camilla Bernild
- The Heart Center, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Nina Fålun
- Haukeland University HospitalBergenNorway
| | - Tone Merete Norekvål
- Haukeland University HospitalBergenNorway
- Department of Clinical ScienceUniversity of BergenBergenNorway
| | | | - Anna Strömberg
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of CardiologyLinköping UniversityLinköpingSweden
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da Silva EF, Matsubara MDGS, Soares MADL, Mazzaia MC, De Domenico EBL. Communication between parents diagnosed with cancer and their children: study with data triangulation. Rev Esc Enferm USP 2024; 57:e20230079. [PMID: 38373186 PMCID: PMC10876183 DOI: 10.1590/1980-220x-reeusp-2023-0079en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/14/2023] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE To characterize the perceptions and feelings of parents diagnosed with cancer in relation to communication with their children between 3 and 12 years old. METHOD A cross-sectional, multicenter, with data triangulation, through structured and semi-structured interviews, with a question with a Semantic Differential Scale, carried out with the father or mother with cancer undergoing outpatient treatment in two hospital institutions in the city of São Paulo, São Paulo, Brazil. Data were analyzed using descriptive statistics, content analysis, using the ATLAS.ti 8.0R software and the Social Representation Theory. RESULTS Forty-three respondents participated, 37 (86.0%) were female, 23 (53.5%) aged between 31 and 50 years old, 29 (67.5%) with only children between 7 and 12 years old. The experience was considered painful (73.1%), stressful (53.6%), clear (53.7%) and safe (51.2%). The feelings experienced generated two categories: Trial by fire; and Grateful rewards. Children's reactions from parents' perspective generated the categories: Sadness and suffering; Trust and support; Change of behavior; and Denial or insensitivity. CONCLUSION Communication was assessed as negative and conflicting, positive and welcoming, and causing changes in children's behaviors.
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Plont M, Mejdahl CT, Haar TR, Skovlund P. Supporting Families with Breast Cancer: Insights from the Danish Nurse-Led Program "The Children's Tour" for Families with Parental Cancer. Semin Oncol Nurs 2023; 39:151482. [PMID: 37537028 DOI: 10.1016/j.soncn.2023.151482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE This study explores how a Danish nurse-led program designed to provide support to families where mothers are affected by breast cancer is experienced by the women attending the program and the nurses organizing it. Their experiences provide insights into the program's impact and potential areas of improvement and inform future interventions targeting the well-being of this specific population. DATA SOURCES The study involved data collected through qualitative research. An observational study of the intervention was conducted to inform the development of an interview guide for semistructured individual interviews and a focus group interview. Five women with breast cancer and children aged 5 to 16 years were interviewed, and four nurses involved in the nurse-led program took part in the focus group interview. Data were audio recorded, transcribed verbatim, and thematically analyzed. CONCLUSION Families participating in the nurse-led program reported it helpful in many ways. Three themes emerged from the analysis of the interviews: 1) "How to talk about parental cancer with school-aged children," 2) "Setting up the room," and 3) "Exchanging imagination for reality." Getting familiar with the treatment room and nurses, playing with hospital gear (syringes, bandages, and the treatment chair), and watching a movie together indicate that the visit to the ward is important and cannot be entirely replaced by digital solutions. With the need for support and limited resources at the hospital, it is pivotal to identify the families most in need. IMPLICATIONS FOR NURSING PRACTICE Women with breast cancer parenting adolescent children need family-based care based at the hospital. Further research is needed to refine the program to cover the concerns of the whole family, including fathers and grandparents, and to apply the program to other families with parental cancer of other types.
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Affiliation(s)
- Marcell Plont
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark.
| | | | - Tina Rotbøl Haar
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
| | - Pernille Skovlund
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
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Shao M, Yang H, Du R, Zhang M, Zhu J, Zhang H, Ma B, Chen C, Wang T. Family resilience in cancer treatment and key influencing factors: A systematic review. Eur J Oncol Nurs 2023; 66:102403. [PMID: 37690311 DOI: 10.1016/j.ejon.2023.102403] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/22/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE To identify the status quo and key influencing factors of family resilience in cancer treatment. METHODS Eight electronic databases (PubMed, Cochrane Library, Embase, CINAHL, Web of Science, CNKI, Wan Fang Database, VIP Database) were searched from 2000 to 10 May 2023. Inclusion criteria were the following: (a) study subjects were cancer patients or their family caregivers, (b) family resilience was measured as a variable, (c) reported factors associated with family resilience, (d) employed either quantitative or mixed methods design, (e) written in English or Chinese, (f) published in peer-reviewed journals. All included studies were evaluated for quality using the Mixed Method Appraisal Tool. RESULTS Thirty studies were included in the systematic review. According to our analysis, the family resilience of cancer patients could be influenced by various factors associated with six clusters: (a) demographic characteristics, (b) severe staging and treatment of cancer, (c) psychological and health statuses, (d) family, and (e) social environment. Meanwhile, several specific protective factors and risk factors of family resilience were also identified. CONCLUSION Family resilience plays an important role in promoting positive adaptation in the face of adversity in families of cancer patients/caregivers. This study classifies related influencing factors by analyzing both protective factors and risk factors (and some controversial factors of family resilience). We found that longitudinal studies are needed to further verify the dynamic changes of family resilience, and future research should focus on understanding family resilience from the dual perspectives of cancer patients and their caregivers, to provide comprehensive information for health professionals, and facilitate the development of effective family resilience intervention programs.
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Affiliation(s)
- Mengwei Shao
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
| | - Huashan Yang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
| | - Ruofei Du
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China; Academy of Medical Sciences of Zhengzhou University, Zhengzhou, 450001, China
| | - Menghan Zhang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Jizhe Zhu
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Haoning Zhang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Bin Ma
- School of Medical, Molecular and Forensic Sciences, Murdoch University, 6149, Australia
| | - Changying Chen
- Department of Quality Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Tao Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China; Medical School, University of Western Australia, Perth, WA, 6872, Australia; People' s Hospital of Hebi, Hebi, 458010, China.
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Finucane AM, Hulbert-Williams NJ, Swash B, Spiller JA, Wright B, Milton L, Gillanders D. Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing. Palliat Med 2023; 37:244-256. [PMID: 36576308 DOI: 10.1177/02692163221143817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Acceptance and Commitment Therapy is a form of Cognitive Behavioural Therapy which uses behavioural psychology, values, acceptance and mindfulness techniques to improve mental health and wellbeing. Acceptance and Commitment Therapy is efficacious in treating stress, anxiety and depression in a broad range of settings including occupational contexts where emotional labour is high. This approach could help palliative care staff to manage work-related stress and promote wellbeing. AIM To develop, and feasibility test, an online Acceptance and Commitment Therapy intervention to improve wellbeing of palliative care staff. DESIGN A single-arm feasibility trial of an 8-week Acceptance and Commitment Therapy based intervention for staff, consisting of three online facilitated group workshops and five online individual self-directed learning modules. Data was collected via online questionnaire at four time-points and online focus groups at follow-up. SETTING/PARTICIPANTS Participants were recruited from Marie Curie hospice and nursing services in Scotland. RESULTS Twenty five staff commenced and 23 completed the intervention (93%). Fifteen participated in focus groups. Twelve (48%) completed questionnaires at follow-up. Participants found the intervention enjoyable, informative and beneficial. There was preliminary evidence for improvements in psychological flexibility (Cohen's d = 0.7) and mental wellbeing (Cohen's d = 0.49) between baseline and follow-up, but minimal change in perceived stress, burnout or compassion satisfaction. CONCLUSION Online Acceptance and Commitment Therapy for wellbeing is acceptable to palliative care staff and feasible to implement using Microsoft Teams in a palliative care setting. Incorporating ways to promote long-term maintenance of behaviour changes, and strategies to optimise data collection at follow-up are key considerations for future intervention refinement and evaluation.
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Affiliation(s)
- Anne M Finucane
- Clinical Psychology, University of Edinburgh, UK.,Marie Curie Hospice Edinburgh, Edinburgh, UK
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Child- and family-specific communication skills trainings for healthcare professionals caring for families with parental cancer: A systematic review. PLoS One 2022; 17:e0277225. [DOI: 10.1371/journal.pone.0277225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/22/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction
As part of high-quality cancer care, healthcare professionals (HCPs) play a significant role in identifying and addressing specific needs of cancer patients parenting minor children. However, HCPs experience various barriers to adequately support parents with cancer. This systematic review explores current CSTs incorporating child- and family- specific modules for HCPs in oncology. Moreover, outcome measures and effectiveness of trainings are systematically investigated.
Methods
The systematic review was registered within PROSPERO (registration code: CRD42020139783). Systematic searches were performed in four databases (PubMed, Cinahl, PsycInfo, Web of Science) in 12/2020, including an update in 12/2021 and 08/2022. Quantitative, primary studies fulfilling the pre-defined inclusion criteria were included. Due to the expected heterogeneity a meta-analysis was not conducted. Study selection and quality assessment were conducted by two independent researchers, data extraction by one. Study quality was assessed using an adapted version of the National Institutes of Health quality assessment tool for pre-post studies without control group.
Results
Nine studies were included in this review following an experimental pre-post design only. Two CSTs were specifically designed to improve communication with cancer patients parenting minor children, the remaining seven incorporated a brief family module only. Seven programs were face-to-face trainings, one an e-learning and one a webinar. Eight studies found at least one statistically significant improvement in communication after training. However, quality of most studies was fair.
Conclusion
This is the first review exploring specific CSTs for HCPs caring for cancer patients parenting minor children. As only two CSTs focused on parental cancer, evidence on the effectiveness of such CSTs is limited. Existing CSTs should be evaluated properly and include details on content of family modules. Further studies including and evaluating specific CSTs focusing on parental cancer are needed in order to strengthen HCPs’ competencies to meet specific needs of patients parenting minor children.
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Inhestern L, Johannsen LM, Bergelt C. Families Affected by Parental Cancer: Quality of Life, Impact on Children and Psychosocial Care Needs. Front Psychiatry 2021; 12:765327. [PMID: 34858234 PMCID: PMC8631390 DOI: 10.3389/fpsyt.2021.765327] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/12/2021] [Indexed: 11/18/2022] Open
Abstract
Parental cancer poses major challenges for families with minor children. Due to diagnosis and treatment family life is disrupted. To prevent long-term consequences in all family members and to design needs-oriented family-centered interventions, further understanding of the family's situation including the impact on the children, quality of life levels and the parental psychosocial needs is necessary. This study aims at investigating the impact of parental cancer on the minor children, family-specific psychosocial needs and quality of life levels of parents and children. Cancer patients parenting at least 1 minor child (<18 years) were eligible for study participation. In total, n=86 cancer patients under treatment participated in the study. After excluding participants without a minor child, 78 patients remained for analyses. We assessed children's quality of life using the parent proxy version of the KIDSCREEN-10 and parental quality of life using the EORTC QLQ C30 quality of life questionnaire. Additionally, the questionnaire comprised open questions about positive and negative changes parents perceived in their children as well as questions on specific family- and child-related psychosocial needs. The majority of participants were mothers (91%), mainly diagnosed with breast cancer (59%). The participating parents provided data on 117 minor children. Parents mentioned positive changes in 38% of the children (e.g., being more attentive and helpful). Negative changes were reported in 37% of the children (e.g., being more anxious and clingy). Parents reported family-specific psychosocial supportive care needs for themselves as a parent (e.g., support regarding parenting concerns), support needs for the partner or the children. Moreover, parents expressed family-related information needs and needs regarding practical aspects (e.g., childcare, household help). Global quality of life was M = 55.7 (SD = 23.4) for parents and M = 57.5 (SD = 15.5) for children. Pearson's correlation coefficient between parental and children's quality of life was 0.377 (p < 0.001). To identify parents with cancer and children in need for additional support, health care providers should proactively inquire about the impact of the disease on the children. In terms of a comprehensive cancer care, the direct assessment of family impact and family-specific support needs in cancer patients with minor children allows for needs-based allocation to support offers.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lene Marie Johannsen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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