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Tan CE, Lau SCD, Abdul Latiff Z, Lee CC, Teh KH, Mohd Sidik S. Parents of children with cancer require health literacy support to meet their information needs. Health Info Libr J 2024; 41:267-282. [PMID: 37332240 DOI: 10.1111/hir.12491] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/07/2023] [Accepted: 05/11/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Timely and relevant information helps parents to cope when a child is diagnosed with cancer. However, obtaining and understanding information is not a straightforward process for parents. OBJECTIVES This article aims to explain paediatric cancer parents' information behaviour related to the care of their child. METHODS Qualitative in-depth interviews were conducted with fourteen Malaysian paediatric cancer parents and eight healthcare professionals who worked with paediatric cancer patients. Reflexivity and inductive approaches were used to interpret the data to identify meaningful themes and subthemes. RESULTS Three themes about how paediatric cancer parents interact with information emerged: Acquiring information, internalising information, and using information. Information may be actively sought or passively acquired. Cognitive and affective aspects influence how information is internalised into meaningful knowledge. Knowledge then leads to further action including further information gathering. CONCLUSION Paediatric cancer parents need health literacy support to meet their information needs. They require guidance in identifying and appraising suitable information resources. Development of suitable supporting materials is needed to facilitate parents' ability to comprehend information related to their child's cancer. Understanding parents' information behaviour could assist healthcare professionals in providing information support in the context of paediatric cancer.
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Affiliation(s)
- Chai Eng Tan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Sie Chong Doris Lau
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zarina Abdul Latiff
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chee Chan Lee
- Department of Paediatrics, Ministry of Health, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Kok Hoi Teh
- Department of Paediatrics, Ministry of Health, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Sherina Mohd Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Tan CE, Admodisastro N, Lau SCD, Tan KA, Teh KH, Lee CC, Mohd Sidik S. Development and user evaluation of an online caregiver education resource for Malaysian parents of children with leukemia or lymphoma. Asia Pac J Oncol Nurs 2024; 11:100363. [PMID: 38304227 PMCID: PMC10831254 DOI: 10.1016/j.apjon.2023.100363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/15/2023] [Indexed: 02/03/2024] Open
Abstract
Objective Malaysian parents of children diagnosed with leukemia or lymphoma stand to benefit from a comprehensive Malay-language online resource, complementing existing caregiver education practices. This study aimed to develop and assess the efficacy of e-Hematological Oncology Parents Education (e-HOPE), an online caregiver education resource in Malay, designed to enhance the knowledge of parents with children diagnosed with leukemia or lymphoma in Malaysia. Methods A user profile and topic list were established based on previous needs analysis studies. Content was developed for each identified topic. An expert panel assessed the content validity of both informational content and activity sections. Subsequently, the contents were presented via a learning management system to parents of children newly diagnosed with leukemia or lymphoma. Parents evaluated the quality of e-HOPE using the Website Evaluation Questionnaire (WEQ) after an 8-week period. Results The scale content validity index (S-CVI/Ave) achieved 0.996 for informational content and 0.991 for the activity section. Sixteen parents provided evaluations of e-HOPE after an 8-week usage period. Mean WEQ scores for various dimensions ranged from 4.23 for completeness to 4.88 for relevance. Conclusions E-HOPE was meticulously designed and developed to offer Malaysian parents a Malay-language resource complementing current caregiver education practices. It exhibited strong content validity and received positive user ratings for quality. Further assessment is warranted to evaluate its effectiveness in supporting parents of children with leukemia or lymphoma. The resource is anticipated to enhance information accessibility and support for Malaysian parents facing hematological cancers in their children. Trial registration Clinicaltrials.govNCT05455268.
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Affiliation(s)
- Chai-Eng Tan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Novia Admodisastro
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Sie Chong Doris Lau
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kit Aun Tan
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Kok Hoi Teh
- Department of Pediatrics, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Chee Chan Lee
- Department of Pediatrics, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Sherina Mohd Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Phiri L, Li WHC, Phiri PGMC, Cheung AT, Wanda‐Kalizang'oma W, Kamwendo A, Lemon S. Experiences of caregivers of children with cancer in Malawi: A qualitative study. Cancer Med 2024; 13:e6963. [PMID: 38379330 PMCID: PMC10844995 DOI: 10.1002/cam4.6963] [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: 11/07/2023] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Studies have shown that caregivers of children with cancer experience challenges when caring for their children. To date, no studies have examined the experience of caregivers of children with cancer in Malawi, a low-income country in sub-Saharan Africa. Hence, this study aimed to explore the experiences of caregivers of Malawian children receiving cancer treatment. METHODS This explorative qualitative study used semi-structured interviews to collect data from 22 caregivers of children receiving cancer treatment. The data were analysed using qualitative content analysis. RESULTS Five themes emerged from the QCA. The caregivers perceived their children's cancer as a burden, a form of psychological torture and a disruptor of family routines and social lifestyles. They also reported self-isolation due to the stigma that they faced in the course of caring for their children and a need for informational, psychosocial, spiritual and financial support. CONCLUSION Caregivers of Malawian children with cancer experience physical and psychosocial challenges as they are caring for their children with cancer. Developing appropriate interventions would enable nurses to offer optimal support to these caregivers in dealing with these challenges and meeting their needs effectively.
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Affiliation(s)
- Lophina Phiri
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong
| | - William Ho Cheung Li
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong
| | - Patrick G. M. C. Phiri
- Institute of Applied Technology, Fatima College of Health SciencesAl AinAbu DhabiUnited Arab Emirates
| | - Ankie Tan Cheung
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong
| | | | | | - Sellina Lemon
- Baylor College of Medicine Childrens Foundation, Global HOPE ProjectLilongweMalawi
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Delemere E, Gitonga I, Maguire R. "A Really Really Almost Impossible Journey" Perceived Needs and Challenges of Families Impacted by Pediatric Cancer: A Qualitative Analysis. Compr Child Adolesc Nurs 2023; 46:277-294. [PMID: 37409984 DOI: 10.1080/24694193.2023.2229429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 06/16/2023] [Indexed: 07/07/2023]
Abstract
Caring for a child with cancer can place a number of burdens on families, however it is unclear the extent to which health-care professionals (HCPs) and other personnel supporting families are aware of these burdens. This study sought to explore the needs and challenges encountered by families impacted by pediatric cancer in Ireland from the perspectives of both parents and the personnel who support them. Twenty-one participants, comprising seven parents (one male, six females), and 14 supportive personnel (nine hospital-based volunteers and five HCPs) took part in in-depth semi-structured interviews via Microsoft Teams (December 2020 to April 2021) to obtain a perspective of the needs, challenges, and currently available support for families. A reflexive thematic approach to analysis was employed. The need to navigate a new normal, a sense of riding the wave and reliance on others were perceived to be the primary challenges encountered by families. Participants reported a need for community service provision, connectivity across the health-care system and more accessible psychological support. High levels of overlap across themes were found for parents and supportive personnel, particularly HCPs. Results highlight the significant challenges encountered by families impacted by pediatric cancer. Themes voiced by parents were frequently echoed by HCPs, suggesting this group is attuned to broader family needs. As such, they may be capable of providing insight where parent perspectives are unavailable. While further analysis including children's voices is needed, findings highlight key areas toward which support for families should be directed.
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Affiliation(s)
- Emma Delemere
- Department of Psychology, Maynooth University Co., Kildare, Ireland
| | - Isaiah Gitonga
- Department of Psychology, Maynooth University Co., Kildare, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University Co., Kildare, Ireland
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Melesse TG, Chau JPC, Li WHC, Yimer MA. Family caregivers' experiences of caring for children diagnosed with haematological malignancies receiving chemotherapy in Ethiopia: A qualitative study. Eur J Oncol Nurs 2023; 66:102376. [PMID: 37506611 DOI: 10.1016/j.ejon.2023.102376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 06/06/2023] [Accepted: 06/16/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE Studies from different countries show that caregivers of children with haematological cancer receiving chemotherapy encounter substantial distress when witnessing their children's suffering from the illness and chemotherapy side effects, alongside experiencing psychosocial problems and financial difficulties. However, no studies for this are available from Ethiopia in its specific cultural background and health care system. Thus, this study aimed to explore and bring into light the experiences of Ethiopian family caregivers of children with haematological malignancies receiving chemotherapy. METHODS A qualitative descriptive study was conducted using a maximum variation purposive sampling method among 20 caregivers. Semi-structured in-depth face-to-face interviews were conducted until no new themes discovered. The data were analysed through qualitative thematic analysis. RESULTS Participants believed cancer comes from different reasons and chemotherapy is ineffective in curing cancer. They identified various chemotherapy-related side effects, and psychosocial problems. The lack of health insurance, loss of job or income, and high cost of treatments were the major financial challenges. Adhering to treatments, acceptance and reassurance, religious and spiritual therapies, traditional medicine, and a support system were the major coping strategies. They had needs for improved support in information and education, psychosocial support, and in the availability of medications. CONCLUSIONS Systematic health assessment, provision of targeted information and education, psychosocial support, nursing care respecting the caregivers' positive coping strategies, improvement in chemotherapy medication availability, and facilitating connections with supporting organisations would help improve child outcomes and address caregiver needs.
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Affiliation(s)
- Tenaw Gualu Melesse
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Department of Paediatrics and Child Health Nursing, College of Health Sciences, Debre Markos University, Ethiopia
| | - Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - William Ho Cheung Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Mulugeta Ayalew Yimer
- Unit of Paediatric Haematology-Oncology, Department of Paediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Ethiopia
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Kantabanlang Y, Lin CP, Nilmanat K, Guo P. Palliative care needs of patients with hematologic malignancies and family caregivers and challenges of palliative care provision in Asia: A review of evidence. Semin Hematol 2023; 60:220-225. [PMID: 37517948 DOI: 10.1053/j.seminhematol.2023.07.002] [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: 05/15/2023] [Revised: 07/16/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
Patients with hematologic malignancies often experience fatigue, lack of vitality, and energy, and high psychological distress. High levels of unmet care needs of patients with hematologic malignancies in Asia were identified. This review provides an overview of current evidence on the experiences and palliative care needs of patients with hematologic malignancies and their families and the barriers and challenges of integrating palliative care into hematology care in Asia. Patients with hematologic malignancies who received palliative care could benefit from less aggressive end-of-life treatments. However, the uncertain and variable nature of the prognosis and illness trajectories of hematologic malignancies increase the difficulties of integrating palliative care into hematologic care. Patients and their families are often referred to palliative care services late, which leaves a short window for palliative care teams to provide holistic needs assessment and person-centered care for those who need it. In addition, cultural differences in medical decision-making patterns and complex social norms and interactions among patients, families, and healthcare staff make it even more challenging to initiate palliative care conversations in Asia. Future research should focus on the development and evaluation of culturally appropriate palliative care for patients with hematologic malignancies and their family caregivers in Asia, given that the low rate of service intake and poor public awareness of the important role of palliative care in disease trajectories were reported. The socio-cultural context surrounding individuals should be taken into consideration to ensure the provision of person-centered care for this group of patients. Digital health could be one of the possible solutions forward to address local needs and challenges.
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Affiliation(s)
- Yupawadee Kantabanlang
- Boromarajonani College of Nursing Suratthani, Faculty of Nursing, Praboromarajchanok Institute, Surat Thani, Thailand
| | - Cheng-Pei Lin
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan; Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, King's College London, London, United Kingdom
| | - Kittikorn Nilmanat
- Division of Fundamental Nursing Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand
| | - Ping Guo
- School of Nursing and Midwifery, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
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Ilic A, Sievers Y, Roser K, Scheinemann K, Michel G. The information needs of relatives of childhood cancer patients and survivors: A systematic review of qualitative evidence. PATIENT EDUCATION AND COUNSELING 2023; 114:107840. [PMID: 37321115 DOI: 10.1016/j.pec.2023.107840] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/25/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To synthesize qualitative research on the information needs of relatives of childhood cancer patients and survivors. METHODS Systematic searches of PubMed, PsycINFO, CINAHL, and Scopus identified relevant literature. Extracted data were combined using thematic synthesis. Methodological quality was assessed using the JBI critical appraisal tool for qualitative research. RESULTS The review included 27 publications, with most research focusing on parents or primary caregivers. Five areas of information needs were identified: treatment, medication, and care; general information about cancer; coping and support; follow-up, late effects, and rehabilitation; and parenting and everyday life. Appropriateness of information depended on health care professionals' aptitude, message characteristics, communication setting, and relatives' personal factors. Preferences for form, sources, and timing for information provision varied. CONCLUSION The review identified information needs, communication barriers, and preferences among caregivers and siblings of childhood cancer patients and survivors, highlighting areas requiring further research and clinical consideration in addressing the identified challenges. PRACTICE IMPLICATIONS Caregivers and siblings have unique but similar information needs regarding childhood cancer. To ensure that these needs are met, health care professionals could use eHealth and mHealth technologies, assess each family member's knowledge, and create a safe and supportive environment for questions and feedback.
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Affiliation(s)
- Anica Ilic
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Yara Sievers
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Center for Pediatric Hematology/Oncology, East Swiss Children's Hospital, St. Gallen, Switzerland; Department of Pediatrics, McMaster Children's Hospital and McMaster University, Hamilton, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
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Tan CE, Lau SCD, Tan KA, Latiff ZA, Teh KH, Lee CC, Mohd Sidik S. Development and Validation of a Caregiving Knowledge Questionnaire for Parents of Pediatric Leukemia and Lymphoma Patients in Malaysia. Cureus 2022; 14:e30903. [PMID: 36465778 PMCID: PMC9710185 DOI: 10.7759/cureus.30903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 06/17/2023] Open
Abstract
Introduction Validated tools to measure caregiving knowledge among parents of children with hematological cancers are needed to measure the clinical outcome of caregiver interventions. This study reports the development and validation of the Hematological Oncology Parents Education Caregiving Knowledge Questionnaire (HOPE-CKQ) among Malaysian parents of pediatric leukemia and lymphoma patients. Methods Initially, 60 items on caregiving knowledge were developed based on a qualitative needs assessment study. Content validity was evaluated using item content validity index (I-CVI) and scale content validity index (S-CVI/Ave). Parents of pediatric leukemia and lymphoma patients were invited to complete the 60-item version of the HOPE-CKQ. Exploratory factor analysis (EFA) using polychoric correlation resulted in an 18-item version of HOPE-CKQ. Confirmatory factor analysis (CFA) was used to verify the factor structure. Known-group validity was tested by comparing the scores among different levels of parent education. Results The I-CVI ranged from 0.83 to 1.00 whereas the S-CVI/Ave was 0.99, indicating good content validity. A total of 167 complete responses were analyzed for factor analysis. EFA using polychoric correlations resulted in a single-factor structure consisting of 18 items. CFA confirmed that the 18-item single-factor HOPE-CKQ model had a good fit for the data. The internal consistency reliability was good (α=0.80). Parents with tertiary education level had higher caregiving knowledge (M=12.61, SD=3.37) compared to parents with secondary education and below (M=10.33, SD=3.80) (t=3.58, p<0.001). Conclusions The 18-item HOPE-CKQ is valid and reliable for use to measure caregiving knowledge among pediatric leukemia and lymphoma parents. This tool may be considered to measure caregiving knowledge in future preventive and intervention programs.
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Affiliation(s)
- Chai-Eng Tan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
- Department of Psychiatry, Universiti Putra Malaysia, Serdang, MYS
| | - Sie Chong Doris Lau
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Kit Aun Tan
- Department of Psychiatry, Universiti Putra Malaysia, Serdang, MYS
| | - Zarina Abdul Latiff
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Kok Hoi Teh
- Department of Pediatrics, Hospital Tunku Azizah (Ministry of Health Malaysia), Kuala Lumpur, MYS
| | - Chee Chan Lee
- Department of Pediatrics, Hospital Tunku Azizah (Ministry of Health Malaysia), Kuala Lumpur, MYS
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