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Huang Y, Huang Y, Lin M, Tao Y. Seeking central hopelessness symptoms which direct link to resilience among parents of children with autism spectrum disorder in China-A network perspective. Psych J 2024; 13:102-112. [PMID: 37942982 PMCID: PMC10917102 DOI: 10.1002/pchj.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023]
Abstract
The intervention process for children with autism spectrum disorder (ASD) is inextricably associated with their parents' mental health problems, such as hopelessness, which may adversely affect resilience and indirectly impact the effectiveness of interventions for their children. Hence, the motivation to help parents of children with ASD reduce hopelessness prompted us to conduct the present study and explore the interrelationship between hopelessness symptoms and resilience. This study evaluated hopelessness and resilience using the Beck Hopelessness Scale (BHS) and the Connor-Davidson Resilience Scale (CD-RISC). Participants met the criteria for their children's ASD diagnosis by a psychiatrist (N = 448; 54.69% mothers; Meanage = 34.59 years, SDage = 4.94 years). Moreover, we used symptom network analysis to examine the variability in network structure between fathers and mothers. The flow function was applied to examine which hopelessness symptoms were directly or indirectly associated with resilience. The results showed that #BHS11 (i.e., unpleasantness-ahead) was the central symptom found in the network structure for all parents and fathers, while #BHS17 (i.e., no-future-satisfaction) was the central symptom in the network structure for mothers. Additionally, #BHS6 ([NOT] expect-to-succeed) was directly and positively associated with resilience in all three network structures (i.e., all parents, fathers, and mothers). The results of the present study provide evidence that influential symptoms should be addressed and offer guidance for further interventions to reduce hopelessness and enhance resilience among parents of children with ASD.
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Affiliation(s)
- Yulin Huang
- Shenzhen Jiayun Psychological InstituteShenzhenChina
- Department of NeuroscienceCity University of Hong KongHong KongChina
| | - Yalin Huang
- Shenzhen Jiayun Psychological InstituteShenzhenChina
- Division of Nutritional Sciences, School of BiosciencesThe University of NottinghamLeicestershireUK
| | - Miaoxuan Lin
- Shenzhen Jiayun Psychological InstituteShenzhenChina
- School of Psychological and Cognitive SciencesPeking UniversityBeijingChina
| | - Yanqiang Tao
- Faculty of PsychologyBeijing Normal UniversityBeijingChina
- Beijing Key Laboratory of Applied Experimental PsychologyNational Demonstration Center for Experimental Psychology EducationBeijingChina
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Bense JE, Stiggelbout AM, Lankester AC, de Pagter APJ. Long-term parental distress after pediatric hematopoietic stem cell transplantation for nonmalignant diseases. Pediatr Blood Cancer 2023; 70:e30638. [PMID: 37638835 DOI: 10.1002/pbc.30638] [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: 03/15/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Survival rates have continued to increase for pediatric hematopoietic stem cell transplantation (HSCT) for nonmalignant diseases. Despite the crucial role of caregivers in this high-intensity treatment, knowledge about long-term parental impact is lacking. PROCEDURE This cross-sectional study assessed parental distress and everyday problems in parents of patients 2 years and older after pediatric HSCT for a nonmalignant disease using Distress Thermometer for Parents (DT-P), and compared outcomes to matched Dutch parents of healthy children and Dutch parents of children with a chronic condition (CC). RESULTS Median follow-up was 5.3 years (interquartile range [IQR]: 2.9-8.6). Underlying diseases were inborn errors of immunity (N = 30), hemoglobinopathies (N = 13), and bone marrow failure (N = 27). Mothers of pediatric HSCT recipients (N = 70) reported comparable overall distress levels to mothers of healthy children, but experienced more distress related to parenting problems, specifically managing their child's emotions, discussing disease consequences, and fostering independence. Fathers of HSCT recipients (N = 45) reported higher overall distress levels and had more emotional distress compared to fathers of healthy children. CONCLUSIONS Overall, parental distress and everyday problems of parents of HSCT recipients are comparable to those of parents of children with CC. However, there is ongoing parental burden, both emotional and in parenting, long-term after HSCT compared to parents of healthy children, and the type of burden differs between mothers and fathers. These results indicate that individualized parental supportive care should not remain restricted to the acute hospitalization phase, but also be actively offered during long-term follow-up after pediatric HSCT.
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Affiliation(s)
- Joëll E Bense
- Department of Pediatrics, Division of Stem Cell Transplantation, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - Anne M Stiggelbout
- Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Leiden, The Netherlands
| | - Arjan C Lankester
- Department of Pediatrics, Division of Stem Cell Transplantation, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - Anne P J de Pagter
- Department of Pediatrics, Division of Stem Cell Transplantation, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
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Wan Ghazali WS, Minhat HS, Mohd Zulkefli NA, Ahmad N, Ismail F, Mashudi DN, Mud Shukri MI, Kanthavelu C. Systematic review on factors associated with depression among mothers of children with cancer. PLoS One 2023; 18:e0285366. [PMID: 37616287 PMCID: PMC10449221 DOI: 10.1371/journal.pone.0285366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/21/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Despite evidence of depression among mothers of children with cancer, there appears to be a lack of studies or concern regarding factors associated with depression among these mothers. OBJECTIVE To review the factors associated with depression among mothers of children with cancer. METHOD Pubmed, Medline, Cochrane, CINAHL, Psychology, and Behavioural Sciences Collection, and Academic Search Complete were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies published between 2010 to 2022 on the associated risk factors of depression among mothers of children with cancer. The keywords used included mothers OR maternal' AND 'Child*' AND 'cancer OR tumo*r OR neoplasm' AND 'factors OR facilitators AND barriers OR predictors OR determinants AND 'depression'. Selected studies were evaluated by quality assessment. RESULT Five articles fulfilled the eligibility criteria. The factors associated with depression among mothers of children were socio-demographic risk factors (marital status, education level, annual income, child cancer diagnosis), and stress factors (caregiving stress, cancer-related stress, general stress). There were other factors associated with depression that act as mediators along the process which were emotion-focused coping and perceived social support. CONCLUSION Besides the commonly reported socio-demographic risk factors (marital status, education level, and annual income), other factors include stress factors (caregiving stress, cancer-related stress, and general stress). Furthermore, emotion-focused coping and perceived social support act as mediators along the process. More studies are warranted to explore depression among these mothers to ensure the most appropriate and effective preventive measures.
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Affiliation(s)
| | | | | | - Norliza Ahmad
- Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Fatin Ismail
- Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Gardner M, Brinkman WB, Carley M, Liang N, Lightfoot S, Pinkelman K, Speiser PW, Schafer-Kalkhoff T, Suorsa-Johnson KI, VanderBrink B, Weidler EM, Wisniewski J, Stacey D, Sandberg DE. Decisional Support Needed when Facing Tough Decisions: Survey of Parents with Children having Differences of Sex Development. FRONTIERS IN UROLOGY 2023; 3:1089077. [PMID: 37920725 PMCID: PMC10621652 DOI: 10.3389/fruro.2023.1089077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Introduction Parents of infants and young children newly diagnosed with differences of sex development (DSD) commonly face medical and psychosocial management decisions at a time when they are first learning about the condition and cannot consult their child for input. The aim of this study was to identify areas of greatest need for parental decisional support. Methods 34 parents of children receiving care for DSD at one of three US children's hospitals participated in a survey to learn what clinical and psychosocial decisions needed to be made on behalf of their child. Parents were then asked to identify and focus on a "tough" decision and respond to questions assessing factors affecting decision-making, decision-making preferences, decisional conflict, and decision regret. Descriptive analyses were conducted. Results Decisions about surgery and aspects of sharing information about their child's condition with others were the two most frequently reported decisions overall, experienced by 97% and 88% of parents, as well as most frequently nominated as tough decisions. Many parents reported mild to moderate levels of decisional conflict (59%) and decision regret (74%). Almost all parents (94%) reported experiencing at least one factor as interfering with decision-making (e.g., "worried too much about choosing the 'wrong' option"). Parents universally reported a desire to be involved in decision-making - preferably making the final decision primarily on their own (79%), or together with their child's healthcare providers (21%). The majority of parents judged healthcare providers (82%) and patient/family organizations (58%) as trustworthy sources of information. Discussion Parents of children with DSD encounter medical, surgical, and psychosocial management decisions. Despite difficulties including emotional distress and informational concerns (including gaps and overload), parents express strong desires to play key roles in decision-making on behalf of their children. Healthcare providers can help identify family-specific needs through observation and inquiry in the clinical context. Together with families, providers should focus on specific clinical management decisions and support parental involvement in making decisions on behalf of young children with DSD.
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Affiliation(s)
- Melissa Gardner
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - William B. Brinkman
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Meg Carley
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Noi Liang
- Patient / parent / caregiver stakeholder partners, Denver, CO, USA
| | | | - Kendra Pinkelman
- Patient / parent / caregiver stakeholder partners, Ann Arbor, MI, USA
| | - Phyllis W. Speiser
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Feinstein Institute for Medical Research, Manhasset, New York, USA
| | | | | | - Brian VanderBrink
- Division of Urology, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
| | - Erica M. Weidler
- Division of Pediatric Surgery, Phoenix Children’s Hospital, Phoenix, AZ
- Accord Alliance, USA
| | | | - Dawn Stacey
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - David E. Sandberg
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
- Accord Alliance, USA
- Division of Pediatric Psychology, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
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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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7
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Atout M, Almomani EM, Alhusban RY, Al-Tarawneh FS, Mohammad S. Stress levels and coping strategies among Jordanian parents caring for newly diagnosed children with leukemia: A cross sectional descriptive correlational study. J Psychosoc Oncol 2021; 40:632-651. [PMID: 34711128 DOI: 10.1080/07347332.2021.1995802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to describe the stress experienced and coping approaches exhibited by Jordanian parents of children recently diagnosed with leukemia. This cross-sectional study collected data from parents of children who had been diagnosed with leukemia within the previous three months (N = 130; 57 fathers (43.8%) and 73 mothers (56.2%), age (Mean = 37.5, SD = 8.4)). The Parenting Stress Index-Short Form was used. Similarly, parents' coping approaches were assessed with the Coping Health Inventory for Parents. Parents' mean total stress and coping strategies scores were 108 (± 26.8) and 93.9 (± 15.6), respectively. There were significant negative relationships between parents' stress levels and age (r = -0.46, p = .01), education level (f = 28.5, p < .05), and income (r = -0.65, p = .01). Additionally, there were significant positive relationships between parents' coping strategies and age (r = 0.34, p = .01) and income (r = 0.53, p < .01). There were non-significant differences between fathers' and mothers' stress levels and coping strategies. Parents of children with leukemia experienced high stress. The findings also confirmed the negative relationship between parents' stress, age, education level, and income; and the positive relationship between parents' coping strategies, age, and income. Several strategies are needed to manage said stress; for example, respite care for parents who spend long hours at the hospital. Volunteers to care for children at home or hospital might also relieve parents' stress.
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Affiliation(s)
- Maha Atout
- School of Nursing, Philadelphia University, Amman, Jordan
| | - Eshraf M Almomani
- USAID Health Service Delivery-Abt Associates, Sweifieh, Amman, Jordan
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Kolemen AB, Akyuz E, Toprak A, Deveci E, Yesil G. Evaluation of the parents' anxiety levels before and after the diagnosis of their child with a rare genetic disease: the necessity of psychological support. Orphanet J Rare Dis 2021; 16:402. [PMID: 34583726 PMCID: PMC8480067 DOI: 10.1186/s13023-021-02046-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/19/2021] [Indexed: 12/31/2022] Open
Abstract
Background The diagnosis of the rare genetic diseases has great importance in treating multisystemic conditions, preventing potential complications, and estimating disease risk for family members. The duration of obtaining genetic test results is varies. The demand to learn the diagnosis of a possible untreatable illness involves a struggle between uncertainty and a lifetime chronic disease. The current uncertainty of their child's condition and the long wait for a diagnosis may increase the parents' anxiety level and cause difficulties in the continuation of diagnostic procedures in some families. This study aimed to investigate the prediagnosis and postdiagnosis anxiety levels of parents who have a child with a rare genetic disease. Method The parents in this study, mothers or fathers, admitted their children to the Bezmialem Vakıf University Medical Genetics Clinic due to a suspected rare genetic disease (n = 40). Researchers created “The Sociodemographic Questionnaire” and used it to analyze the parents' sociodemographic status. In addition, they used the State-Trait Anxiety Inventory (STAI) to determine the anxiety levels of the parents. Results The state anxiety levels of parents decreased significantly after learning the diagnosis. However, there was no statistically significant decrease observed in trait anxiety levels. Conclusion Data from this study revealed that informing parents about their child's disease and properly explaining to them the expected difficulties might help to reduce their anxiety levels. Psychological support for parents is necessary to reduce their long-term stress, thus increasing the patient's compliance with treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-02046-2.
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Affiliation(s)
- Ayse B Kolemen
- Department of Medicine, Bezmialem Vakıf University Faculty of Medicine, Istanbul, Turkey
| | - Enes Akyuz
- Department of Biophysics, Saglık Bilimleri University Faculty of International Medicine, Istanbul, Turkey
| | - Ali Toprak
- Department of Biostatistics and Medicine Informatics, Division of Basic Medical Sciences, Bezmialem Vakıf University Faculty of Medicine, Istanbul, Turkey
| | - Erdem Deveci
- Department of Psychiatry, Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Gozde Yesil
- Department of of Medical Genetics, Istanbul University Faculty of Medicine, Istanbul, Turkey.
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Tsumura A, Okuyama T, Ito Y, Kondo M, Saitoh S, Kamei M, Sato I, Ishida Y, Kato Y, Takeda Y, Akechi T. Reliability and validity of a Japanese version of the psychosocial assessment tool for families of children with cancer. Jpn J Clin Oncol 2020; 50:296-302. [PMID: 31836884 DOI: 10.1093/jjco/hyz181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/22/2019] [Accepted: 10/30/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Patients with childhood cancer and their families frequently experience psychosocial distress associated with cancer and its treatment. We thus examined the reliability and validity of a Japanese version of the Psychosocial Assessment Tool, which was designed to screen for psychosocial risk factors among families of children with cancer. METHODS Forward-backward translation was used to develop the Japanese version of the Psychosocial Assessment Tool. We conducted a cross-sectional study. Mothers (N = 117), who were the primary caregivers of children with cancer, completed the Japanese version of the Psychosocial Assessment Tool and other measures to establish validity. The internal consistency and 2-week test-retest reliability of the Japanese version of the Psychosocial Assessment Tool were also examined. RESULTS The internal consistency of the Japanese version of the Psychosocial Assessment Tool total score was sufficient (Kuder-Richardson 20 coefficient = 0.84); however, the subscales 'structure and resources,' 'stress reactions' and 'family beliefs' were less than optimal (Kuder-Richardson 20 coefficients = 0.03, 0.49 and 0.49, respectively). The test-retest reliability for the Japanese version of the Psychosocial Assessment Tool total score was sufficient (intraclass correlation coefficient = 0.92). Significant correlations with the criteria measures indicated the validity of the Japanese version of the Psychosocial Assessment Tool total score. The optimal cut-off score for screening mothers with high psychosocial risk was 0.9/1.0, which was associated with 92% sensitivity and 63% specificity. CONCLUSIONS This study indicated that the Japanese version of the Psychosocial Assessment Tool is a valid and reliable tool to screen mothers for elevated distress.
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Affiliation(s)
- Akemi Tsumura
- Department of Psycho-oncology and Palliative Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.,Department of Nursing, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Toru Okuyama
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.,Division of Psycho-oncology and Palliative care, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Yoshinori Ito
- Division of Psycho-oncology and Palliative care, Nagoya City University Hospital, Nagoya, Aichi, Japan
| | - Masaki Kondo
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Michi Kamei
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Iori Sato
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Yuji Ishida
- Department of Pediatrics, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Yuka Kato
- Department of Nursing, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Yoshimi Takeda
- Department of Nursing, Osaka City General Hospital, Osaka, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.,Division of Psycho-oncology and Palliative care, Nagoya City University Hospital, Nagoya, Aichi, Japan
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10
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West CH, Dusome DL, Winsor J, Rallison LB. Falling Down the Rabbit Hole: Child and Family Experiences of Pediatric Hematopoietic Stem Cell Transplant. QUALITATIVE HEALTH RESEARCH 2020; 30:1125-1138. [PMID: 32249699 PMCID: PMC7252601 DOI: 10.1177/1049732320912410] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pediatric hematopoietic stem cell transplant (HSCT) is an intensive treatment that can be life-threatening. All family members experience distress. We conducted a grounded theory study using a family systems-expressive arts framework to develop a theoretical understanding of the family experience of HSCT. Six families (15 family members) participated in two interviews, drew an image, and were guided through a "dialoguing with images" process. Participants did not always perceive HSCT as an experience they had lived as a family and were surprised to hear other family members' experiences. While one mother drew, she suddenly understood it was not only her ill child, but the entire family who had "fallen down the rabbit hole." The family experience of HSCT is described across (a) the pre-HSCT trajectory, (b) family fragmentation (hospitalization), and (c) family reintegration. We identified a critical need for targeted family intervention during the transition into HSCT, throughout and following hospitalization.
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Affiliation(s)
| | - Debra L. Dusome
- Brandon University (Winnipeg site), Winnipeg,
Manitoba, Canada
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11
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Parent Psychological and Physical Health Outcomes in Pediatric Hematopoietic Stem Cell Transplantation. Cancer Nurs 2020; 42:448-457. [PMID: 30362974 DOI: 10.1097/ncc.0000000000000652] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parents of children undergoing hematopoietic stem cell transplantation (HSCT) are at risk of adverse health outcomes due to their intense caregiver demands. OBJECTIVE The aim of this study was to describe adverse health outcomes in parents of children who survived an allogeneic HSCT done within the past 1 to 10 years. METHODS This cross-sectional study, conducted at a children's hospital in the western United States, enrolled English- and Spanish-speaking parents of children who survived allogeneic HSCT between 2005 and 2015. Outcome measures included Beck Anxiety and Depression Inventories, Perceived Stress and Parent Stress Scales, Physical Symptom Inventory, and Short-Form 36 version 2. Parent scores were compared with normative means. Subsequently, the parent sample was stratified by the amount of time since their child's HSCT for comparison between groups. RESULTS Fifty-four mothers and 7 fathers (n = 61) were enrolled. Global mental health scores were lower for parents in the sample compared with norms (P = .003). Parents in the sample reported moderate anxiety and depression (20% and 23%, respectively), yet reported less parenting stress and superior health outcomes compared with norms (P < .001). Social functioning and general health scores were lower for parents whose children survived an allogeneic HSCT done within the past 1 to 4.99 years (P = .012). CONCLUSION Parents of survivors of allogeneic HSCT may concurrently experience posttraumatic growth and stress following their child's HSCT. IMPLICATIONS FOR PRACTICE Health screening and psychological support for parents of children post-HSCT may help to identify parents at risk of adverse outcomes and allow for early, targeted interventions.
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12
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Peterson RK, Chung J, Barrera M. Emotional symptoms and family functioning in caregivers of children with newly diagnosed leukemia/lymphomas and solid tumors: Short-term changes and related demographic factors. Pediatr Blood Cancer 2020; 67:e28059. [PMID: 31724323 DOI: 10.1002/pbc.28059] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/07/2019] [Accepted: 10/10/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pediatric oncology diagnoses are distressing to caregivers. However, researchers have not investigated the impact that the type of cancer diagnosis has on caregiver anxiety, depression, distress, and family functioning. The purpose of this study was to longitudinally investigate the early trajectory of caregiver psychological symptoms of anxiety, depression, distress, and family functioning near diagnosis and 6 months later by cancer type, and to examine the demographic factors that may be associated with caregiver emotional and family functioning outcomes. METHODS Caregivers (n = 122) of children with a recent diagnosis of leukemia/lymphoma or solid tumor completed self-report measures of psychological and family functioning (Hospital Anxiety and Depression Scale, Distress Thermometer, and Family Environment Scale). RESULTS In general, caregivers endorsed elevated psychological symptoms at the time of diagnosis, which decreased 6 months later. Caregivers of children with solid tumors endorsed greater anxiety across time than caregivers of children with leukemia/lymphoma did. In addition to caring for a child with a solid tumor, female sex, non-White ethnicity, and non-English language spoken in the home were factors associated with anxious and depressive symptoms and poorer family functioning. CONCLUSION When creating psychosocial interventions for families of children with cancer, the unique demands of solid tumor treatments, the caregiver's sex, and cultural characteristics must be considered to promote coping, resiliency, and problem-solving skills around the time of diagnosis, particularly in more vulnerable families.
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Affiliation(s)
- Rachel K Peterson
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joanna Chung
- Department of Psychology, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Maru Barrera
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Cavadini R, Drain E, Bernaudin F, D'Autume C, Giannica D, Giraud F, Baubet T, Taïeb O. Hematopoietic stem cell transplantation in children with sickle cell anemia: The parents' experience. Pediatr Transplant 2019; 23:e13376. [PMID: 30786109 DOI: 10.1111/petr.13376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 12/17/2018] [Accepted: 12/28/2018] [Indexed: 12/17/2022]
Abstract
Genoidentical HSCT is currently the only curative treatment for SCA, preventing further vascular complications in high-risk children. Studies on the psychological implications of HSCT for recipient, sibling donor, and the rest of the family have been limited in SCA. This study enrolled ten families and used semi-structured interviews to explore the parents' experience at three time points: first before transplantation, then 3 months later, and 1 year later. Three themes emerged from the results: (a) the presence of anxiety, experienced throughout the process, and alleviated by coping strategies (positive thinking, family support, praying); (b) the ability to remain parents to recipient and other family members, despite apprehension and feelings of helplessness, reinforced by the mobilization of important resources at the individual/family levels; (c) the ability to acknowledge the opportunity for their child to be cured of the disease, despite feelings of guilt toward families without a donor, or their own families back home. Overall, the parental experience with HSCT is complex, involving intra-psychic, familial, cultural, religious, and existential factors. Thus, it is important for medical teams to be cognizant of these issues in order to provide the best support to families during the HSCT process.
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Affiliation(s)
- Raphaël Cavadini
- Child Psychiatry Department, 11th District, Hôpital Maison Blanche, Paris, France.,Department of Psychopathology, Avicenne Hospital, Paris XIII University & Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Elise Drain
- Department of Psychopathology, Avicenne Hospital, Paris XIII University & Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Françoise Bernaudin
- Referral Center for Sickle Cell Disease, Department of Pediatrics, Centre Hospitalier Intercommunal, Créteil, France
| | - Clémence D'Autume
- Department of Psychopathology, Avicenne Hospital, Paris XIII University & Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Davide Giannica
- Department of Psychopathology, Avicenne Hospital, Paris XIII University & Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - François Giraud
- Department of Psychopathology, Avicenne Hospital, Paris XIII University & Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Thierry Baubet
- Department of Psychopathology, Avicenne Hospital, Paris XIII University & Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Olivier Taïeb
- Department of Psychopathology, Avicenne Hospital, Paris XIII University & Assistance Publique-Hôpitaux de Paris, Bobigny, France
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14
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Salem H, Andersen EW, Dalton SO, Schmiegelow K, Winther JF, Lichtenthal WG, Johansen C, Bidstrup PE. Psychotropic Medication Use in Parents of Children Diagnosed With Cancer. Pediatrics 2019; 143:peds.2018-2605. [PMID: 30944153 PMCID: PMC7548106 DOI: 10.1542/peds.2018-2605] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Objective measures on parental distress after a child's cancer diagnosis are sparse. We examined the risk for first prescription of psychotropic medicine among parents of children with cancer compared with parents of children who were cancer free. In addition, we examined if sociodemographic and clinical characteristics are associated with risk of first prescription of psychotropic medication in parents of children with cancer. METHODS We followed all parents of children with cancer (N = 6744) from the Danish Cancer Registry (1998-2014) using parents of matched children who were cancer free (N = 65 747) as a comparison. To identify vulnerable subgroups among parents of children with cancer, we followed all parents of children with cancer from the Childhood Cancer Registry (2003-2015; N = 3290 parents). In Cox proportional hazard models, we estimated hazard ratios (HRs) for a first prescription of psychotropic medication according to cancer status of the child and sociodemographic and clinical risk factors. RESULTS Parents of children with cancer were at increased risk for a first prescription of psychotropic medication compared with parents of children who were cancer free up to 2 years after the diagnosis, the risk being highest in the first year (HR, 1.83 [95% confidence interval (CI), 1.66-2.01]). Parents of children with cancer, especially parents who lost their child, had an increased risk for a first prescription of hypnotics (HR, 6.91; 95% CI, 3.50-13.66) and anxiolytics (HR, 4.55, 95% CI, 1.57-13.17) in the first year after diagnosis. CONCLUSIONS Efforts should be made to ensure that medical teams are adequately educated to address stress responses in the parents.
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Affiliation(s)
| | | | - Susanne O. Dalton
- Unit of Survivorship, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- University Hospital Rigshospitalet; Institute of Clinical Medicine, Medical Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark;,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Wendy G. Lichtenthal
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Christoffer Johansen
- Unit of Survivorship, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark;,Department of Oncology, Finsen Centre, University Hospital Rigshospitalet
| | - Pernille E. Bidstrup
- Unit of Survivorship, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
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15
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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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Kisecik Sengul Z, Altay N. Effect of parental depression level on children's quality of life after haematopoietic stem cell transplantation. Eur J Oncol Nurs 2018; 31:90-95. [PMID: 29173833 DOI: 10.1016/j.ejon.2017.08.003] [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: 04/18/2016] [Revised: 07/20/2017] [Accepted: 08/11/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE This descriptive cross-sectional study aimed to determine the impact of parental depression level on children's quality of life after haematopoietic stem cell transplantation (HSCT). METHOD This study was conducted in a bone marrow transplantation unit of a children's hospital in Ankara, Turkey. The research sample consisted of 82 parents. Children aged 2-18 years and monitored in polyclinics 100 days after HSCT were included in the study. A sociodemographic data form, parent forms of the Pediatric Quality of Life Inventory, and the Beck Depression Inventory (BDI) were used. RESULTS Forty (48%) mothers and 42 (51.2%) fathers participated in the study. Of the children, 30 (36.6%) were female and 52 (63.4%) were male, and their mean age was 10.68 [standard deviation (SD) 4.80] years. Twenty-six children (31.7%) had been diagnosed with thalassaemia, and 29 children (35.4%) had undergone HSCT in the previous 25-36 months. The mean total scale score on the Pediatric Quality of Life Inventory was 61.37 (SD 21.85), and the mean parental BDI Score was 14.57 (SD 11.03). Fourteen (17.1%) parents had severe depression and 10 (12.2%) parents had moderate depression. Low statistical correlation was found between the parental BDI score and the total scale score on the Pediatric Quality of Life (r = -0.281; P = 0.011). CONCLUSION Parental depression level affects children's quality of life after HSCT. Following transplantation, it is important to evaluate parental depression level and provide support.
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Affiliation(s)
- Zeynep Kisecik Sengul
- Department of Nursing, Faculty of Health Sciences, Suleyman Demirel University, Isparta, Turkey.
| | - Naime Altay
- Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
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17
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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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18
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Burns W, Péloquin K, Sultan S, Moghrabi A, Marcoux S, Krajinovic M, Sinnett D, Laverdière C, Robaey P. A 2-year dyadic longitudinal study of mothers' and fathers' marital adjustment when caring for a child with cancer. Psychooncology 2016; 26:1660-1666. [PMID: 27278682 DOI: 10.1002/pon.4189] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 05/02/2016] [Accepted: 06/06/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Studies examining interrelationships within parental couples confronted with pediatric cancer are scarce. This study explored dyadic longitudinal associations between both partners' family functioning and mood at diagnosis, and marital adjustment 2 years later. METHOD Parents of children (n = 47 couples) with acute lymphoblastic leukemia (ALL) completed the Family Well-Being Assessment and Profile of Mood States-Bipolar Form at diagnosis, and the Locke-Wallace Marital Adjustment Test 2 years post diagnosis. Multilevel linear models using the actor-partner interdependence model (APIM) and controlling for baseline marital adjustment were conducted to evaluate within subject and dyadic longitudinal effects. RESULTS For mothers, better marital adjustment 2 years post diagnosis was associated with perception of greater family support and less role conflict and role overload at diagnosis. For fathers, better marital adjustment 2 years post-diagnosis was associated with perception of less role conflict, greater role ambiguity, and being more tired at diagnosis, as well as their partner's perception of less role conflict at diagnosis. CONCLUSIONS These findings highlight the importance of considering both partners' perspectives in understanding marital adjustment across treatment phases in parents of children with ALL. Early interventions for couples should be tailored to meet each partner's needs in order to foster resilience within the couple.
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Affiliation(s)
- W Burns
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - K Péloquin
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - S Sultan
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - A Moghrabi
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - S Marcoux
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - M Krajinovic
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - D Sinnett
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - C Laverdière
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - P Robaey
- Sainte-Justine University Health Center, Montréal, Québec, Canada.,Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
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19
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Manne S, Mee L, Bartell A, Sands S, Kashy DA. A randomized clinical trial of a parent-focused social-cognitive processing intervention for caregivers of children undergoing hematopoetic stem cell transplantation. J Consult Clin Psychol 2016; 84:389-401. [PMID: 26913620 PMCID: PMC5580924 DOI: 10.1037/ccp0000087] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Providing care to one's child during and after a hematopoietic stem cell transplant (HSCT) is a universally stressful experience, but few psychological interventions have been developed to reduce caregiver distress. The goal of this study was to test the efficacy of a brief cognitive-behavioral intervention delivered to primary caregivers. METHOD Two hundred eighteen caregivers were assigned either best-practice psychosocial care (BPC) or a parent social-cognitive intervention program (P-SCIP). The 5 session P-SCIP was delivered during the HSCT hospitalization. Caregivers completed measures of distress, optimism, coping, and fear appraisals preintervention, 1, 6 months, and 1 year. RESULTS P-SCIP reduced caregiver's distress significantly more than BPC between the pretransplant assessment (Time 1) and 1-month follow-up assessment (Time 2). P-SCIP had a stronger effect than BPC among caregivers who began the hospitalization reporting higher depression and anxiety, and among caregivers whose children developed graft-versus-host disease (GvHD). Long-term treatment effects of P-SCIP were seen in traumatic distress among caregivers who reported higher anxiety pretransplant as well as among caregivers whose children had GvHD at HSCT discharge. CONCLUSIONS Screening caregivers for elevations in pretransplant anxiety and targeting interventions specifically to these caregivers, as well as targeting caregivers to children who develop GvHD, may prove beneficial.
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Affiliation(s)
- Sharon Manne
- Department of Medicine, Rutgers Cancer Institute of New Jersey
| | - Laura Mee
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Abraham Bartell
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Stephen Sands
- Department of Pediatrics, Columbia University School of Medicine
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20
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Di Battista A, Hancock K, Cataudella D, Johnston D, Cassidy M, Punnett A, Shama W, Barrera M. Healthcare Providers' Perceptions of the Utility of Psychosocial Screening Tools in Childhood Cancer: A Pilot Study. Oncol Nurs Forum 2016; 42:391-7. [PMID: 26148318 DOI: 10.1188/15.onf.391-397] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine the perceptions of healthcare providers (HCPs) regarding the utility of two psychosocial screening tools designed for pediatric oncology, the Psychosocial Assessment Tool-Revised (PATrev) and the Psychosocial Care Checklist (PCCL). DESIGN Repeated measures comparative study. SETTING Four pediatric health centers in Ontario, Canada. SAMPLE 15 oncologists, 14 nurses, and 8 social workers. METHODS Using a visual analog scale (VAS), participants were asked to rate how useful they found (a) the psychosocial summary derived from the parent-completed PATrev, used to assess family psychosocial risk, and (b) the HCP-completed PCCL, used to identify family psychosocial needs. Measures were completed soon after diagnosis and six months later. Mann-Whitney U tests were used for analyses. MAIN RESEARCH VARIABLE VAS scores. FINDINGS Pediatric oncology HCPs differ in their acceptance of the psychosocial screening tools tested. The highest utility ratings for both instruments were from nurses, and the lowest utility ratings were from social workers; moderate ratings were obtained from oncologists. CONCLUSIONS Psychosocial screening tools can identify the psychosocial needs of children with cancer and their families throughout the cancer trajectory. Consequently, these tools could foster communication among colleagues (medical and nonmedical) who are caring for children with cancer about the psychosocial needs of this population and the allocation of resources to address those needs. IMPLICATIONS FOR NURSING Nurses seem to value these tools more than other HCPs, which may have positive implications for their clinical practice.
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Chen J, Liu Y, Cai QQ, Liu YM, Wang T, Zhang K, Wang JF, Chen WQ, Huang H. Type D personality parents of children with leukemia tend to experience anxiety: the mediating effects of social support and coping style. Medicine (Baltimore) 2015; 94:e627. [PMID: 25761192 PMCID: PMC4602458 DOI: 10.1097/md.0000000000000627] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aims were to access anxiety and type D personality (TDP) in parents of children with leukemia, and to determine the mediating effect of social support and coping style on the relationship between TDP and anxiety. A cross-sectional study was conducted among 231 parents of children with leukemia and 261 parents of children with acute diseases in hospitals. Parents completed questionnaires on anxiety, TDP, social support, coping styles, children's clinical characteristics, and demographic characteristics. Parents of children with leukemia showed higher prevalence of anxiety (64.5% vs 40.2%, P < 0.01) and TDP (44.2% vs 24.1%, P < 0.01) compared with controls. TDP (odds ratio [OR] = 4.34, P < 0.01), lower social support (OR = 1.92, P = 0.02), and less positive coping (OR = 1.87, P = 0.02) were independently associated with anxiety. Parents with TDP showed lower social support and less positive coping, but more negative coping compared with those without. Moreover, multiple mediation analyses revealed that the significant effect of TDP on anxiety was partially mediated by social support and positive coping. In conclusion, anxiety and TDP were highly prevalent in parents of children with leukemia. The predictive factors could be used to identify those parents who are at high risk of anxiety and may also be targets for prevention and intervention.
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Affiliation(s)
- Jie Chen
- From the Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology (JC, YL, TW, KZ, JFW, HH); Sun Yat-sen Memorial Hospital of Sun Yat-sen University (JC, YL, YML, TW, KZ, JFW, HH); Department of Internal Medicine (QQC), Cancer Center; and Department of Biostatistics and Epidemiology (WQC), School of Public Health, Sun Yat-sen University, Guangzhou, China
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22
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The role of social and cognitive processes in the relationship between fear network and psychological distress among parents of children undergoing hematopoietic stem cell transplantation. J Clin Psychol Med Settings 2014; 21:223-33. [PMID: 25081956 DOI: 10.1007/s10880-014-9403-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The current study examined whether cognitive and social processing variables mediated the relationship between fear network and depression among parents of children undergoing hematopoietic stem cell transplant (HSCT). Parents whose children were initiating HSCT (N = 179) completed survey measures including fear network, Beck Depression Inventory, cognitive processing variables (positive reappraisal and self-blame) and social processing variables (emotional support and holding back from sharing concerns). Fear network was positively correlated with depression (p < .001). Self-blame and holding back emerged as individual partial mediators in the relationship between fear network and depression. Together they accounted for 34.3% of the variance in the relationship between fear network and depression. Positive reappraisal and emotional support did not have significant mediating effects. Social and cognitive processes, specifically self-blame and holding back from sharing concerns, play a negative role in parents' psychological adaptation to fears surrounding a child's HSCT.
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23
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Lindahl Norberg A, Mellgren K, Winiarski J, Forinder U. Relationship between problems related to child late effects and parent burnout after pediatric hematopoietic stem cell transplantation. Pediatr Transplant 2014; 18:302-9. [PMID: 24483231 DOI: 10.1111/petr.12228] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2013] [Indexed: 11/29/2022]
Abstract
A few studies have indicated that parents' reactions to a child's serious disease may entail long-term stress for the parents. However, further knowledge of its consequences is valuable. The aim of the study was to investigate the occurrence of burnout in a Swedish national sample of parents of children who had undergone HSCT and survived. Burnout (Shirom-Melamed Burnout Questionnaire) and estimations of the child's health status (Lansky/Karnofsky estimations and study-specific questions) were self-reported by 159 mothers and 123 fathers. In addition, physicians made estimations of the child's health status (Lansky/Karnofsky estimations). Nonparametric tests revealed that burnout symptoms occurred more often among fathers of children who had undergone transplantation within the last five yr compared to fathers of children with no history of serious disease (34.4% vs. 19.9%). Burnout among mothers and fathers was associated with the child's number and severity of health impairments up to five yr after the child underwent HSCT (Spearman's rho for mothers 0.26-0.36 and for fathers 0.36-0.61). In conclusion, chronic stress in parents after a child's HSCT seems to abate eventually. However, parents should be monitored and offered adequate support when needed. Moreover, the situation of fathers in the often mother-dominated pediatric setting should receive more attention in research as well as in the clinic.
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Affiliation(s)
- Annika Lindahl Norberg
- Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden; U-CARE/Psychosocial Oncology and Supportive Care, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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24
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Lindwall JJ, Russell K, Huang Q, Zhang H, Vannatta K, Barrera M, Alderfer M, Phipps S. Adjustment in parents of children undergoing stem cell transplantation. Biol Blood Marrow Transplant 2014; 20:543-8. [PMID: 24434783 DOI: 10.1016/j.bbmt.2014.01.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 01/09/2014] [Indexed: 02/02/2023]
Abstract
Pediatric stem cell transplantation (SCT) is a demanding procedure for children and parents. Interventions to promote positive adjustment of parents in this setting are needed. A total of 171 patient-parent dyads from 4 sites received 1 of 3 interventions to reduce SCT-related distress: a child intervention with massage and humor therapy, an identical child intervention plus a parent intervention with massage and relaxation/imagery, or standard care. Parents completed weekly self-report measures of distress and positive affect during the acute phase of treatment (weeks -1 through +6); and measures of depression, posttraumatic stress (PTSD), and benefit finding at baseline and week +24. No significant differences across treatment arms were observed on repeated measures of parental distress. There was a marginally significant effect of the child intervention on parental positive affect. Over time, parental distress decreased significantly and positive affect increased significantly in all groups. Similarly, there were no significant intervention effects on the global adjustment outcomes of depression, PTSD, and benefit finding. However, reports of depression and PTSD decreased significantly and reports of benefit finding increased significantly from baseline to week +24 for all groups. Across all study arms, parent adjustment improved over time, suggesting that parents demonstrate a transient period of moderately elevated distress at the time of their child's admission for transplantation, followed by rapid improved to normative levels of adjustment. Similar to results previously reported for their children, these parents appear resilient to the challenges of transplantation.
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Affiliation(s)
- Jennifer J Lindwall
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee; Department of Psychiatry and Behavioral Sciences, Children's Hospital of Colorado, Aurora, Colorado
| | - Kathy Russell
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Qinlei Huang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Hui Zhang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kathryn Vannatta
- Center for Biobehavioral Heatlh, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Maru Barrera
- Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Melissa Alderfer
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.
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25
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Chen J, Liu Y, Cai Q, Liu Y, Wang T, Wang J, Chen WQ, Huang H. Depression in parents of children with leukemia in southern China accompanied by the prevalence of type D personality. Support Care Cancer 2013; 22:1277-86. [PMID: 24326951 DOI: 10.1007/s00520-013-2082-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 11/26/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE The aims of this study were to assess depression and type D personality in parents of children with leukemia in southern China and to investigate the associations between parents' depression and type D personality, social support, coping style, and demographic characteristics. METHODS Parents (n=231) of children with leukemia (study group) and parents (n=261) of children with acute respiratory/digestive infections (control group) were recruited from five hospitals in southern China. Children's clinical characteristics and parents' demographic characteristics, depression, type D personality, coping styles, and social support were collected with self-report questionnaires. RESULTS Parents of children with leukemia, especially mothers, reported higher levels of depression accompanied by a higher prevalence of type D personality, more negative coping styles, and less subjective social support, but received more objective social support than controls (P<0.05). The depression in parents in the study group was positively correlated with type D personality and negative coping style, but negatively correlated with social support and positive coping styles (P<0.05). Multivariate logistic regression analyses showed that type D personality (OR=5.64, P<0.001), lower social support (OR=2.38, P=0.020), and less positive coping (OR=3.32, P=0.003) were independently associated with depression in parents of children with leukemia. As for demographic characteristics, female, lower education level, unemployed, and paying medical expenses at one's own expenses were independent predictors of depression in parents of children with leukemia. CONCLUSION Depression and type D personality were remarkably prevalent in parents of children with leukemia in southern China. Type D personality and multiple social factors were associated with depression in parents of children with leukemia.
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Affiliation(s)
- Jie Chen
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
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Barrera M, Hancock K, Rokeach A, Atenafu E, Cataudella D, Punnett A, Johnston D, Cassidy M, Zelcer S, Silva M, Jansen P, Bartels U, Nathan PC, Shama W, Greenberg C. Does the use of the revised psychosocial assessment tool (PATrev) result in improved quality of life and reduced psychosocial risk in Canadian families with a child newly diagnosed with cancer? Psychooncology 2013; 23:165-72. [PMID: 24003005 DOI: 10.1002/pon.3386] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/25/2013] [Accepted: 08/02/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Early psychosocial screening may guide interventions and ameliorate the adverse psychosocial effects of childhood cancer. The revised psychosocial assessment tool provides risk information - Universal (typical distress), Targeted (additional specific distress), and Clinical (severe distress) - about the child with cancer and his or her family. This pilot study investigated the benefits of providing a summary of family psychosocial risk information to the medical team treating the newly diagnosed child (Experimental Group, EG). METHOD We conducted a pilot randomized control trial with a sample of 67 parents, comparing the EG to the control group (CG) on parental perception of family psychosocial difficulties (revised psychosocial assessment tool risk levels), child behavior (behavior assessment scale for children-2), pediatric quality of life (PedsQL), and parental anxiety (state-anxiety scale of the state-trait anxiety inventory ), 2-4 weeks after diagnosis (Time 1) and 6 months later (Time 2). RESULTS Compared to the CG, participants in the EG had significantly reduced targeted and clinical risk (p < 0.001), and improved pain related PedsQL at Time 2 (p < 0.05). Scores for PedsQL total and nearly all subscales improved over time in both groups (p < 0.05 to p < 0.001). No changes in behavior scores were noted. CONCLUSION Preliminary findings suggest that providing a summary of the Psychosocial Assessment Tool to the treating team shortly after diagnosis may help reduce family wide psychosocial risk 6 months later and improve quality of life related to pain for children who are undergoing treatment for cancer.
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Affiliation(s)
- M Barrera
- The Hospital for Sick Children, Toronto, Canada; University of Toronto, Toronto, Canada
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Current world literature. Curr Opin Organ Transplant 2013; 18:241-50. [PMID: 23486386 DOI: 10.1097/mot.0b013e32835f5709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rodday AM, Terrin N, Parsons SK. Measuring global health-related quality of life in children undergoing hematopoietic stem cell transplant: a longitudinal study. Health Qual Life Outcomes 2013; 11:26. [PMID: 23442200 PMCID: PMC3644228 DOI: 10.1186/1477-7525-11-26] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 02/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric health-related quality of life (HRQL) measures explore multiple domains of HRQL. To ease administration, burden, and implementation, we created a 7-item unidimensional global HRQL scale for children. This paper evaluates the psychometric properties of the global HRQL scale in children undergoing hematopoietic stem cell transplant (HSCT) and describes the trajectory of global HRQL scores over the 12-month course following HSCT. METHODS As part of two longitudinal HSCT studies, HRQL was collected on 312 parent-child dyads using the Child Health Ratings Inventories. Parents of children aged 5-18 completed the pediatric global HRQL scale about their child and 117 adolescents completed the scale themselves. Psychometric properties were compared across both raters. Two repeated measures models were built to describe trajectories of (1) global HRQL for all children based on parent proxy report and (2) global HRQL for adolescents based on adolescent self-report and parent proxy report. RESULTS Internal consistency reliability was high for parent proxy report and adolescent self-report (Cronbach's alpha 0.9, 0.8, respectively). Unidimensionality was verified using principal components analysis. Both models indicated decreased global HRQL in the presence of early complications related to HSCT and Model 1 further indicated decreased HRQL in the presence of later complications. Model 2 showed that parent proxies reported lower global HRQL scores than adolescent self-report. CONCLUSIONS This study has demonstrated the unidimensionality and strong psychometric properties of a 7-item global HRQL scale in a sample of children undergoing HSCT. Despite its brevity, scale scores vary in clinically meaningful ways. Future applications of this scale are encouraged.
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Affiliation(s)
- Angie Mae Rodday
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
- Graduate Program in Clinical and Translational Science, Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA, USA
| | - Norma Terrin
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA, USA
| | - Susan K Parsons
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA, USA
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Differences in mothers' and fathers' health-related quality of life after pediatric SCT: a longitudinal study. Bone Marrow Transplant 2011; 47:855-9. [PMID: 21946382 DOI: 10.1038/bmt.2011.190] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to examine longitudinally health-related quality of life (HRQOL) and related factors in mothers and fathers of children who undergo SCT, before, and 1 and 2 years after SCT. A total of 84 parents (49 mothers/35 fathers) of patients diagnosed mainly with leukemia completed a HRQOL measure before SCT, 46 at 1 year (26 mothers/20 fathers) and 50 parents (31 mothers/19 fathers) at 2 years post SCT. Physical and psychosocial HRQOL summary scores are reported. Parents' age and gender, child's diagnosis, radiation history, age, behavior and physical health were examined. Linear mixed models for repeated measures with a covariate structure were used for analysis. Physical HRQOL did not differ between mothers and fathers or over time. Maternal and paternal psychosocial HRQOL scores improved by 2 years post SCT. Child's behavior problems and poor health, and maternal age (younger) predicted poor maternal psychosocial HRQOL 2 years post SCT. Child's behavior problems, diagnosis and treatment severity predicted poor paternal psychosocial HRQOL. These findings identify similar (child's poor behavior) and differential risk factors (parental young age, disease and treatment severity, and child's poor health status) for poor HRQOL for mothers and fathers. These findings can guide comprehensive family-care interventions before, during and after pediatric SCT.
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