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Levesque A, Ogez D, Gravel V, Marcil V, Curnier D, Rondeau É, Sinnett D, Péloquin K, Sultan S. Feasibility Study of Taking Back Control Together, an Intervention to Support Parents of Children with Cancer. J Clin Psychol Med Settings 2024; 31:444-454. [PMID: 38127090 DOI: 10.1007/s10880-023-09998-6] [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] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Parents of children with cancer can experience increased emotional distress. This study aimed to assess the feasibility (i.e., reach, treatment fidelity, and social validity) of Taking Back Control Together (TBCT). METHODS We assessed reach with the enrollment and dropout ratios. We assessed treatment fidelity using items from existing programs, controlling for the reliability of the items. For social validity, we used an adapted version of the Treatment Evaluation Inventory and compared means with theoretical cut-points. RESULTS 42 participants enrolled in the intervention. The enrollment and dropout ratios were 39% and 38%, respectively. Treatment fidelity was 77.3-84.3% (95%CI 75.3-86%). Acceptability (M = 90%), satisfaction (M = 87%), and relevance (M = 82%) were significantly positive. CONCLUSION This study suggests that certain elements of TBCT need to be reassessed before the intervention is pilot tested. Although reach was likely impacted by the COVID-19 pandemic, it could be improved with some modifications to the intervention.
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Affiliation(s)
- Ariane Levesque
- Department of Psychology, Université de Montreal, Montreal, Canada
- Research Center, Sainte-Justine University Health Center, Montreal, Canada
| | - David Ogez
- Department of Psychology, Université de Montreal, Montreal, Canada
- Department of Anesthesiology, Université de Montreal, Montreal, Canada
| | - Vivianne Gravel
- Department of Psychology, Université de Montreal, Montreal, Canada
| | - Valérie Marcil
- Research Center, Sainte-Justine University Health Center, Montreal, Canada
- Department of Nutrition, Université de Montreal, Montreal, Canada
| | - Daniel Curnier
- Research Center, Sainte-Justine University Health Center, Montreal, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montreal, Montreal, Canada
| | - Émélie Rondeau
- Research Center, Sainte-Justine University Health Center, Montreal, Canada
| | - Daniel Sinnett
- Research Center, Sainte-Justine University Health Center, Montreal, Canada
- Department of Pediatrics, Université de Montreal, Montreal, Canada
| | | | - Serge Sultan
- Department of Psychology, Université de Montreal, Montreal, Canada.
- Research Center, Sainte-Justine University Health Center, Montreal, Canada.
- Department of Pediatrics, Université de Montreal, Montreal, Canada.
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Robichaud LA, Felipe J, Duval M, Michon B, Olivier-D’Avignon M, Perreault S, Tyo-Gomez M, Marquis MA, Sultan S. Quality-of-Life Assessment in Pediatric Advanced Cancer: Development of the Patient-Reported Outcome Measure Advance QoL. Curr Oncol 2024; 31:2289-2304. [PMID: 38668073 PMCID: PMC11049209 DOI: 10.3390/curroncol31040170] [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: 03/22/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
A recent measure was developed to assess the Quality of Life (QoL) of young people with advanced cancer and is available for parents and professionals (Advance QoL). The present study aimed to elaborate self-reported versions for children and adolescents with advanced cancer. We adopted a four-phase research plan: (1) to elaborate the Advance QoL questionnaire for youth (8-12 and 13-18 years old) with a team of young research partners; (2) to evaluate the understandability of these versions in a sample of 12 young patients from the target population using cognitive interviews; (3) to assess social validity in the same group using a questionnaire and the content validity index (CVI); and (4) to refine the questionnaires according to these results. Four major themes were identified: (1) issues affecting the understanding of the tool; (2) issues that did not affect the understanding of the tool; (3) modifications to improve the tool; and (4) positive features of the tool. Advance QoL was well received, and feedback was positive. Adjustments were made according to young people's comments and two self-reported versions are now available. It is essential to measure the key domains of QoL in advanced cancer. Advance QoL self-report versions will help target the specific needs of young people with this condition and their families.
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Affiliation(s)
- Lye-Ann Robichaud
- Department of Psychology, Université de Montréal, Montréal, QC H3C 3J7, Canada; (L.-A.R.); (J.F.)
- Azrieli Research Centre, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada;
| | - Julie Felipe
- Department of Psychology, Université de Montréal, Montréal, QC H3C 3J7, Canada; (L.-A.R.); (J.F.)
| | - Michel Duval
- Department of Pediatrics, Université de Montréal, Montréal, QC H3C 3J7, Canada; (M.D.); (M.-A.M.)
- Department of Hematology-Oncology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
| | - Bruno Michon
- Centre Mère-Enfant Soleil, CHU de Québec-Université Laval, Québec, QC G1V 4G2, Canada;
| | | | - Sébastien Perreault
- Azrieli Research Centre, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada;
- Department of Neurology, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
| | - Mathias Tyo-Gomez
- Psycho-Oncology Center (CPO), CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada;
| | - Marc-Antoine Marquis
- Department of Pediatrics, Université de Montréal, Montréal, QC H3C 3J7, Canada; (M.D.); (M.-A.M.)
- Department of General Pediatrics, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montréal, Montréal, QC H3C 3J7, Canada; (L.-A.R.); (J.F.)
- Azrieli Research Centre, CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada;
- Department of Pediatrics, Université de Montréal, Montréal, QC H3C 3J7, Canada; (M.D.); (M.-A.M.)
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Maleki M, Dehghan Nayeri N, Hamidieh AA, Pouraboli B. Parents' experiences of living with a child with cancer undergoing hematopoietic stem cell transplantation: a qualitative content analysis study. Front Psychol 2024; 15:1359978. [PMID: 38533218 PMCID: PMC10963479 DOI: 10.3389/fpsyg.2024.1359978] [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: 01/04/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
Objectives Pediatric Hematopoietic Stem Cell Transplant (HSCT) profoundly impacts the physical, psychological, and social aspects of parents' lives. Thus, this study aimed to explore the experiences of parents living with a child with cancer who undergoes HSCT. Methods This qualitative study involved 20 parents of children with cancer who were undergoing HSCT at a referral hospital in Iran. Purposive sampling was used to select the participants from February 2023 to November 2023. In-depth semi-structured interviews, featuring open-ended questions, were utilized for data collection. Data analysis was performed using conventional content analysis. Results Data analysis revealed two main themes. "Surrounded by hardships" and "Self-actualization." The first theme encompassed participants' experiences of facing difficulties in life after being aware of their child's need for HSCT. This theme consisted of four categories: "uncertainty about the child's future," "exhaustion from the child's treatment process," "worrying about the healthy child(ren)," and "helplessness." The second theme "self-actualization" included with two categories: "transformation in life's philosophy" and "acquisition of new capabilities." These categories highlighted the positive outcomes experienced by the participants following their child's HSCT. Conclusion Our findings underscore the importance of healthcare providers being attuned to parents' experiences throughout their child's HSCT trajectory. It is crucial for healthcare providers to encourage parents to articulate their concerns and feelings and seek support from healthcare providers, family, and friends. The development of psychological support services in healthcare settings can facilitate tailored interventions to alleviate parents' difficulties.
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Affiliation(s)
- Maryam Maleki
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ali Hamidieh
- Pediatric Cell and Gene Therapy Research Centre, Gene, Cell & Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Batool Pouraboli
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Casini F, Scaltrito F, Grimaldi MT, Pop TL, Calcaterra V, Zuccotti GV, Pettoello-Mantovani M, Ferrara P, Corsello G, Fabiano V. Use of complementary and alternative medicine in children affected by oncologic, neurologic and liver diseases: a narrative review. Ital J Pediatr 2023; 49:152. [PMID: 37968663 PMCID: PMC10647067 DOI: 10.1186/s13052-023-01554-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/20/2023] [Indexed: 11/17/2023] Open
Abstract
Complementary and alternative medicine (CAM) consist of a broad group of restorative resources often linked to existing local cultures and established health care systems and are also increasingly used in children with some serious illnesses. In this narrative review, we examine the epidemiology of the use, efficacy, and safety of complementary and alternative medicine in pediatric oncology, neurology, and hepatology. We searched for relevant articles published in Pubmed evaluating CAM use and its efficacy in safety in children affected by oncologic, neurologic and liver diseases. CAM is used to improve the success of conventional therapies, but also to alleviate the pain, discomfort, and suffering resulting from the diseases and their treatment, which are often associated with a significant burden of adverse effects. CAM use must be evaluated in children with neurological, oncological and liver diseases.
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Affiliation(s)
- Francesca Casini
- Pediatric Department, University of Milan, "V. Buzzi" Children's Hospital, 20154, Milan, Italy
| | - Francesca Scaltrito
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Tudor Lucian Pop
- 2Nd Pediatric Discipline, Department of Mother and Child, Center of Expertise in Pediatric Liver Rare Diseases, Iuliu Hatieganu University of Medicine and Pharmacy2Nd Pediatric ClinicEmergency Clinical Hospital for Children Cluj-Napoca, Cluj-Napoca, Romania
- European Pediatric Association-Union of National European Pediatric Societies and Associations, Berlin, Germany
| | - Valeria Calcaterra
- Pediatric Department, University of Milan, "V. Buzzi" Children's Hospital, 20154, Milan, Italy
- Department of Internal Medicine, University of Pavia, 27100, Pavia, Italy
| | - Gian Vincenzo Zuccotti
- Pediatric Department, University of Milan, "V. Buzzi" Children's Hospital, 20154, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Massimo Pettoello-Mantovani
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- European Pediatric Association-Union of National European Pediatric Societies and Associations, Berlin, Germany
| | - Pietro Ferrara
- Department of Medicine and Surgery, University Campus Bio-Medico, Rome, Italy
- Operative Research Unit of Pediatrics, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | - Valentina Fabiano
- Pediatric Department, University of Milan, "V. Buzzi" Children's Hospital, 20154, Milan, Italy.
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy.
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Laporte PF, Ranger M, MacPhee M. Support interventions offered to family members of a child treated with hematopoietic stem cell transplant: A scoping review. Can Oncol Nurs J 2023; 33:417-425. [PMID: 38919589 PMCID: PMC11195819 DOI: 10.5737/236880763334417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
A scoping review was conducted to explore support interventions for family members of a child treated with hematopoietic stem cell transplant (HSCT). Three databases (CINAHL, Embase, and Medline) were searched to answer the review question: What are the support interventions offered to family members of a child treated with HSCT and are they based on a family-centred care approach? Out of 665 screened articles, nine were selected for full review. Findings revealed two main types of family-centred support interventions: psychological face-to-face and technology-based interventions. The majority of interventions assisted in improving family members' psychological well-being and included a portion of the core concepts from the Institute for Patient and Family-Centered Care Model in their approach. Based on the review findings, interventions that incorporate family-centred care concepts can enhance the psychological well-being and quality of life of family members whose child is undergoing HSCT treatment.
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Affiliation(s)
- Pauline F Laporte
- Registered Nurse at BC Children's Hospital, 903-1768 West 8th Avenue, Vancouver, BC Telephone: 236 886 7629,
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Laporte PF, Ranger M, MacPhee M. Revue exploratoire des interventions de soutien offertes aux membres de la famille d’un enfant subissant une greffe de cellules souches hématopoïétiques. Can Oncol Nurs J 2023; 33:426-435. [PMID: 38919595 PMCID: PMC11195817 DOI: 10.5737/23688076334426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
Nous avons effectué cette revue exploratoire pour connaître les interventions de soutien offertes actuellement aux membres de la famille d’un enfant subissant une greffe de cellules souches hématopoïétiques (GCSH). Nous avons consulté trois bases de données (CINAHL, Embase et Medline) pour répondre à la question suivante : Quelles sont les interventions de soutien offertes aux membres de la famille d’un enfant subissant une greffe de cellules souches hématopoïétiques, et sont-elles fondées sur une approche de soins axés sur la famille? Parmi les 665 articles présélectionnés, nous en avons retenu neuf à lire au complet. Nos résultats montrent qu’il existe deux principaux types d’interventions de soutien axées sur la famille : les interventions psychologiques en personne et les interventions pratiquées à l’aide de la technologie. La plupart de ces interventions ont contribué à améliorer le bien-être psychologique des membres de la famille et s’appuyaient sur certains principes du modèle de soins de l’Institute for Patient- and Family-Centered Care. La présente revue exploratoire nous permet d’affirmer que les interventions qui s’appuient sur les principes des soins axés sur la famille peuvent améliorer le bien-être psychologique et la qualité de vie des membres de la famille d’un enfant subissant une GCSH.
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Affiliation(s)
- Pauline F Laporte
- Infirmière autorisée au BC Children's Hospital, 903-1768 West 8th Avenue, Vancouver (C.-B.) V6J 5L2 , Tél. : 236-886-7629, Courriel :
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Park M, Kim S, Lee H, Shin YJ, Lyu CJ, Choi EK. Development and effects of an internet-based family resilience-promoting program for parents of children with cancer: A randomized controlled trial. Eur J Oncol Nurs 2023; 64:102332. [PMID: 37146351 DOI: 10.1016/j.ejon.2023.102332] [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: 11/16/2022] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE The diagnosis of cancer in children can negatively impact their parents, owing to the complex treatment processes. Families with high levels of resilience can overcome these difficulties and thus perform higher family functions. We aimed to develop an internet-based family resilience-promoting program for parents of children with cancer and evaluate its effect on the levels of family resilience, depression, and family function. METHODS This prospective, parallel-group, randomized-controlled study that was conducted at Yonsei Cancer Center from June to October 2021 included 41 parents of children with cancer. In total, four sessions of the internet-based family resilience-promoting program, led by a nurse, were conducted individually for parents. Levels of family resilience, depression, and family function were measured before, immediately after, and 4 weeks after the program. The data were analyzed using the linear mixed-effect model, and program satisfaction was evaluated through an internet-based questionnaire and interview. RESULTS The experimental group (the family resilience-promoting program participants) differed more significantly from the control group in the level of change in family resilience (β = 13.214, p = 0.003, effect size = 0.374) and family function (β = 1.256, p = 0.018, effect size = 0.394). However, there was no significant difference between the groups in the level of depression (β = 2.133, p = 0.187, effect size = 0.416). All the program participants showed a high program satisfaction score of 4.75 out of 5.00 points overall. CONCLUSIONS The applicability of the internet-based family resilience-promoting program as an appropriate nursing intervention was verified. Its application can help the families of children with cancer adapt to the stressful situation of their children's cancer diagnosis and treatment.
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Affiliation(s)
- Mina Park
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Sunah Kim
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Hyejung Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Yoon Jung Shin
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - Chuhl Joo Lyu
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Kyoung Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
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Applebaum AJ, Sannes T, Mitchell HR, McAndrew NS, Wiener L, Knight JM, Nelson AJ, Gray TF, Fank PM, Lahijani SC, Pozo-Kaderman C, Rueda-Lara M, Miran DM, Landau H, Amonoo HL. Fit for Duty: Lessons Learned from Outpatient and Homebound Hematopoietic Cell Transplantation to Prepare Family Caregivers for Home-Based Care. Transplant Cell Ther 2023; 29:143-150. [PMID: 36572386 PMCID: PMC9780643 DOI: 10.1016/j.jtct.2022.12.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
In the past decade, the demand for home-based care has been amplified by the Coronavirus disease 2019 pandemic. Home-based care has significant benefits for patients, their families, and healthcare systems, but it relies on the often-invisible workforce of family and friend caregivers who shoulder essential health care responsibilities, frequently with inadequate training and support. Hematopoietic cell transplantation (HCT), a potentially curative but intensive treatment for many patients with blood disorders, is being increasingly offered in home-based care settings and necessitates the involvement of family caregivers for significant patient care responsibilities. However, guidelines for supporting and preparing HCT caregivers to effectively care for their loved ones at home have not yet been established. Here, informed by the literature and our collective experience as clinicians and researchers who care for diverse patients with hematologic malignancies undergoing HCT, we provide considerations and recommendations to better support and prepare family caregivers in home-based HCT and, by extension, family caregivers supporting patients with other serious illnesses at home. We suggest tangible ways to screen family caregivers for distress and care delivery challenges, educate and train them to prepare for their caregiving role, and create an infrastructure of support for family caregivers within this emerging care delivery model.
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Affiliation(s)
- A J Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - T Sannes
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - H R Mitchell
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
| | - N S McAndrew
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Froedtert & the Medical College of Wisconsin, Froedtert Hospital, Patient Care Research, Milwaukee, Wisconsin
| | - L Wiener
- Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, MD
| | - J M Knight
- Departments of Psychiatry, Medicine, and Microbiology & Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - A J Nelson
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts
| | - T F Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - P M Fank
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - S C Lahijani
- Department of Psychiatry & Behavioral Sciences, Division of Medical Psychiatry, Stanford University School of Medicine, Palo Alto, California
| | - C Pozo-Kaderman
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - M Rueda-Lara
- University of Miami/Leonard Miller School of Medicine, Department of Psychiatry and Behavioral Sciences, Sylvester Comprehensive Cancer Center, Miami, Florida
| | - D M Miran
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - H Landau
- Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - H L Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Papasarantopoulou A, Polikandrioti M, Dousis E, Evagelou E, Zartaloudi A, Dafogianni C, Misouridou E, Pavlatou N, Mintzaridis K, Koutelekos I. Anxiety and Depression in Parents of Children Undergoing Hematopoietic Stem Cell Transplant (HSCT). ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:31-46. [PMID: 37581779 DOI: 10.1007/978-3-031-31986-0_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Hematopoietic stem cell transplantation (HSCT) is a well-established therapy tool for several malignant and non-malignant diseases. Parents of children undergoing HSCT experience physiological distress for various reasons such as intensive caregiving, potential complications, and medically intensive process. The purpose of this study was to explore anxiety/depression in parents of children who underwent HSCT and the associated self-reported characteristics. METHOD AND MATERIAL In the present study were enrolled 100 parents of children who underwent HSCT. Data were collected by the completion of the "Hospital Anxiety and Depression Scale (HADs)," which also included parents' characteristics. The statistical significance level was p < 0.05. RESULTS Of the 100 participants, 81% and 64% of parents experienced anxiety and depression, respectively, based on HADs scores. A statistically significant association was observed between parental anxiety and gender (p = 0.017), frequency of visiting the hospitalized child (p = 0.023), whether they desired family members to remain in hospital (p = 0.033), as well as with the need for participation in daily care (p = 0.023), for help based on personal needs (p = 0.026), for scheduled meetings with parents having same problems (p = 0.006), for contact with hospital after discharge (p = 0.035), and for written information (p = 0.044). In terms of depression, a statistically significant association was observed with difficulties during the hospital stay (p = 0.034), whether they desired other family members to remain in hospital (p = 0.009), as well as with the need for opportunities or time for questions (p = 0.004), for scheduled meetings with parents having the same problems (p = 0.026), and for contact with hospital after discharge (p = 0.038). CONCLUSION Anxiety and depression were associated with possibility of family members to remain in the hospital as well as with the need for scheduled meetings with parents having the same problems and for contact after hospital discharge. Based on the findings presented, it is suggested that understanding parents' needs and perceptions is fundamental to the development of appropriate interventions that address their worries.
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Affiliation(s)
| | | | - Evangelos Dousis
- Department of Nursing, University of West Attica, Athens, Greece
| | - Eleni Evagelou
- Department of Nursing, University of West Attica, Athens, Greece
| | | | | | | | - Niki Pavlatou
- Department of Nursing, University of West Attica, Athens, Greece
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Engin E, Cam MO, Demirkol H, Dogan O. The Effect of Psychoeducation on Care Burden Applied to Mothers of Children Who Underwent Allogeneic Bone Marrow Transplantation in Turkey: A Quasi-Experimental Study. Semin Oncol Nurs 2022; 38:151342. [PMID: 36244886 DOI: 10.1016/j.soncn.2022.151342] [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: 05/09/2022] [Revised: 08/26/2022] [Accepted: 09/09/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The purpose of this study was to examine at the effect of psychoeducation on the care burden for mothers whose children underwent allogeneic bone marrow transplantation (Allo-BMT). DATA SOURCES The single group, quasi-experimental study was conducted in a children's BMT unit in the Aegean Region of Turkey. No sampling method was used, and the study sample consisted of 21 mothers who fulfilled the inclusion criteria of turning 18 years old, volunteering for study participation, speaking and understanding Turkish, and having a child who had undergone Allo-BMT. The psychoeducation covered the following topics: (i) Allo-BMT and Child Care After Transplantation, (ii) Feelings Concerning the Disease and the Role of Caregiver, (iii) Stress and Anger Management, and (iv) Family-Spousal and Social Relations. The care burden was measured using the Clinically Adapted Zarit Burden Interview (CA-ZBI). Data analysis was performed on SPSS 20.0 software using repeated measures of analysis of variance (ANOVA) and Bonferroni adjusted post hoc test. After the psychoeducation, a significant difference was found between pretest (26.85 ± 12.9) and posttest (20.42 ± 12.66) care burden of mean scores (P < .05). In addition, a significant difference was found between pretest and follow-up test (20.52 ± 11.49) mean scores of care burden (P < .05). CONCLUSION The psychoeducation reduced the care burden experienced by the mothers of the children who underwent Allo-BMT and this positive impact lasted for a month. IMPLICATIONS FOR NURSING PRACTICE Nurses, especially consultation liaison psychiatric nurses, can provide similar psychoeducation to caregivers in BMT units, assisting them in protecting their physical and mental health by reducing their care burden.
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Affiliation(s)
- Esra Engin
- Professor, Nursing Faculty, Psychiatric and Mental Health Nursing Department, Ege University, Izmir, Turkey
| | - Mahire Olcay Cam
- Professor, Nursing Faculty, Psychiatric and Mental Health Nursing Department, Ege University, Izmir, Turkey
| | - Hacer Demirkol
- Faculty of Health Sciences, Psychiatric and Mental Health Nursing Department, Bozok University, Yozgat, Turkey.
| | - Ozenir Dogan
- Faculty of Medicine Hospital, Psychiatry Department, Ege University, Izmir, Turkey
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Aguilera V, Schaefer MR, Parris K, Long A, Triplett B, Phipps S. Psychosocial outcomes of parents in pediatric haploidentical transplant: parental hematopoietic cell donation as a double-edged sword. Bone Marrow Transplant 2022; 57:377-383. [PMID: 35001081 DOI: 10.1038/s41409-021-01547-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/16/2021] [Accepted: 11/30/2021] [Indexed: 12/26/2022]
Abstract
Parents are increasingly used as donors for their child's haploidentical hematopoietic cell transplant, creating a dual role for parents that may increase the stress of caring for their ill child. Empiric research on the psychological adjustment of parental donors is lacking. We conducted a retrospective survey of parents (n = 136) whose child underwent transplant with a parental donor or a matched-unrelated donor, including both donor and nondonors, and both parents of survivors and bereaved. All parents completed standardized measures of quality of life, depression, anxiety, post-traumatic stress, and life satisfaction. Bereaved parents also completed measures of their grief response, while parents of survivors completed measures of the parent-child relationship. The overall sample reported psychological functioning near normative levels, but bereaved parents demonstrated significantly poorer outcomes across all measures. The effect of donor status differed by transplant outcome: for parents of survivors, donors reported better mental health than nondonors, but amongst bereaved parents, donors fared more poorly than nondonors. Bereaved donors reported greater difficulties with grief than nondonors. Results suggest that serving as donor can be a double-edged sword, acting as a protective factor when there is a successful outcome but a significant risk factor when the child does not survive.
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Affiliation(s)
- Vanessa Aguilera
- Department of Psychology, St. Jude Children's Research Hospital Memphis, Memphis, TN, USA
| | - Megan R Schaefer
- Department of Psychology, St. Jude Children's Research Hospital Memphis, Memphis, TN, USA
| | - Kendra Parris
- Department of Psychology, St. Jude Children's Research Hospital Memphis, Memphis, TN, USA
| | - Alanna Long
- Department of Psychology, St. Jude Children's Research Hospital Memphis, Memphis, TN, USA
| | - Brandon Triplett
- Department of Bone Marrow Transplantation & Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital Memphis, Memphis, TN, USA.
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Eche IJ, Yusufov M, Isibor DA, Wolfe J. A systematic review and meta-analytic evaluation of psychosocial interventions in parents of children with cancer with an exploratory focus on minority outcomes. Pediatr Blood Cancer 2021; 68:e29328. [PMID: 34523798 DOI: 10.1002/pbc.29328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/28/2021] [Accepted: 08/13/2021] [Indexed: 11/11/2022]
Abstract
Parents of children with cancer are prone to psychosocial distress, yet little is known about intervention response among diverse parents. Our systematic review and meta-analysis evaluated the efficacy of psychosocial interventions on anxiety and depression among parents of children with cancer and explored race and/or ethnicity differences in the efficacy of these interventions. Twenty articles met inclusion. The aggregate effect size on anxiety (-0.01, 95% CI: -0.95, 0.93, p = .97) and depression (-0.56, 95% CI: -1.65, 0.54, p = .32) showed micro to medium effects, with larger negative effect sizes indicating that anxiety and depression scores after treatment were lower for parents in intervention group as compared to control group. Neither aggregate effect size was statistically significantly different from zero. Due to underrepresentation of minorities, we could not perform subgroup or moderator analyses. Several efficacious psychosocial interventions were found to reduce parental anxiety. Future studies to examine psychosocial interventions in minority parents are warranted.
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Affiliation(s)
- Ijeoma Julie Eche
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Miryam Yusufov
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
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13
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Health-Related and Economic Burden Among Family Caregivers of Patients with Acute Myeloid Leukemia or Hematological Malignancies. Adv Ther 2021; 38:5002-5024. [PMID: 34499319 PMCID: PMC8478752 DOI: 10.1007/s12325-021-01872-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023]
Abstract
Introduction Acute myeloid leukemia (AML) is associated with lower survival and greater unmet need compared with some other hematologic malignancies (HMs). Despite differences in acuteness between AML and other HMs, the burden of family caregivers (FCs) of patients with these malignancies offer similar patient experiences. A targeted literature review was conducted to explore FC burden of patients with AML and HM with and without hematopoietic stem cell transplant (HSCT). Instruments to measure and interventions to address FC burden were identified. Methods Studies on economic burden and compromised health-related quality of life (HRQoL) associated with FC burden, family affairs, and childcare from 1 January 2010 to 30 June 2019 were identified through database and hand searches. Published English articles on randomized controlled trials or standardized qualitative or quantitative observational studies were included. FCs were those in close familial proximity to the patient (i.e., spouse, parents, children, relatives, other family members, significant others). Results Seventy-one publications were identified (AML, n = 3; HM, n = 29; HSCT, n = 39). Predominant burden categories included humanistic (n = 33), economic (n = 17), and interventions (n = 22); one study was classified as humanistic and economic. FCs lack sufficient resources to manage stressors and experience negative psychological, behavioral, and physiological effects. FCs of patients with HMs reported post-traumatic stress disorder, significant sleep problems, moderate-to-poor HRQoL, and negative impacts on family relationships. Instruments designed to measure caregiver burden were generic and symptom-specific. Educational, expressional, and self-adjustment interventions were used to improve FC burden. Conclusion Findings indicate a need for additional research, public health approaches to support FCs, and effective interventions to address FC burden. Minimizing FC burden and improving quality of life may reduce the overall healthcare service use and allow FCs to more effectively fulfill caregiver tasks. Support systems to alleviate caregiver burden may create reinforced integrators, thus positively affecting quality of life and possibly the outcomes of patients. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01872-x.
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Beckmann NB, Dietrich MS, Hooke MC, Gilmer MJ, Akard TF. Parental Posttraumatic Growth After Pediatric Hematopoietic Stem Cell Transplant. J Hosp Palliat Nurs 2021; 23:331-338. [PMID: 34185727 DOI: 10.1097/njh.0000000000000759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Little is known about the development of posttraumatic growth among parents of children with serious advanced disease. The purpose of this study is to describe parental posttraumatic growth 100 days after pediatric stem cell transplant. This is a cross-sectional, descriptive study of 24 parents, approximately 100 days after their children received stem cell transplant. Participants reported environmental, personal, and disease characteristics and completed measures of distress, coping, rumination, and posttraumatic growth. Evidence of parental posttraumatic growth was described in each of 5 dimensions (relating to others, new possibilities, personal strength, spiritual change, and appreciation of life). Posttraumatic growth was positively associated with parental distress, disengagement coping, and rumination measures (r = 0.44-0.47, P < .05). Appreciation of life demonstrated the strongest associations with distress and rumination (r = 0.53-0.61, P < .01). Curvilinear relationships were observed for the association of distress, disengagement coping, and involuntary engagement with posttraumatic growth (P < .05). Study results highlight opportunities for palliative care nurses and clinicians to facilitate opportunities to support parent posttraumatic growth during treatment for children's advanced disease.
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Perceived Benefits and Facilitators and Barriers to Providing Psychosocial Interventions for Informal Caregivers of People with Rare Diseases: A Scoping Review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 13:471-519. [PMID: 32785886 DOI: 10.1007/s40271-020-00441-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Little is known about the benefits, and barriers and facilitators to providing psychosocial support to caregivers to a loved one with a rare disease. OBJECTIVE The aim of our scoping review was to map evidence on (1) perceived benefits and (2) barriers and facilitators of establishing and maintaining services. METHODS The CINAHL and PubMed databases were searched in December 2018. Qualitative and quantitative studies in any language that described perceived or tested benefits of participating in psychosocial interventions for caregivers, or the barriers and facilitators of providing these interventions, were eligible. RESULTS Thirty-four studies were included. Interventions were behavioural or psychological, supportive, educational, or multicomponent. All included studies reported on the benefits of participating in psychosocial interventions; 14 (41%) studies also reported on facilitators and 19 (56%) reported on barriers. Benefits that were most commonly found included statistically significant improvements in emotional states (e.g. stress) and caregiver burden and narrative reports of intervention helpfulness. Statistically significant improvements in mental health outcomes (e.g. depression symptoms) were rarely detected. Four themes for facilitators were identified, including intervention characteristics, intervention delivery characteristics, provision of necessary resources, and support provided outside of the intervention. Four barrier themes were also identified: misalignment of intervention to caregiver needs, inability to make time for intervention, practical barriers, emotional barriers. CONCLUSIONS Psychosocial interventions for caregivers to a loved one with a rare disease may be helpful in reducing stress, burden, and feelings of isolation among caregivers. Future research should design interventions for caregivers that take into account facilitators and barriers to establishing and maintaining such interventions.
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Ogez D, Péloquin K, Bertout L, Bourque CJ, Curnier D, Drouin S, Laverdière C, Marcil V, Aramideh J, Ribeiro R, Rondeau É, Sinnett D, Sultan S. “Taking back control together”: Definition of a new intervention designed to support parents confronted with childhood cancer. COGENT MEDICINE 2021. [DOI: 10.1080/2331205x.2021.1944476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- David Ogez
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Psychology, Université De Montréal, Québec, Canada
- Department of Anesthesiology and Pain Medicine, Université De Montréal, Québec
| | | | - Laurence Bertout
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Claude-Julie Bourque
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université De Montréal, Québec, Canada
| | - Daniel Curnier
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Kinesiology, Université De Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université De Montréal, Québec, Canada
| | - Valérie Marcil
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Nutrition, Université De Montréal, Québec, Canada
| | | | - Rebeca Ribeiro
- Department of Psychology, Université De Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université De Montréal, Québec, Canada
| | - Serge Sultan
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Psychology, Université De Montréal, Québec, Canada
- Department of Pediatrics, Université De Montréal, Québec, Canada
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Evans AM, Thabrew H, Arroll B, Cole N, Drake R. Audit of Psychosocial and Palliative Care Support for Children Having Allogeneic Stem Cell Transplants at the New Zealand National Allogeneic Transplant Centre. CHILDREN (BASEL, SWITZERLAND) 2021; 8:356. [PMID: 33946879 PMCID: PMC8146388 DOI: 10.3390/children8050356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 11/17/2022]
Abstract
Psychosocial and palliative care support during stem cell transplants (SCT) is known to improve outcomes. AIM evaluate the support provided to children and families at the New Zealand National Allogeneic Stem Cell Transplant unit (NATC). METHOD the psychosocial and palliative care support for children who received SCT between December 2012 and April 2018 was audited. RESULTS of the 101 children who received SCT, 97% were reviewed by the social work team (SW) and 82% by the psychiatric consult liaison team (CLT) at least once during their illness. However, pre-transplant psychological assessment only occurred in 16%, and during the SCT admission, only 55% received SW support, and 67% received CLT support. Eight out of eighty-five families (9%) were offered support for siblings. Eight of the sixteen children who died were referred for pediatric palliative care (PPC) with all supported and half the families who experienced a death (n = 8; 50%) received bereavement follow up. CONCLUSION although the majority received some social work and psychological support, auditing against the standards suggests the consistency of involvement could be improved. Referrals for PPC were inadequate and largely for end-of-life phase. Sibling support, in particular donor siblings, had insufficient psychological assessment and support. Key recommendations are provided to address this underperformance.
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Affiliation(s)
- Amanda M. Evans
- Paediatric Palliative Care Service, Starship Children’s Health, Auckland and Mary Potter Hospice, Wellington 6242, New Zealand
| | - Hiran Thabrew
- Consult Liaison Psychiatry Team, Starship Children’s Health and University of Auckland, Auckland 1010, New Zealand;
| | - Bruce Arroll
- Department of General Practice and Primary Health Care, University of Auckland, Auckland 1010, New Zealand;
| | - Nyree Cole
- Oncology and Haematogy Service, Birmingham Women’s and Children’s, Birmingham B15 2TG, UK;
| | - Ross Drake
- Paediatric Palliative Care and Pain Service, Starship Children’s Health, Auckland 1023, New Zealand;
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18
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Dewez S, Laurin C, Ogez D, Bourque CJ, Curnier D, Laverdière C, Levesque A, Marcil V, Sinnett D, Sultan S. Elaboration and refinement of a motivational communication training program for healthcare professionals in pediatric oncology: a feasibility and acceptability study. Health Psychol Behav Med 2021; 9:220-238. [PMID: 34104558 PMCID: PMC8158256 DOI: 10.1080/21642850.2021.1903326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/04/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION A healthy lifestyle could have a positive impact in reducing the incidence of some long-term sequelae secondary to pediatric cancer treatments. Motivational communication (MC) is effective at improving healthy lifestyle habits, especially when patients experience change as a challenge. To date, there is no available intervention program using MC that promotes healthy lifestyles in pediatric oncology. OBJECTIVES The aim of this study was to develop the first MC training program for professionals in pediatric oncology and assess its feasibility and acceptability. MATERIALS AND METHODS Following standard procedures involving professionals, we developed a professional-targeted training named the Motivation Cafés, consisting in six sessions of core MC skills for healthcare professionals who wish to positively impact lifestyles of families in pediatric oncology. We used a mixed-methods quantitative-qualitative study to assess the program feasibility and acceptability. Professionals in nutrition and physical activity (N = 16) attended two rounds of the training and completed surveys to evaluate the training. They reported self-efficacy and knowledge in MC. Participation and retention rates were used to assess acceptability and feasibility, and a thematic analysis of the open-ended questions was performed to identify strengths and weaknesses of the program to further refine the program. We used non-parametric statistics to compare pre-post changes on measures of self-efficacy and knowledge in MC. RESULTS Attendance and retention (average 4.2/6 sessions completed) were high, suggesting very good adherence and feasibility. We also found high levels of acceptability and pertinence of the program (i.e. >90%). The results suggested probable improvements in self-efficacy and knowledge, but these were not statistically significant given the limited sample size. CONCLUSION The training Motivation Cafés is now ready to be pilot tested in pediatric cancer care centers.
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Affiliation(s)
- Sébastien Dewez
- Department of Psychology, Université de Montréal, Montréal, Canada
- Sainte-Justine University Health Centre, Montréal, Canada
| | - Catherine Laurin
- CanChange Network, Montréal, Canada
- Sacré-Coeur Hospital, Montréal, Canada
| | - David Ogez
- Sainte-Justine University Health Centre, Montréal, Canada
- Maisonneuve-Rosemont Hospital, Montréal, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Claude-Julie Bourque
- Sainte-Justine University Health Centre, Montréal, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Canada
| | - Daniel Curnier
- Sainte-Justine University Health Centre, Montréal, Canada
- Department of Kinesiology, Université de Montréal, Montréal, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Centre, Montréal, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Canada
| | - Ariane Levesque
- Department of Psychology, Université de Montréal, Montréal, Canada
- Sainte-Justine University Health Centre, Montréal, Canada
| | - Valérie Marcil
- Sainte-Justine University Health Centre, Montréal, Canada
- Department of Nutrition, Université de Montréal, Montréal, Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Centre, Montréal, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montréal, Montréal, Canada
- Sainte-Justine University Health Centre, Montréal, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Canada
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19
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Beckmann NB, Dietrich MS, Hooke MC, Gilmer MJ, Akard TF. Parent Caregiving Experiences and Posttraumatic Growth Following Pediatric Hematopoietic Stem Cell Transplant. J Pediatr Oncol Nurs 2021; 38:242-253. [PMID: 33750237 DOI: 10.1177/1043454221992306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Parents of children recovering from hematopoietic stem cell transplant (HSCT) experience significant distress due to unpredictable and potentially life-threatening complications. Distress is heightened by intensive caregiving parents provide the child during the first 100 days after HSCT. Management of distress and adaptation to caregiving responsibilities may be enhanced if parents find benefit in their experiences through posttraumatic growth (PTG), yet little is known about how parents' experiences after HSCT foster PTG. This study aimed to explore how parents experience caregiving and PTG 100 days after children's HSCT. Methods: Thirty-one parents completed semi-structured interviews ∼100 days after children received HSCT. Results: Four major themes emerged from the data to describe parent experiences after HSCT: (1) psychosocial and healthcare contextual factors; (2) cognitive, affective, and social support reactions to HSCT; (3) problem-based, emotion-based, and cognitive coping strategies; and (4) PTG. Discussion: Results increase the understanding of how parents' experiences and caregiving responsibilities contribute to PTG. These findings may guide future research to understand how these experiences influence PTG. Nurses are integral to the parents' experiences. Future work should focus on nursing interventions that enhance positive reinterpretation of parents' experiences after their children's HSCT.
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Affiliation(s)
- Nicole B Beckmann
- School of Nursing, 16194Vanderbilt University, Nashville, USA.,Pediatric Blood & Marrow Transplant, 65830University of Minnesota Masonic Children's Hospital, Minneapolis, USA
| | - Mary S Dietrich
- School of Nursing, 16194Vanderbilt University, Nashville, USA
| | - Mary C Hooke
- School of Nursing, University of Minnesota, Minneapolis, USA
| | - Mary J Gilmer
- School of Nursing, 16194Vanderbilt University, Nashville, USA
| | - Terrah F Akard
- School of Nursing, 16194Vanderbilt University, Nashville, USA
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20
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Onyeneho CA, Ilesanmi RE. Burden of Care and Perceived Psycho-Social Outcomes among Family Caregivers of Patients Living with Cancer. Asia Pac J Oncol Nurs 2021; 8:330-336. [PMID: 33850967 PMCID: PMC8030593 DOI: 10.4103/2347-5625.308678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 12/08/2020] [Indexed: 11/24/2022] Open
Abstract
Objective: Caring for patients living with cancer requires the support of family caregivers. Literature reports experiences of diverse burdens and health effects among caregivers. This study examined the burden, physical, psycho-social, and financial outcomes of caregiving among caregivers of patients living with cancer. Methods: This cross-sectional descriptive study was conducted in the University College Hospital, Ibadan, Nigeria, between January and March 2019. A convenient sample of 201 caregivers who were direct family relatives were selected to complete a validated Zarit Burden Interview (ZBI) Questionnaire (r = 0.994) and perceived outcomes of caregiving questionnaire. The burden scale score ranged from 0 to 20 (no burden) to 61–88 (severe burden). Other outcomes of caregiving were measured on a Likert scale 0–4 (where 2.00 is the threshold score of effect of caregiving experienced), to determine the strength of the effect of caregiving on each variable of interest. The factors that contributed to the health outcomes were also identified. The Statistical Package for the Social Sciences version 22.0 was used for data analysis. Results: The mean age was 37.68 ± 14.29 years and majority (60.4%) were female. The mean duration of caregiving was 2.34 ± 1.14. Caregivers (44.5%) reported a mild level of the burden while 4.4% reported severe burden. The mean burden score was 28.30 ± 15.78. Findings also indicate that caregiving affected the physical health (mean = 2.58 ≥ 2.00) and social well-being (mean = 2.42 ≥ 2.00) of the caregivers. The impact on psychological health was less than the threshold value (mean = 1.88 ≤ 2.00), suggesting less impact. Some factors associated with physical effects include poor eating (mean = 2.80) and lack of sleep (mean = 2.92). However, the psychological outcomes were associated with loss of hope (mean = 1.53) and feelings of frustration (mean = 1.65). Conclusions: Reported burden of care was mild; although negative health outcomes were noted. Health-care professionals can ameliorate such effects through a regular systemic assessment with standardized instruments, for early identification and intervention.
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Affiliation(s)
- Chiemerigo Anne Onyeneho
- Department of Nursing, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rose Ekama Ilesanmi
- College of Nursing, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE
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21
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Fukuhara JS, O'Haver J, Proudfoot JA, Spies JM, Kuo DJ. Yoga as a Complementary and Alternative Therapy in Children with Hematologic and Oncologic Disease. J Pediatr Oncol Nurs 2020; 37:278-283. [PMID: 32167404 DOI: 10.1177/1043454220909787] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A diagnosis of a hematologic or oncologic disease in a child can be stressful for the patient and the family. Yoga as an intervention has been reported to decrease stress in adults diagnosed with chronic disorders but few studies have been reported with children and their families. A convenience sample of patients diagnosed with cancer or a blood disorder (ages 7-17 years) and their caregivers was selected to participate in a single bedside yoga class. Participants were surveyed pre and post yoga with the Spielberger State Trait Anxiety Scale. Children were also surveyed pre and post yoga with the Wong-Baker Faces Pain Scale. Children had a significant decrease in pain post yoga but no change in anxiety. Adolescents and parents had a significant decrease in anxiety post yoga intervention.
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Affiliation(s)
- Julia S Fukuhara
- Division of Pediatric Hematology-Oncology, Rady Children's Hospital San Diego/University of California, San Diego, CA, USA
| | - Judith O'Haver
- Division of Pediatric Hematology-Oncology, Rady Children's Hospital San Diego/University of California, San Diego, CA, USA
| | - James A Proudfoot
- Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Jeanie M Spies
- Division of Pediatric Hematology-Oncology, Rady Children's Hospital San Diego/University of California, San Diego, CA, USA
| | - Dennis J Kuo
- Division of Pediatric Hematology-Oncology, Rady Children's Hospital San Diego/University of California, San Diego, CA, USA
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Bahrami N, Pahlavanzadeh S, Marofi M. Effect of a Supportive Training Program on Anxiety in Children with Chronic Kidney Problems and their Mothers' Caregiver Burden. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:193-199. [PMID: 31057635 PMCID: PMC6485030 DOI: 10.4103/ijnmr.ijnmr_88_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Chronic problems have a long course of treatment and are one of the important causes of the childhood hospitalization. The aim of this study was to determine the effect of a supportive training program on the children's anxiety and their mothers' caregiver burden. Materials and Methods This study was a randomized controlled clinical trial, performed on two groups in three stages in the autumn of 2017 on 112 individuals. The study population consisted of all children with chronic kidney problems who hospitalized in Emam Hossein Hospital (Isfahan, Iran) and their mothers. Sampling selection method was convenient. Participants were randomly assigned to experimental (n = 56) and control (n = 56) groups and the supportive training program, that was a self-regulating program, was done for the experimental group. The Face Anxiety Scale and the Zarit Caregiver Burden Scale were completed by both groups before, after and 1 month after the intervention. Statistical significance was set at 5%. Results There was a significant difference in the mean scores of anxiety and caregiver burden in the experimental group preintervention [anxiety: (t54= 0.31, p = 0.75); caregiver burden: (t54= 1.34, p = 0.18)], postintervention [anxiety: (t54= 5.30, p < 0.001); caregiver burden: (t54= 2.72, p = 0.009)], and follow-up [anxiety: (t54= 2.39, p = 0.01); caregiver burden: (t54= 3.06, p = 0.003)], whereas there was no significant difference in the mean scores of anxiety and caregiver burden in the control group. In order to controlling for pretest scores, the repeated measure analysis of covariance was adopted. Conclusions The results showed that the supportive training program can reduce children's anxiety and their mothers' caregiver burden and suggesting to nurses, an effective program to reduce the negative effects of hospitalization on children and their mothers.
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Affiliation(s)
- Niloofar Bahrami
- MSc of Pediatric Nursing, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeid Pahlavanzadeh
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Marofi
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Psychological treatment for family members of children with cancer: A systematic review and meta‐analysis. Psychooncology 2019; 28:960-969. [DOI: 10.1002/pon.5052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/14/2019] [Accepted: 03/01/2019] [Indexed: 01/11/2023]
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Law E, Fisher E, Eccleston C, Palermo TM. Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database Syst Rev 2019; 3:CD009660. [PMID: 30883665 PMCID: PMC6450193 DOI: 10.1002/14651858.cd009660.pub4] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Psychological therapies for parents of children and adolescents with chronic illness aim to improve parenting behavior and mental health, child functioning (behavior/disability, mental health, and medical symptoms), and family functioning.This is an updated version of the original Cochrane Review (2012) which was first updated in 2015. OBJECTIVES To evaluate the efficacy and adverse events of psychological therapies for parents of children and adolescents with a chronic illness. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, and trials registries for studies published up to July 2018. SELECTION CRITERIA Included studies were randomized controlled trials (RCTs) of psychological interventions for parents of children and adolescents with a chronic illness. In this update we included studies with more than 20 participants per arm. In this update, we included interventions that combined psychological and pharmacological treatments. We included comparison groups that received either non-psychological treatment (e.g. psychoeducation), treatment as usual (e.g. standard medical care without added psychological therapy), or wait-list. DATA COLLECTION AND ANALYSIS We extracted study characteristics and outcomes post-treatment and at first available follow-up. Primary outcomes were parenting behavior and parent mental health. Secondary outcomes were child behavior/disability, child mental health, child medical symptoms, and family functioning. We pooled data using the standardized mean difference (SMD) and a random-effects model, and evaluated outcomes by medical condition and by therapy type. We assessed risk of bias per Cochrane guidance and quality of evidence using GRADE. MAIN RESULTS We added 21 new studies. We removed 23 studies from the previous update that no longer met our inclusion criteria. There are now 44 RCTs, including 4697 participants post-treatment. Studies included children with asthma (4), cancer (7), chronic pain (13), diabetes (15), inflammatory bowel disease (2), skin diseases (1), and traumatic brain injury (3). Therapy types included cognitive-behavioural therapy (CBT; 21), family therapy (4), motivational interviewing (3), multisystemic therapy (4), and problem-solving therapy (PST; 12). We rated risk of bias as low or unclear for most domains, except selective reporting bias, which we rated high for 19 studies due to incomplete outcome reporting. Evidence quality ranged from very low to moderate. We downgraded evidence due to high heterogeneity, imprecision, and publication bias.Evaluation of parent outcomes by medical conditionPsychological therapies may improve parenting behavior (e.g. maladaptive or solicitous behaviors; lower scores are better) in children with cancer post-treatment and follow-up (SMD -0.28, 95% confidence interval (CI) -0.43 to -0.13; participants = 664; studies = 3; SMD -0.21, 95% CI -0.37 to -0.05; participants = 625; studies = 3; I2 = 0%, respectively, low-quality evidence), chronic pain post-treatment and follow-up (SMD -0.29, 95% CI -0.47 to -0.10; participants = 755; studies = 6; SMD -0.35, 95% CI -0.50 to -0.20; participants = 678; studies = 5, respectively, moderate-quality evidence), diabetes post-treatment (SMD -1.39, 95% CI -2.41 to -0.38; participants = 338; studies = 5, very low-quality evidence), and traumatic brain injury post-treatment (SMD -0.74, 95% CI -1.25 to -0.22; participants = 254; studies = 3, very low-quality evidence). For the remaining analyses data were insufficient to evaluate the effect of treatment.Psychological therapies may improve parent mental health (e.g. depression, anxiety, lower scores are better) in children with cancer post-treatment and follow-up (SMD -0.21, 95% CI -0.35 to -0.08; participants = 836, studies = 6, high-quality evidence; SMD -0.23, 95% CI -0.39 to -0.08; participants = 667; studies = 4, moderate-quality evidence, respectively), and chronic pain post-treatment and follow-up (SMD -0.24, 95% CI -0.42 to -0.06; participants = 490; studies = 3; SMD -0.20, 95% CI -0.38 to -0.02; participants = 482; studies = 3, respectively, low-quality evidence). Parent mental health did not improve in studies of children with diabetes post-treatment (SMD -0.24, 95% CI -0.90 to 0.42; participants = 211; studies = 3, very low-quality evidence). For the remaining analyses, data were insufficient to evaluate the effect of treatment on parent mental health.Evaluation of parent outcomes by psychological therapy typeCBT may improve parenting behavior post-treatment (SMD -0.45, 95% CI -0.68 to -0.21; participants = 1040; studies = 9, low-quality evidence), and follow-up (SMD -0.26, 95% CI -0.42 to -0.11; participants = 743; studies = 6, moderate-quality evidence). We did not find evidence for a beneficial effect for CBT on parent mental health at post-treatment or follow-up (SMD -0.19, 95% CI -0.41 to 0.03; participants = 811; studies = 8; SMD -0.07, 95% CI -0.34 to 0.20; participants = 592; studies = 5; respectively, very low-quality evidence). PST may improve parenting behavior post-treatment and follow-up (SMD -0.39, 95% CI -0.64 to -0.13; participants = 947; studies = 7, low-quality evidence; SMD -0.54, 95% CI -0.94 to -0.14; participants = 852; studies = 6, very low-quality evidence, respectively), and parent mental health post-treatment and follow-up (SMD -0.30, 95% CI -0.45 to -0.15; participants = 891; studies = 6; SMD -0.21, 95% CI -0.35 to -0.07; participants = 800; studies = 5, respectively, moderate-quality evidence). For the remaining analyses, data were insufficient to evaluate the effect of treatment on parent outcomes.Adverse eventsWe could not evaluate treatment safety because most studies (32) did not report on whether adverse events occurred during the study period. In six studies, the authors reported that no adverse events occurred. The remaining six studies reported adverse events and none were attributed to psychological therapy. We rated the quality of evidence for adverse events as moderate. AUTHORS' CONCLUSIONS Psychological therapy may improve parenting behavior among parents of children with cancer, chronic pain, diabetes, and traumatic brain injury. We also found beneficial effects of psychological therapy may also improve parent mental health among parents of children with cancer and chronic pain. CBT and PST may improve parenting behavior. PST may also improve parent mental health. However, the quality of evidence is generally low and there are insufficient data to evaluate most outcomes. Our findings could change as new studies are conducted.
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Affiliation(s)
- Emily Law
- Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA
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Psychosocial Intervention Programs for Parents of Children with Cancer: A Systematic Review and Critical Comparison of Programs’ Models and Development. J Clin Psychol Med Settings 2019; 26:550-574. [DOI: 10.1007/s10880-019-09612-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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26
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Supporting caregivers during hematopoietic cell transplantation for children with primary immunodeficiency disorders. J Allergy Clin Immunol 2018; 143:2271-2278. [PMID: 31178019 DOI: 10.1016/j.jaci.2018.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 08/23/2018] [Accepted: 10/09/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Caregivers of children with primary immunodeficiency disorders (PIDs) experience significant psychological distress during their child's hematopoietic cell transplantation (HCT) process. OBJECTIVES This study aims to understand caregiver challenges and identify areas for health care system-level improvements to enhance caregiver well-being. METHODS In this mixed-methods study caregivers of children with PIDs were contacted in August to November 2017 through online and electronic mailing lists of rare disease consortiums and foundations. Caregivers were invited to participate in an online survey assessing sociodemographic variables, the child's medical characteristics, psychosocial support use, and the World Health Organization-5 Well-Being Index. Open-ended questions about health care system improvements were included. Descriptive statistics and linear multivariate regression analyses were conducted. A modified content analysis method was used to code responses and identify emergent themes. RESULTS Among the 80 caregiver respondents, caregivers had a median age of 34 years (range, 23-62 years) and were predominantly female, white, and married with male children given a diagnosis of severe combined immune deficiency. In the adjusted regression model lower caregiver well-being was significantly associated with lower household income and medical complications. Challenges during HCT include maintaining relationships with partners and the child's healthy sibling or siblings, managing self-care, and coping with feelings of uncertainty. Caregivers suggested several organizational-level solutions to enhance psychosocial support, including respite services, online connections to other PID caregivers, and bedside mental health services. CONCLUSIONS Certain high-risk subpopulations of caregivers might need more targeted psychosocial support to reduce the long-term effect of the HCT experience on their well-being. Caregivers suggested several organizational-level solutions for provision of this support.
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Tillery R, Joffe NE, Mara CA, Davies SM, Pai ALH. Longitudinal examination of family efficacy following pediatric stem cell transplant. Psychooncology 2018; 27:1915-1921. [PMID: 29682835 DOI: 10.1002/pon.4741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Pediatric stem cell transplant (pSCT) is emotionally demanding for families. Yet, we know little of how the family unit responds to the adversity of pSCT within the first year after transplant. Family efficacy, an indicator of family resilience, is linked to positive parent, child, and family adjustment. Better understanding the factors that promote family efficacy during this difficult time could inform modifiable intervention targets and improve child and parent adjustment. The primary objectives were to examine patterns of family efficacy beliefs and identify factors that promote or hinder family efficacy. METHODS Ninety caregivers (71% white, 7% black, 3% Hispanic, 4% Asian, 14% multiple ethnicities) of children receiving pSCT completed demographic forms, the Psychosocial Assessment Tool, and the Filial Parental and Collective Family Efficacy Beliefs scale prior to the family's discharge, and 1, 3, 6, and 9 months post-discharge. Latent growth curve modeling was used to examine family efficacy across time. Parent, child, and sibling distress, social support, and demographic factors served as predictors. RESULTS Latent growth curve modeling demonstrated that family efficacy was stable for 9 months post pSCT discharge. Social support was positively related to family efficacy beliefs. No other variables predicted family efficacy. CONCLUSION Most families perceive themselves as resilient following pSCT. Social relationships and support are critical in maintaining a family's sense of efficacy during the arduous pSCT course.
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Affiliation(s)
- Rachel Tillery
- Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Naomi E Joffe
- Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Constance A Mara
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stella M Davies
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Bone Marrow Transplant and Immune Deficiency, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ahna L H Pai
- Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Paltin I, Schofield HL, Baran J. Rehabilitation and Pediatric Oncology: Supporting Patients and Families During and After Treatment. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2018. [DOI: 10.1007/s40141-018-0181-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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The need to support caregivers during pediatric bone marrow transplantation (BMT): A case report. Palliat Support Care 2018; 16:367-370. [PMID: 29380715 DOI: 10.1017/s1478951517001018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTObjective:Pediatric bone marrow transplants represent a medically stressful, potentially traumatic experience for children and caregivers, and psychological support for parental caregivers is paramount to their long-term well-being. However, many medical centers do not have protocols in place to sustain caregiver well-being during these distressing experiences. METHOD We report on a case of a 10-month-old infant with Wiskott Aldrich Syndrome who was hospitalized for bone marrow transplantation. RESULT We describe the significant burden that fell upon caregivers during and after a bone marrow transplantation. SIGNIFICANCE OF RESULTS This case helped guide our suggestions to improve care for caregivers. Several logistical hurdles could be overcome to alleviate some of these burdens. We suggest that a child psychologist or psychiatrist should be on patient care teams and be attentive to parental stress, impairments, or impediments to self-care, and signs of emergency of mental illness in this setting of medical trauma. Additionally, promotion of sleep hygiene and linkage to support systems can maximize resiliency. Finally, we believe that hospital administrators should partner with clinicians to facilitate routine support during highly stressful transitions of care.
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Doupnik SK, Hill D, Palakshappa D, Worsley D, Bae H, Shaik A, Qiu MK, Marsac M, Feudtner C. Parent Coping Support Interventions During Acute Pediatric Hospitalizations: A Meta-Analysis. Pediatrics 2017; 140:e20164171. [PMID: 28818837 PMCID: PMC5574731 DOI: 10.1542/peds.2016-4171] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2017] [Indexed: 02/06/2023] Open
Abstract
CONTEXT Parents may experience psychological distress when a child is acutely hospitalized, which can negatively affect child outcomes. Interventions designed to support parents' coping have the potential to mitigate this distress. OBJECTIVE To describe interventions designed to provide coping support to parents of hospitalized children and conduct a meta-analysis of coping support intervention outcomes (parent anxiety, depression, and stress). DATA SOURCES We searched Pubmed, Embase, PsycINFO, Psychiatry Online, and Cumulative Index to Nursing and Allied Health Literature from 1985 to 2016 for English-language articles including the concepts "pediatric," "hospitalization," "parents," and "coping support intervention." STUDY SELECTION Two authors reviewed titles and abstracts to identify studies meeting inclusion criteria and reviewed full text if a determination was not possible using the title and abstract. References of studies meeting inclusion criteria were reviewed to identify additional articles for inclusion. DATA EXTRACTION Two authors abstracted data and assessed risk of bias by using a structured instrument. RESULTS Initial searches yielded 3450 abstracts for possible inclusion. Thirty-two studies met criteria for inclusion in the systematic review and 12 studies met criteria for inclusion in the meta-analysis. The most commonly measured outcomes were parent depression, anxiety, and stress symptoms. In meta-analysis, combined intervention effects significantly reduced parent anxiety and stress but not depression. Heterogeneity among included studies was high. LIMITATIONS Most included studies were conducted at single centers with small sample sizes. CONCLUSIONS Coping support interventions can alleviate parents' psychological distress during children's hospitalization. More evidence is needed to determine if such interventions benefit children.
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Affiliation(s)
- Stephanie K Doupnik
- Division of General Pediatrics,
- Center for Pediatric Clinical Effectiveness and PolicyLab, and
- Leonard Davis Institute of Health Economics and
| | - Douglas Hill
- Division of General Pediatrics
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Deepak Palakshappa
- Division of General Pediatrics
- Center for Pediatric Clinical Effectiveness and PolicyLab, and
| | - Diana Worsley
- Division of General Pediatrics
- Center for Pediatric Clinical Effectiveness and PolicyLab, and
| | - Hanah Bae
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Aleesha Shaik
- College of Medicine, Drexel University, Philadelphia, Pennsylvania; and
| | - Maylene Kefeng Qiu
- Biomedical Library, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Meghan Marsac
- Department of Pediatrics, Kentucky Children's Hospital and College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Chris Feudtner
- Division of General Pediatrics
- Center for Pediatric Clinical Effectiveness and PolicyLab, and
- Leonard Davis Institute of Health Economics and
- Pediatric Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Sands SA, Mee L, Bartell A, Manne S, Devine KA, Savone M, Kashy DA. Group-Based Trajectory Modeling of Distress and Well-Being Among Caregivers of Children Undergoing Hematopoetic Stem Cell Transplant. J Pediatr Psychol 2017; 42:283-295. [PMID: 27543915 DOI: 10.1093/jpepsy/jsw064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/21/2016] [Indexed: 02/04/2023] Open
Abstract
Objective To examine the trajectories of caregiver psychological responses in the year following their child's hematopoetic stem cell transplant (HSCT), and whether cognitive and social processing strategies differentiated between trajectories. Method One hundred and eight caregivers randomized to the control condition of a cognitive-behavioral intervention study completed measures of distress, coping, and social support at baseline, 1 month, 6 months, and 1 year post HSCT of their child. Results The majority reported moderate or low anxiety, depression, or distress that decreased over time, but a small group demonstrated high anxiety, depression, or distress that persisted or increased over time. Maladaptive coping was highest among caregivers in the high-persistent distress subgroup compared with the moderate-decreasing and low-stable groups. Adaptive coping was minimally associated with trajectory subgroups. Conclusions Screening HSCT caregivers for distress and maladaptive coping may be useful in identifying caregivers likely to experience persistently high distress who may benefit from psychological intervention.
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Affiliation(s)
- Stephen A Sands
- Clinical Psychology Departments of Pediatrics and Psychiatry, Columbia University School of Medicine, New york, USA
| | - Laura Mee
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Sharon Manne
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Katie A Devine
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Mirko Savone
- Clinical Psychology Departments of Pediatrics and Psychiatry, Columbia University School of Medicine, New york, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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