Coping skills and mental health status in adolescents when a parent has cancer: a multicenter and multi-perspective study

Coping strategies and belief in COVID-19 conspiracy theories

Conspiracy beliefs have been related to aversive emotional experiences often accompanying major world events and have also been linked to maladaptive ways of coping with stress. In this research, we examined how different coping strategies (i.e. self-sufficient, social-support, avoidance and religious) predicted the adoption of COVID-19 conspiracy theories. In two studies (Study 1, n = 1000 and Study 2, n = 616) conducted among Polish participants, we found that avoidance and religious coping were positively linked to COVID-19 conspiracy beliefs. In Study 1, conspiracy beliefs also mediated the positive relationships between avoidance and religious coping and adherence to safety and self-isolation guidelines during the COVID-19 pandemic. Study 2 additionally showed that the relationship between fear, induced by reading threatening news on COVID-19, and conspiracy beliefs was the strongest among those high in avoidance coping. These studies highlight the role of coping strategies in the adoption of COVID-19 conspiracy beliefs.

Supportive and psychosocial peer-group interventions for children and adolescents of parents with cancer: A systematic review

OBJECTIVE

Children and adolescents are highly affected by their parents` cancer disease. This review aims to summarize peer-group interventions for children and adolescents of cancer patients, where those affected have the opportunity to exchange and normalize their feelings among equals.

METHODS

A systematic review searching four different databases (MEDLINE, PsycInfo, CINAHL and Web of Science) was conducted. We included studies investigating psychosocial peer-group interventions for offspring of cancer patients. A narrative synthesis summarised the characteristics of the interventions and the findings on effects and evaluation.

RESULTS

Ten articles on seven different peer-group interventions were analysed. Research designs and intervention concepts were heterogeneous. Overall, high acceptance, feasibility and positive effects of peer-group support were reported. Significant effects were found in six studies, e.g. in relation to psychological well-being, quality of life and coping skills.

CONCLUSION

Peer-group interventions are an accepted and helpful form of support. Providing children and adolescents of cancer patients for example with psychoeducation, community and coping strategies, thereby impacting on psychological well-being.

PRACTICE IMPLICATIONS

For comprehensive care, it seems to be important to offer support throughout the parent's cancer journey and to offer support flexibly as needed through group services as well as individual sessions.

COVID-19 Stressors and Aggression among Chinese College Students: The Mediation Role of Coping Strategies

Although college students experienced excessive stressors (COVID-19 disease and negative COVID-19 news) during the COVID-19 pandemic, few studies have been aimed at coping strategies used by college students to deal with stress caused by the pandemic. Coping strategies are efforts to deal with anxiety in the face of a perceived threat or stress. Aggression is harmful social interaction with the intention of inflicting damage or harm upon another individual. In the present study, we aimed to examine the direct effect of stressors resulting from the pandemic on college students' aggression, as well as the indirect effect via their coping strategies. Through a cross-sectional survey of 601 Chinese college students (M-age = 20.28), we tested the proposed framework. We first found that information stressors of COVID-19 ranked highest among the four stressors of the pandemic. Results also indicated that college students' stressors of COVID-19 were directly and positively associated with their aggressive behavior. For the indirect effect, college students would adopt both adaptive coping strategies (self-help strategy) and maladaptive coping strategies (avoidance strategy and self-punishment strategy) with the stressors of COVID-19. Furthermore, adaptive coping strategy (approach strategy) was negatively related to their aggression, whereas maladaptive coping strategy (avoidance strategy and self-punishment strategy) was positively related to their aggressive behavior. The present research extends the general strain theory in the COVID-19 context. Practical implications are also discussed.

Child Posttraumatic Stress after Parental Cancer: Associations with Individual and Family Factors

Objective

This study aimed to examine the severity of posttraumatic stress disorder (PTSD) symptoms in children of parents with cancer and to identify individual and family factors associated with these symptoms.

Methods

The sample consisted of 175 children (52% girls, aged M = 11.98, SD = 3.20, range = 6–20 years) from 92 families, of which 90 parents with a current or past cancer diagnosis and 71 healthy co-parents also completed questionnaires. Children reported on PTSD symptoms, trauma-related cognitions, emotion regulation difficulties, general family functioning, and family communication. Both parents reported on their own PTSD symptoms. Associations were investigated using multilevel regression.

Results

Twenty-seven percentage of the children showed clinically relevant PTSD symptoms. Intraclass correlations indicated that children from the same family showed little overlap in these symptoms. Multilevel analyses showed that child trauma-related cognitions and emotion regulation difficulties were related to higher levels of PTSD symptoms at the individual level. General family functioning was only related to child PTSD symptoms at the family level. Child PTSD severity was unrelated to parental PTSD symptoms and family communication at the family level when taking into account the other factors.

Conclusions

The current study highlights the psychological impact of parental cancer on children. Individual factors contributed more strongly to child PTSD symptoms than family factors. Trauma-related cognitions and emotion regulation difficulties might be targeted through specific psychoeducation for children and parents, family-oriented support and interventions, and evidence-based treatments for child PTSD.

Early adolescent psychological adaptation differences by stress-coping profiles: a latent transition analysis

BACKGROUND & OBJECTIVES

This study sought to reveal adolescent coping profiles by focusing on the combination of help-seeking and active/passive coping styles, and to compare affective and school adaptation levels across different profiles.

DESIGN

One-year longitudinal data were collected from 695 Japanese secondary-school students (359 males, 330 females, and 6 unknowns) every semester. All participants reported their positive/negative affect and school adaptation. Only those who experienced any personal problem in the past month completed self-report measures including four stress-coping strategies use.

METHODS

Latent transition analysis (LTA) was conducted to identify stress-coping profiles and their transitions, conducting Tukey's tests to examine the association between the profiles and psychological adaptability.

RESULTS

LTA suggested a seven-class solution. One of the profiles represented participants who did not report any stressor during the past month, and the other six classes were sorted by the amount of help-seeking (low, moderate, and high) and active/passive coping style. The results indicated that simultaneous use of help-seeking and active coping was important for school adaptation and affect balance. Low-adaptation profiles showed high stability during the investigation period.

CONCLUSIONS

Findings suggest that clinicians should assess and intervene with help-seeking and stress-coping styles before or during early adolescence.

Factors associated with quality of life for children affected by parental illness or substance abuse

BACKGROUND

There have been inconsistent findings from studies examining factors associated with quality of life (QoL) for children affected by parental illness.

AIM

The aim of this study was to explore factors associated with self-reported QoL in children affected by parental illness or parental substance abuse.

DESIGN

A cross-sectional multicentre study.

METHODS

The sample included 246 families with children 8-18 years recruited via ill parents who received treatment for severe physical illness, mental illness or substance abuse in specialised health services. We performed multiple linear regression analyses to examine factors associated with the children's self-reported QoL.

MAIN OUTCOME MEASURE

KIDSCREEN-27.

RESULTS

The children's self-reported QoL was positively associated with the ill parent's self-reported physical health, the children's self-reported social skills, the degree to which other adults took over the ill parent's responsibilities, provision of sibling care, provision of health care for the ill parent and positive outcome of caregiving. The children's QoL was negatively associated with the children's self-reported responsibilities due to parental illness, provision of emotional care for the ill parent, negative outcomes of caregiving and external locus of control. The model explained 63% of the variance (adjusted R2 ) in children's total QoL.

STUDY LIMITATIONS

Sampling bias may have occurred during recruitment.

CONCLUSIONS

The findings suggest factors of importance for the children's QoL. Clinicians should assess whether an ill parent's physical health may influence negatively on their ability to perform daily responsibilities at home and care for their children, and clinicians can use children's self-reported QoL to identify children who are most negatively affected.

Cultural values as a resilience resource for Latino/a adolescents and young adults coping with parental cancer

Purpose: Although research on how adolescents and young adults (AYAs) cope with their own cancer is expanding, there is little knowledge on how AYAs cope with a parent's cancer. And, thus, little evidence-based knowledge for how to deliver services. Moreover, most research has been with majority White populations. To fill this gap, we examined whether the cultural values of familismo (familism) and espíritu (spirit) moderate the association between stress appraisals and coping with psychological distress among Latino/AYAs facing a parent's cancer.Design: Cross-sectional, observational.Sample: Thirty eight adolescents and young adults between the ages of 12 and 25 whose mother had breast cancer.Methods: Participants completed standardized measures. Generalized estimating equation analysis was used to analyze the nested data.Results: There was a protective pattern of familismo and espíritu against symptoms of depression. AYAs experienced psychological distress, but those with higher levels of familismo and espíritu fared better than those with lower levels, regardless of the coping strategies they used.Implications: Psychosocial interventions for Latino/a AYAs coping with parental cancer should incorporate or strengthen these values.

Children's experiences of information, advice and support from healthcare professionals when their parent has a cancer disease - experiences from an oncological outpatient department

PURPOSE

This study was carried out in order to evaluate children's experiences after taking part in the pilot clinical intervention "See Me" aimed at supporting children as relatives.

METHOD

A qualitative explorative design with interviews was chosen, with analyses using an inductive approach. Interviews were conducted with 19 children (9 aged 7-12 years and 10 aged 13-18 years). The younger children were asked to draw a picture of a person in hospital, using the Child Drawing: hospital (CD:H) instrument to measure the child's level of anxiety. The older children completed the Caring Professional Scale (CPS) as a measure of the caring approach in their encounter with the nurse.

RESULTS

The interviews with the children show that: they felt expected and welcomed at the hospital; they needed knowledge about their parent's situation; they needed information and participation based on their individual situation; and they needed the nurse to offer them information and support. The results from the pictures showed that one child had above-average levels of anxiety. The older children reported that the nurses were Competent Practitioners, but to a lesser degree that they were Compassionate Healers.

CONCLUSIONS

The results of this pilot study indicate that the structure of "See Me" could be used as a starting point to ensure that children as relatives receive information, advice, and support. Further the results indicate that both CD:H and CPS could be used to evaluated children's experiences of support when a parent has a long-term illness.

Estimates of Prevalence Rates of Cancer Patients With Children and Well-Being in Affected Children: A Systematic Review on Population-Based Findings

This review assessed population-based estimate rates of cancer patients with minor and young adult children (≤ 25 years), children and young adults having a parent with cancer as well as the psychosocial situation and well-being of children and young adults affected by parental cancer. Eighteen publications on population-based studies were included. Studies varied in the age ranges of both cancer patients and children. The prevalence rates of cancer patients having children ranged from 14 to 24.7% depending on the sample structure (e.g., age, gender). Studies reported that between 1.6 and 8.4% of children resp. young adult children have a parent with a history of cancer. Seven publications reported on the psychosocial situation or well-being in children and young adults affected by parental cancer. Estimate rates of psychosocial problems, psychiatric diagnoses or distress ranged between 2.5 and 34% of children depending on the method of measurement and outcome. The differences in the sample structure between the studies impeded the comparison of prevalence rates. However, the findings help to determine the need for specific support services and health care planning. The results emphazise the importance to routinely include issues on the parental role of patients and questions on the well-being and coping of children into psychooncological care. If necessary, support should be provided to families living with a cancer diagnosis.

Investigating relationships among coping, personal growth, and life satisfaction among individuals with physical disabilities

Background: It is well-documented that active coping strategies can lead to better positive adjustment and psycho-social outcomes among individuals with disabilities and illnesses. However, little information exists related to exploring how coping is related to health benefits such as personal growth and life satisfaction in an international context. Thus, this study examined how the use of coping strategies is associated with personal growth and life satisfaction among individuals with physical disabilities in non-Western settings.

Methods: In this cross-sectional study, we employed a nonprobability methodology, purposivesampling, to recruit 351 participants who adults over the age of 18 living with a physicaldisability and currently enrolled in the Korean Disability Association. A hierarchical linearregression analysis was conducted to determine which types of coping strategies predictedpersonal growth and life satisfaction, while controlling for the effects of the demographicvariables (i.e., gender and age).

Results: With regard to personal growth, problem-solving coping strategy (β = 0.663, P < 0.001,95% CI [0.51, 0.70]) was the strongest predictor, followed by avoidance coping strategy(β = -0.263, P < 0.001, 95% CI [-0.37, -0.20]). As for life satisfaction, problem-solving copingstrategy (β = 0.268, P < 0.001, 95% CI [0.18, 0.70]) was the strongest predictor, followed bysocial support seeking coping strategy (β = 0.264, P < 0.001, 95% CI [-0.19, 0.10]).

Conclusion: Our study suggests that problem-focused and social support coping strategies playimportant roles in improving the personal growth and life satisfaction among Korean individualswith physical disabilities. This study provides implications for health professionals seeking waysto facilitate the personal growth and enhance the life satisfaction of individuals with physicaldisabilities.

Impact of Coping Skills Training on the Quality of Life Among the Daughters of Mothers with Breast Cancer

Background

Cancer affects the quality of life (QoL) of patients and their families. The purpose of this study was to determine the effect of coping skills training on the QoL among daughters of mothers with breast cancer.

Methods

In this quasi-experimental pre-test/post-test design, data were collected from 70 participants (35 in each of the control and education groups) from January 2016 to July 2017 in Imam Khomeini and Rasole-e-Akram Hospitals in Tehran. The education group participated in a workshop and group discussion (groups of 5 to 8 participants) with the presence of a pediatric psychiatrist and two pediatric nurses, and then a follow up program was performed. The Pediatric Quality of Life Inventory version 4.0 was used in this study in two stages of pre-test (before education) and post-test (four weeks later). Data were analyzed through SPSS, version 21 using independent t-test and paired t-test for comparison of the mean scores of the two groups, with the significance level of 0.05.

Results

After the education, there were significantly improved scores of the QoL in the dimensions of physical functioning (P<0.001), emotional functioning (P<0.001), and school functioning (P<0.001) in the study group compared to the control group. The social functioning did not show a significant change (P<0.083).

Conclusion

The findings of the study confirm that coping skills training can lead to the improvement of QoL in adolescent daughters of mothers with breast cancer. Healthcare professionals must provide the mothers and daughters with information about breast cancer and instruments to handle their situation to promote the daughters' QoL.

Psychosocial consequences in offspring of women with breast cancer

OBJECTIVE

Breast cancer (BC) accounts for 24% of female cancers, with approximately one quarter of women likely to have offspring aged less than 25 years. Recent publications demonstrate negative psychosocial well-being in these offspring. We prospectively assessed for psychological distress and unmet needs in offspring of BC patients.

METHODS

Eligible offspring aged 14 to 24 years were consented and completed the Kessler-10 Questionnaire and Offspring Cancer Needs Instrument. Demographic and BC details were obtained.

RESULTS

Over a 7-month period, 120 offspring from 74 BC patients were included. Fifty-nine mothers had nonmetastatic BC (nMBC), and 27 had metastatic BC (MBC) with median time from diagnosis of 27.6 and 36.1 months, respectively. The prevalence of high/very high distress was 31%, with significantly higher scores reported by female offspring (P = .017). Unmet needs were reported by more than 50% of offspring with the majority of needs relating to information about their mother's cancer. Greater unmet needs were seen in female offspring and offspring with none or one sibling for several domains (practical assistance, time-out, dealing with feelings, and support from friends; P < .05). Greater unmet needs were seen in regard to feelings for MBC patients' offspring compared with nMBC but were similar for other unmet needs.

CONCLUSIONS

Our study confirms high levels of psychological distress in offspring of BC patients, with female offspring reporting significantly higher emotional distress and unmet needs. More than 50% of respondents reported unmet needs in areas that can potentially be supported, including greater information provision, improving practical issues, and enabling sufficient recreational time.

Is there an app for that? A cluster randomised controlled trial of a mobile app-based mental health intervention

Demand for the use of mobile apps in mental health interventions has grown in recent years, particularly among adolescents who experience elevated levels of distress. However, there is a scarcity of evidence for the effectiveness of these tools within this population. The aim of this study was to test the effectiveness of CopeSmart, a mental health mobile app, using a multicentre cluster randomised controlled trial design. Participants were 15-18-years-olds (N = 560) recruited from 10 schools randomly assigned to an intervention or control condition. Intervention participants used the app over a 4-week period. Multi-level modelling analyses revealed no significant changes in the intervention group from pre-test to post-test, when compared to the control group, in terms of emotional distress, well-being, emotional self-awareness or coping strategies. Findings suggest that a 4-week app-based intervention may not be enough to elicit intra-personal changes in mental health outcomes in a general adolescent population.

A systematic review of the current interventions available to support children living with parental cancer

OBJECTIVE

Children living with parental cancer are vulnerable to distress and developmental disruption. This review aims to identify current interventions to support cancer patients' children and summarise how effective these are based on children's reports.

METHODS

Between 25 May 2015 and 6 August 2018, a broad search strategy was used to identify relevant references. Seven databases were searched, and grey literature was also vetted. This review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane guidelines.

RESULTS

Eight studies evaluating six interventions were retained. Research designs and interventions were heterogenous, and study quality was low. A limited number of significant results were reported by studies. These evidenced improvement for PTSD symptoms, emotional regulation, and depression. However, overall current interventions do not appear effective among patients' children.

CONCLUSION

Despite encouraging preliminary findings, interventions do not yet adequately support cancer patients' children. There is a need for more tailored and targeted interventions. A theoretical model conceptualising the impact of parental cancer may assist this.

PRACTICE IMPLICATIONS

Findings will assist future intervention research by promoting standardised levels of care among cancer patients' children, that is empirically supported, effective, and meets principles of non-maleficence.

Coping strategies in adolescence and labour-market participation in young adulthood: A prospective birth cohort study

Aims: The aim of this study was to investigate whether coping strategies in adolescence (14-15 years of age) were associated with labour-market participation (LMP) in young adulthood (25-26 years of age) and whether the association differed by sex. Methods: A birth cohort from the former county of Ringkjoebing, Denmark, consisting of 2826 individuals, comprised the study population. In 2004, the study population completed a questionnaire from which information about coping and covariates were gathered. Coping strategies were measured using five sub-scales of the Brief COPE Scale, which were combined into two overall coping strategies: active coping and avoidant coping. Ten years later, the participants were followed for a 52-week period in a register on social benefits. Logistic regression was applied to data, with adjustment for covariates: sex, parents' socio-economic status (education and income) and self-rated health. Results: A total of 2203 (78%) participants were categorised as high LMP at follow-up. No significant associations were found between active coping in adolescence and LMP in 2014/2015. For avoidant coping, in the fully adjusted model, medium-level avoidant coping was associated with higher odds (odds ratio (OR)=1.02 (95% confidence interval (CI) 0.83-1.25) of high LMP. For low avoidant coping, the OR was 1.37 (95% 1.07-1.75). For both coping strategies, sex did not modify the association. Conclusions: Findings showed that avoidant coping was significantly associated with high LMP. Further research is needed to investigate coping in relation to specific problem areas.

Parental hospital-treated somatic illnesses and psychosis of the offspring-The Northern Finland Birth Cohort 1986 study

AIM

The aim of this study was to investigate whether parental somatic illnesses during childhood increase the risk for later psychosis in the offspring. In addition, we examined which parental illnesses in particular are associated with increased risk of psychosis in the offspring.

METHOD

The data of the Northern Finland Birth Cohort 1986 (NFBC 1986), included 9137 children born alive in northern Finland between the July 1, 1985, and the June 30, 1986. Information regarding the parents' somatic morbidity was collected through various healthcare registers up to age 28 of the cohort members.

RESULTS

Psychosis was diagnosed in 169 (1.8%) of the cohort members between the ages of 16 and 28. Accumulation of parental somatic diseases was related to later psychosis in the offspring. In addition, some specific somatic diagnostic groups of parents were emphasized in relation to psychosis in the offspring.

CONCLUSIONS

Our study findings indicated that parental somatic illness should be taken into account in the prevention of serious mental health problems in their offspring.

Parenting with a Life-Limiting Illness

Parents with life-threatening illness face unique challenges in their dual roles as patients and parents. They are at risk for depression, parenting stress, and impaired family functioning, and their children are at risk for adjustment difficulties. In addition to treatment of depression and other mental health issues, patients may also benefit from evidence-informed guidance addressing the challenges of parenting while ill. Consultations should be tailored to each family, with consideration of children's developmental stage and temperament. Clinical recommendations for communication about a parent's anticipated death, helping children spend meaningful time with an ill parent, and legacy leaving are provided.

Frequency and correlates of symptoms of anxiety and depression among young caregivers of cancer patients: a pilot study

Objectives

To determine the frequency of symptoms of anxiety and depression among the young caregivers of family members with cancer and their correlation with role of gender, age and socio-economic status.

Results

A total of 87.8% of caregivers were between 11 and 16 years of age, with 94.6% reported having support from another caregiver. At least 95% of caregivers reported symptoms of anxiety with a higher predisposition among females. Around 73% of caregivers had low monthly incomes followed by (22.9%) middle and (4.1%) high monthly incomes. Care givers belonging to low income groups were more likely to report anxiety and depressive symptoms (70%). Young adults 17–18 years of age reported fewer symptoms of anxiety (10.9%) than their younger counterparts. Reported symptoms of anxiety and depression decreased when the number of care givers increased—2 (67.5%), 3 (16.2%), 4 (5.4%). Increased hospital stay was associated with increased frequency of symptoms, but not beyond 5 weeks.

Electronic supplementary material

The online version of this article (10.1186/s13104-018-3740-8) contains supplementary material, which is available to authorized users.

Levels of unmet needs among adolescents and young adults (AYAs) impacted by parental cancer

PURPOSE

In this study, we aim to assess types and levels of psychosocial needs in adolescents and young adults (AYAs) who have a parent with cancer. And define and describe the variables analyzing the demographic characteristics.

METHODS

This descriptive study with cross-sectional design was conducted on 217 participants from five hospitals in Tehran. By use of the "Offspring Cancer Needs Instrument," in adolescents and young adults who had the inclusion criteria, information about the psychosocial needs were collected. Also, a demographic questionnaire was completed by the participants. Mean and standard deviation calculated for each domain and overall scores. Independent t test and one-way ANOVA was used for the comparison of needs' mean and demographic variables.

RESULTS

Total scores' mean was 126 and among domains, the "information" got the highest and the "support from friends" the lowest mean. Among demographic variables, we found a relationship between parent education (p value = 0.007), treatment statue (p value = 0.015), parent gender (p value = 0.018), and parent-child relationship (p value = 0.027) with the level of psychosocial needs.

CONCLUSIONS

In this target group of adolescents and young adults, the need for "information" is the strongest domain of psychosocial need during parent cancer trajectory.

How does parental cancer affect adolescent and young adult offspring? A systematic review

OBJECTIVES

To i) identify and synthesise evidence published since 2007 regarding the impact of parental cancer on adolescent and young adult offspring, ii) identify methodological and evidence gaps addressed during this period and iii) highlight those requiring further attention.

DESIGN

A systematic review and thematic synthesis of peer reviewed literature regarding the impact of parental cancer upon AYA offspring.

DATA SOURCES

Online searches of CINAHL, Embase, Medline, PsychInfo and Scopus databases were conducted. Reference lists of included articles were screened and additional searches by prominent authors were performed.

REVIEW METHODS

Study selection, data extraction and quality analysis was undertaken by three independent researchers. Extracted study data was iteratively reviewed and discussed to achieve consensus regarding thematic synthesis of included studies.

RESULTS

Database and hand-searching yielded 1730 articles, 54 of which were included in the final synthesis. Included studies are discussed with respect to the following themes: i) study design and quality; ii) measurement and sampling; iii) positive and negative aspects of parental cancer; iv) needs; v) communication and information; vi) coping strategies; vii) interventions; and viii) family functioning and other predictors. Twenty-nine studies reported negative impacts related to parental cancer, while eight identified positive outcomes related to post-traumatic growth. Five returned null or mixed findings. Unmet needs were frequently explored and a new validated measure developed. Communication and information were particularly important for offspring, though these needs were often unmet and parents wanted guidance regarding discussions with their children. Offspring may adopt a variety of coping strategies, some of which appear maladaptive, and may cycle between different approaches. Few evaluations of interventions were identified, and further work in this area is needed. Further evidence has emerged that poorer family functioning and other family and illness-related factors predict worse psychosocial outcomes for offspring, however evidence for other predictors such as age and gender remain mixed.

CONCLUSIONS

Additional evidence for the negative psychosocial impact of parental cancer on adolescent and young adult offspring, their needs, and factors predicting psychosocial outcomes has emerged in the last decade. However, substantial gaps and methodological issues remain and evidence for the development, efficacy or implementation of interventions for this population is very limited. There is also a clear need for greater focus on bereaved and young adult offspring and those from non-western cultural groups, who remain under-represented in research conducted to date.

Coping styles in youth exposed to maltreatment: Longitudinal patterns reported by youth in foster care

Coping styles in youth living in foster care with a history of maltreatment were examined to determine the nature and stability of self-reported coping behavior over time. Participants included 542 (time 1), 377 (time 2), and 299 (time 3) youth ages 8-22 years (M=13.28years, SD=3.04). Using the Behavioral Inventory of Strategic Control, a dimensional, continuous measure of coping, across four possible coping styles endorsed in reference to specific potentially stressful situations, the results indicated that direct action coping was the most frequently endorsed or preferred style for more than 50% of the sample at each time point. A number of youth endorsed using more than one coping style, indicating some flexibility in the approach to coping when problems occur. Although most youth endorsed a preferred style, coping style endorsed did vary somewhat over time. The coping style endorsed also varied depending on the type of problem referenced, but no statistically significant differences were noted across situations, including social, academic, general, and foster-specific situations. Effects for age were also examined and the results indicated no significant differences across the age range for type of coping most commonly endorsed. The present study is the first large-scale, longitudinal assessment of coping styles in youth in foster care and the results suggest that coping is not a simple, categorical-only construct and the implications for the endorsement of the direct approach for youth in foster care along with the other findings are discussed.

Associations of stressful life events with coping strategies of 12-15-year-old Norwegian adolescents

Successful adaptation to the environment requires strategies to cope with stressful situations. The aim of this study was to examine the role of stressful life events in coping strategies during early adolescence. A representative sample of 2464 adolescents in Norway were assessed at two time-points, one year apart (i.e., at T1, mean age 13.7 years, and at T2, mean age 14.9 years), with identical questionnaires. The participation rate was 88.3% at T1. Stressful life events and daily hassles were measured by questionnaires constructed for this study. Coping with stress was measured by a modified version of the Coping Inventory for Stressful Situations (CISS), which measures three coping dimensions: emotional, task and avoidance coping. Depressive symptoms were assessed by the Mood and Feelings Questionnaire (MFQ). Standard multiple linear regression methods were applied. Different domains of stressful life events were associated with the coping strategies, and these relationships differed at various time-points by gender. In sum, school stress and stressful life events in one's network (network stress) was associated with coping strategies more strongly among girls, while family and miscellaneous stress showed a stronger association among boys. These relationships were partly mediated by depressive symptom levels, more strongly in cross-sectional than in longitudinal analyses. However, daily hassles seemed to represent smaller events of no importance in coping strategies. In preventive work, reducing stressful events, treating depression and teaching healthier coping strategies are important.

The Relationship Between Perceived Family Support and Depressive Symptoms in Adolescence: What is the Moderating Role of Coping Strategies and Gender?

This study examined the moderating role of gender and coping strategies in the relationship between perceived family support, self-esteem and depressive symptoms. Data were used from the My World Survey Second Level (MWS-SL), a national survey of mental health among 6062 young people aged 12-19 years. Conditional process analyses indicated that planned coping moderated the relationship between perceived family support and depressive symptoms for those engaging in low-moderate levels but not high levels of planned coping, and this moderating role was stronger for females than males. Avoidance coping was a moderator for those engaging in moderate-high but not low levels of avoidance coping, and gender also moderated this relationship. Support-focused coping only moderated the perceived family support/depressive symptoms relationship for females. Findings suggest that the strength of the relationship between perceived family support and depressive symptoms depends on level of engagement with a particular coping strategy, and this engagement is a consistently stronger moderator for females.

Levels of unmet needs and distress amongst adolescents and young adults (AYAs) impacted by familial cancer

OBJECTIVE

To describe levels of, and relationships between, distress and psychosocial unmet needs in adolescents and young adults (AYAs) with a family member with cancer.

METHODS

Adolescents and young adults (12-24 years old) with a living sibling or parent with cancer participated. Participants completed demographics, the Kessler 10 (K10) distress scale and the Sibling or Offspring Cancer Needs Instruments. Descriptive statistics were obtained for all measures, item-level frequencies were examined to identify common unmet needs, and relationships between distress and unmet needs were explored.

RESULTS

Average sibling (N = 106) and offspring (N = 256) distress levels were in the high range (K10total = 22-30), with 29.6% and 31.6% in the very high range (K10total = 31-50), respectively. Siblings had mean = 19.7 unmet needs (range 0-45), 66% had ≥10 unmet needs, and 44% of the 45 needs were unmet on average. Offspring had mean = 22.4 unmet needs (range 0-47), 77% had ≥10 unmet needs, and 48% of the 47 needs were unmet on average. Strong positive correlations were found between K10 distress and the number of sibling/offspring unmet needs (r = 0.599 and r = 0.522, respectively, P = .00).

CONCLUSIONS

Australian AYA siblings and offspring impacted by familial cancer experience high levels and numbers of unmet needs and substantial distress. Strong associations were found between increased distress and more unmet needs. Distress levels were comparable to AYAs seeking treatment for mental health issues. Insights into the type and number of needs experienced by AYA siblings and offspring will facilitate development and delivery of targeted, age-appropriate interventions, and resources for these vulnerable and underserved young people.

Children as relatives to a sick parent: Healthcare professionals’ approaches

An illness or injury sustained by a family member affects all family members. It is consequently important that a child’s need to be involved in a family member’s care is clearly recognized by healthcare professionals. The aim of this study was to describe healthcare professionals’ approaches to children as relatives of a parent being cared for in a clinical setting. A web-based study-specific questionnaire was sent and responded to by 1052 healthcare professionals in Sweden. Data were analysed using descriptive statistics and qualitative analysis. The results show that guidelines and routines are often lacking regarding involving children in the care of a parent. Compared to other areas, psychiatric units seem to have enacted routines and guidelines to a greater extent than other units. The results indicate that structured approaches based on an awareness of the children’s needs as well as a child-friendly environment are vital in family-focused care. These aspects need to be prioritized by managers in order to support children’s needs and promote health and wellbeing for the whole family.

Health-related quality of life in teenagers with a parent with cancer

PURPOSE

Health-related quality of life (HRQoL) in teenagers exposed to parental cancer has shown divergent results as an outcome measure. In this study we wanted to: 1) compare the HRQoL of teenagers exposed to parental cancer (CASES) with normative European HRQoL data (NORMs) measured close to parental diagnosis and treatment; 2) study changes in the HRQoL of CASES from baseline to follow-up; 3) explore sex differences in the HRQoL of CASES; and 4) explore eventual confounders of HRQoL of CASES at baseline.

METHODS

Forty-five families with one parent diagnosed with primary invasive cancer were included, these families had 69 teenagers. At the follow-up, 26 families with 29 teenagers complied. Both parents and teenagers filled in electronic questionnaires over the Internet. HRQoL in teenagers was self-rated by the KIDSCREEN-27 at baseline and follow-up, and the responses were compared to a European normative sample (NORMs).

RESULTS

1) The teenagers scored significantly lower on the Physical well-being dimension compared to the NORMs at baseline, while no significant differences were observed concerning the four other HRQoL dimensions. 2) Some significant improvements were observed on HRQoL dimensions from baseline to follow-up. 3) CASES girls showed a trend towards lower HRQoL scores compared to boys. 4) Parental cancer-related characteristics and family function were not related to teenagers' HRQoL, but so were teenagers' self-esteem.

CONCLUSIONS

At group level, living with a parent who receives curative treatment for a recently diagnosed cancer affects teenagers' HRQoL to certain extent. Self-esteem is a confounder to teenagers' HRQoL in our sample.

The well-being of children impacted by a parent with cancer: an integrative review

PURPOSE

This paper reviewed the peer-reviewed scientific literature on well-being of children impacted by a parent with cancer.

METHOD

An integrative review of peer-reviewed literature between 2000 and 2015 regarding parental cancer and its impact on families was conducted by searching relevant databases using predefined key search terms. A thematic analysis was undertaken on literature that met inclusion criteria.

RESULTS

Forty-nine studies met the criteria for this review, and five major themes were established: impact of cancer, communication, coping strategies, parenting factors mediating impact, and support services. There was considerable variability in study design, methodological approaches, and findings. In the majority of studies, children were significantly impacted by the parent's cancer diagnosis and exhibited distress. Daughters appeared to experience worsened mental health, and sons experienced a greater totality of internalizing and externalizing problems. Children of all ages were impacted by their parent's cancer diagnosis and initiated a number of coping strategies in response. Despite this, a significant number of studies revealed that parents underestimated the impact that their cancer had on their children. Family functioning, as well as the ill parents' gender, coping strategies, cancer severity, and mental and physical health mediated their children's well-being. Parent-child communication was a key element in supporting children.

CONCLUSION

Parental cancer may impact children's long-term well-being. Further investigations are needed in this area. Additionally, review of support programs and interventions are warranted in terms of their uptake and impact on families affected by a parent's cancer.

[Coping and depression in underage children of cancer patients: Data on the course]

BACKGROUND

There is increasing consideration of a family-focused perspective of the psychosocial consequences of cancer.

OBJECTIVES

This study examined the psychosocial situation of children and adolescents (11 to 17 years old) of cancer patients assessing their psychological distress and coping over time.

METHODS

A total of 110 children and adolescents were assessed post-treatment of parents with cancer (t1), 6 (t2) and 12 months (t3) after t1. Participants completed validated questionnaires assessing coping (KidCope) and depressive symptoms (CES). These data were compared with a matched sample from the general population.

RESULTS

The children reported using a combination of coping measures. In particular, active coping was perceived as being helpful. In terms of coping, there were only small gender differences and 6 months after completion of treatment of the parents (t2), depressive symptoms of the children were still elevated. Depression diminished over time and was near the level of the comparison group at t3.

CONCLUSION

Children and adolescents are particularly psychologically distressed after cancer treatment of parents. This distress was connected with not helpful coping strategies. The extended adjustment of children/adolescents of cancer patients has to be considered in the clinical and psychosocial care of the families.

A comparison of the emotional and behavioral problems of children of patients with cancer or a mental disorder and their association with parental quality of life

OBJECTIVE

To compare the emotional and behavioral problems of children of patients suffering from cancer or a mental disorder and their association with parental quality of life.

METHODS

A total of 223 children from 136 families and their 160 parents were investigated from multiple perspectives in a cross-sectional study. The consistency of different adjustment reports between family members was examined. Through mixed models, the differences between parental HRQoL and the children's symptomatology were studied with regard to the type of parental illness. The prediction of children's adjustment through parental HRQoL was further examined. Additionally, gender and age of the children were considered.

RESULTS

Half of the children exhibited psychosocial problems. Gender and age differences were independent of the type of parental disease. In families with parental cancer, the reports of children's adjustment were more consistent between family members than in families where a parental mental disorder was present. We found differences in HRQoL between families with mentally ill parents and those with parental cancer patients. Specifically, the healthy partners of mentally ill parents showed worse HRQoL compared with healthy partners of cancer patients. Healthy parents' reduced HRQoL was associated with worse adjustment in their children, regardless of the type of parental illness, but this result was not found for ill parents.

CONCLUSION

Family members confronted with parental cancer or mental disorders are more burdened compared with those from the "normal" population, independently of the type of disease. Our results indicate that the type of a parental disease has no direct effect on children's adjustment. However, there are disease-specific effects on parental HRQoL, which are associated with children's adjustment.

Padres diagnosticados de cáncer: malestar emocional y recursos para comunicarse con sus hijos meno

Objetivo: Conocer los recursos que poseen los padres afectados por cáncer al comunicar la enfermedad a sus hijos menores y su relación con el malestar emocional de estos pacientes. Método: Se evaluó el estilo de comunicación familiar mediante una subescala del FAD (Mc Master Family Assessment Device). Se elaboró un cuestionario específico para evaluar los recursos de los pacientes, donde cada ítem era valorado con una escala de 0 a 10 (siendo 0 nada en absoluto y 10, la máxima puntuación posible). También se utilizó una escala numérica de valoración del malestar emocional, en forma de un solo ítem (0-10). El conjunto de pruebas se aplicó a 60 pacientes de edades comprendidas entre los 34 y los 60 años todos ellos padres afectados de cáncer con hijos menores a su cargo. Resultados: Los recursos que parecen poseer en mayor medida los padres evaluados son los recursos relacionados con la gestión de la vida doméstica (media = 8,3), seguidos de los que hacen referencia a delegar a terceras personas los cuidados de sus hijos durante momentos difíciles. Al analizar con más profundidad estos dos recursos, detectamos que más del 80% de los padres de la muestra poseen el recurso relacionado con la gestión de la vida doméstica. Por el contrario, el recurso de como informar sobre la situación de enfermedad a los niños, lo tiene poco más de la mitad de los pacientes evaluados (55%). Los datos indican que existe una relación inversa entre la disponibilidad de este recurso y el nivel de malestar emocional, ya que los pacientes que consideran tener recursos para hablar de la enfermedad a sus hijos, presentan un menor malestar emocional. Conclusiones: Los padres recién diagnosticados de cáncer que plantean comunicar la situación de enfermedad a sus hijos menores, poseen más recursos para gestionar la vida doméstica y delegar el cuidado de sus hijos cuando lo precisan a terceras personas, que para informar sobre la enfermedad y sostener emocionalmente a sus hijos. Así mismo, el no disponer de recursos para comunicar el diagnóstico a los hijos se asocia con una mayor presencia de malestar emocional.