1
|
Son H, Kim N. Therapeutic Parent-Child Communication and Health Outcomes in the Childhood Cancer Context: A Scoping Review. Cancers (Basel) 2024; 16:2152. [PMID: 38893270 PMCID: PMC11172360 DOI: 10.3390/cancers16112152] [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: 04/23/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Family communication has been thought to be an important area to support children's adjustment to a cancer diagnosis. However, the characteristics of therapeutic parent-child communication that contribute to better patient outcomes and the specific patient health outcomes have been less explored. This current review explored the characteristics of therapeutic parent-child communication and its physical and psychological health outcomes. A total of 5034 articles were initially identified, and only 10 articles remained for inclusion in this review after application of the exclusion criteria. Most studies used a cross-sectional design and measured verbal communication characteristics and its psychological outcomes, but no physical outcomes. The characteristics of therapeutic verbal communication (openness, maternal validation, quality of information shared, etc.) and nonverbal communication (eye contact, close physical distance, and acknowledging behaviors) were identified. The psychological health outcomes included less distress, a lower level of PTSS, less internalizing and externalizing of symptoms, increased levels of social emotional competencies, better peer relationships, and more cooperation during the procedure at the individual level. Increased family cohesion and family adaptation were family-level outcomes. Longitudinal studies are needed to identify what qualities of communication predict better psychological outcomes so that interventions can be developed and tested. In addition, physical outcomes should be evaluated.
Collapse
Affiliation(s)
- Heeyeon Son
- College of Nursing, University of Tennessee, 1412 Circle Drive, Knoxville, TN 37996, USA
| | - Nani Kim
- School of Nursing, The University of Texas at Austin, 1710 Red River St., Austin, TX 78712, USA;
| |
Collapse
|
2
|
Farley S, Bansal S, Barks MC, Pollak KI, Kaye EC, Quarles A, Briglia K, Johnson E, Lakis K, Lemmon ME. Role of Social Workers in Family Conferences for Critically Ill Infants. J Palliat Med 2022; 25:1236-1242. [PMID: 35285675 PMCID: PMC9347387 DOI: 10.1089/jpm.2021.0574] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Communication challenges in the neonatal intensive care unit include fragmented communication, challenges managing expectations amidst uncertainty, and navigating complex medical information. Social workers are well suited to mitigate these challenges. Objective: In this study, we aimed to characterize the extent and nature of social worker participation in family conferences for critically ill infants. Design: We used a longitudinal observational mixed-methods design, enrolling infants with a neurological condition, their parent(s), and their clinicians. All audio-recorded conferences were transcribed and de-identified. Emergent themes and subthemes were identified using conventional content analysis. Results: We enrolled 40 infants and 61 parents. Sixty-eight conferences were held and audio recorded for 24 infants. Social workers were present for 51 of these conferences (n = 51/68, 75%) across 18 cases (n = 18/24, 75%). We identified four themes, conceptualized as distinct roles played by social workers in family conferences: (1) Translator: social workers served as a communicative bridge between parents and the medical team; (2) Coordinator: social workers simplified logistics and connected parents to community resources, including home health agencies and financial assistance; (3) Expectation manager: social workers provided anticipatory guidance and helped parents conceptualize the remainder of the hospital stay, discharge, and life at home; and (4) Advocate: social workers validated parental values and concerns and provided immediate emotional support. Conclusions: Social workers participated in three-quarters of family conferences for critically ill infants. When they participated, they facilitated communication, coordinated care, managed expectations, and advocated for families. These findings underscore the important, varied, and concurrent roles social workers play in the care of critically ill infants. Future communication and family support interventions should leverage these distinct roles.
Collapse
Affiliation(s)
- Sam Farley
- Duke University, Durham, North Carolina, USA
| | | | - Mary Carol Barks
- Duke University, Durham, North Carolina, USA
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kathryn I. Pollak
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Erica C. Kaye
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Anna Quarles
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kathleen Briglia
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Erika Johnson
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kristen Lakis
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
- Division of Palliative Care, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Monica E. Lemmon
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| |
Collapse
|
3
|
Yang H, Chen R, Chen J, Yan F, Zhang H, Wei L, Jia X, Wang Y. ECMO-assisted resection of left main bronchial malignant tumor and left pneumonectomy with comprehensive nursing support: a case report. J Cardiothorac Surg 2020; 15:300. [PMID: 33023608 PMCID: PMC7538043 DOI: 10.1186/s13019-020-01348-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 09/28/2020] [Indexed: 11/24/2022] Open
Abstract
Background Patients with Extracorporeal Membrane Oxygenation (ECMO) undergoing primary bronchial malignancy resection and left pneumonectomy via bilateral thoracic approach are rare for there exist few reports available to date. And the nursing experience about this disease is rare reported. Case presentation This study reported a 50-year-old man with adenoid cystic carcinoma in left main bronchus by computed tomography (CT), fiberoptic bronchoscopy, and puncture biopsy. The case is the first report about operation method and the comprehensive nursing care, including conventional nursing, airway management, fluid management, nutritional support, and psychosocial support for patients undergoing primary bronchial malignancy resection and left pneumonectomy. After multidisciplinary treatment and comprehensive care, the patient was cured and discharged on the 17th day after surgery. Conclusion This study reported a rare case with bronchial malignancy resection and left pneumonectomy and discussed its nursing care. A skilled management of ECMO, intraoperative position transformation, and prevention, as well as control of pulmonary complications are fundamental in caring patients with bronchial tumors. Monitoring of pulmonary function and blood pressure, adequate nutrition, and psychological support could be contributing factors for successful treatment during the postoperative stage.
Collapse
Affiliation(s)
- Hui Yang
- Department of Thoracic Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Ruiyun Chen
- Department of Thoracic Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Jingru Chen
- Department of Thoracic Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Fan Yan
- Nursing Department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Hongmei Zhang
- Nursing Department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China.
| | - Li Wei
- Department of Thoracic Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Xiangbo Jia
- Department of Thoracic Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Yuming Wang
- Department of Administration, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China.
| |
Collapse
|
4
|
Demiris G, DeKeyser Ganz F, Han CJ, Pike K, Parker Oliver D, Washington K. Design and Preliminary Testing of the Caregiver-Centered Communication Questionnaire (CCCQ). J Palliat Care 2020; 35:154-160. [PMID: 31696787 PMCID: PMC7202953 DOI: 10.1177/0825859719887239] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study objective was to develop and test a new survey instrument that measures caregiver-centered communication. We developed a questionnaire inspired by the National Cancer Institute framework on patient-centered communication, focusing on family caregiver communication for this tool. The questionnaire includes 5 subscales: exchange of information, relationship with team, emotions, managing care, and decision-making. The initial questionnaire was reviewed by domain experts for face validity and edited further to include 30 items. We administered the modified questionnaire to 115 family caregivers of patients with serious illness in various settings. Cronbach α for the entire scale was 0.97 and ranged from 0.82 to 0.93 for the 5 subscales. Participants found that the survey addressed important concepts and that items were in most cases easy to understand. This instrument provides a structured way to assess caregiver-centered communication, addressing a pressing need for tools that measure the extent to which communication is responsive to the needs and preferences of family caregivers. Further testing and refinement are needed to improve the ease of use and examine the reliability and validity of this measure.
Collapse
Affiliation(s)
- George Demiris
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Freda DeKeyser Ganz
- Henrietta Szold Hadassah-Hebrew, University School of Nursing, Hashmonaim, Israel
| | - Claire J. Han
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Washington, DC, USA
| | - Kenneth Pike
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Washington, DC, USA
| | - Debra Parker Oliver
- Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Karla Washington
- Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, USA
| |
Collapse
|
5
|
Kawashima T, Tanaka M, Kawakami A, Muranaka S. Nurses' contribution to end-of-life family conferences in critical care: A Delphi study. Nurs Crit Care 2020; 25:305-312. [PMID: 32383497 DOI: 10.1111/nicc.12512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 03/20/2020] [Accepted: 04/21/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Family conferences (FCs) in the intensive care unit play an important role in reducing the psychological burden of patients' families at the end of life. However, no studies have clarified the specific roles and contributions of nurses related to FCs for terminally ill patients in critical care and their families. AIMS AND OBJECTIVES To clarify nurses' contribution to FCs for terminally ill patients in critical care and their families and examine the priority of each item. DESIGN A modified Delphi method was used. METHODS This study consisted of two phases. In phase 1, an initial list was developed based on a literature review, individual interviews, and a focus group interview. Phase 2 involved two rounds of the Delphi survey. Practitioners (N = 55) from hospitals across Japan were recruited to the Expert Panel for phase 2. They were asked to rate each nurse's contribution in terms of its importance using a 9-point Likert scale (1 being "not important at all" to 9 being "very important"). Fifty participants responded to round 1 of the survey, and 46 participants completed round 2. If at least 80% of the panellists chose an importance level of 7 or higher, the item was considered "important". RESULTS The 65 items of the potential list were classified into three domains: preparation (16 items), discussion and facilitating meaning during a FC (32 items), and follow up after a FC (17 items). The expert panel determined that, of 65 items, 49 items on the proposed list of nurses' contribution were considered important. CONCLUSIONS This study clarified nurses' contribution to FCs, with consensus on their importance by expert nurses. RELEVANCE TO CLINICAL PRACTICE This study could be useful for improving and ensuring the quality of nurses' contribution to FCs and promoting collaboration between nurses and other medical professionals.
Collapse
Affiliation(s)
- Tetsuharu Kawashima
- Department of Critical and Invasive-Palliative Care Nursing, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Makoto Tanaka
- Department of Critical and Invasive-Palliative Care Nursing, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Aki Kawakami
- Department of Critical and Invasive-Palliative Care Nursing, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Saori Muranaka
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, Japan
| |
Collapse
|
6
|
Lim JW, Shon EJ. The Dyadic Effects of Family Cohesion and Communication on Health-Related Quality of Life: The Moderating Role of Sex. Cancer Nurs 2019; 41:156-165. [PMID: 28114262 PMCID: PMC5519452 DOI: 10.1097/ncc.0000000000000468] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Spouses' ability to care for survivors can be particularly challenging because patients and spouses are interdependent and mutually influence one another. Family functioning such as family cohesion and communication may play a primary role in improving the health-related quality of life (HRQOL) of couples, given that cancer can influence family dynamics. OBJECTIVE The aims of this study were to investigate the mediating effect of family communication on the relationship between family cohesion and HRQOL and examine the moderating effect of sex on this relationship among cancer survivor-spouse dyads. METHODS A total of 91 cancer survivors with a diagnosis of breast, colorectal, or prostate cancer and their spouses were recruited from the University Hospital Registry in Cleveland, Ohio. The dyadic data were analyzed using structural equation modeling with the actor-partner interdependence mediation model. RESULTS Findings demonstrated that the spouses' own perceived family communication mediated the associations between their own family cohesion and physical HRQOL and between the survivors' family cohesion and physical HRQOL. The spouse actor effects between family communication and HRQOL significantly differed by sex. CONCLUSIONS Enhancing family cohesion and communication within the family can improve the spouses' HRQOL. Findings regarding sex differences serve as a rationale for gender-based approaches to improving HRQOL in survivorship care in the family context. IMPLICATIONS FOR PRACTICE Couple- and/or family-based interventions should be designed to enhance family cohesion and improve family communication skills for effective adjustments within couples and families. Supportive care within the family context can be promoted to address the diverse challenges of survivorship care.
Collapse
Affiliation(s)
- Jung-Won Lim
- Author Affiliations: College of Social Welfare, Kangnam University, Yongin, Gyeonggi, Korea (Dr Lim); and Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH (Ms Shon)
| | | |
Collapse
|
7
|
Powazki RD, Walsh D, Aktas A, Hauser K. Palliative Medicine Family Conferences Reduce Spokesperson Distress and Enhance Communication in Advanced Cancer. J Palliat Med 2018; 21:1086-1093. [DOI: 10.1089/jpm.2018.0143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ruth D. Powazki
- Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
- The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Declan Walsh
- Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Aynur Aktas
- Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
- The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Katherine Hauser
- Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
- The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
8
|
Blazin LJ, Cecchini C, Habashy C, Kaye EC, Baker JN. Communicating Effectively in Pediatric Cancer Care: Translating Evidence into Practice. CHILDREN-BASEL 2018. [PMID: 29534479 PMCID: PMC5867499 DOI: 10.3390/children5030040] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Effective communication is essential to the practice of pediatric oncology. Clear and empathic delivery of diagnostic and prognostic information positively impacts the ways in which patients and families cope. Honest, compassionate discussions regarding goals of care and hopes for patients approaching end of life can provide healing when other therapies have failed. Effective communication and the positive relationships it fosters also can provide comfort to families grieving the loss of a child. A robust body of evidence demonstrates the benefits of optimal communication for patients, families, and healthcare providers. This review aims to identify key communication skills that healthcare providers can employ throughout the illness journey to provide information, encourage shared decision-making, promote therapeutic alliance, and empathically address end-of-life concerns. By reviewing the relevant evidence and providing practical tips for skill development, we strive to help healthcare providers understand the value of effective communication and master these critical skills.
Collapse
Affiliation(s)
- Lindsay J. Blazin
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (L.J.B.); (E.C.K.)
| | - Cherilyn Cecchini
- Department of Pediatrics, Children’s National Medical Center, Washington, DC 20010, USA; (C.C); (C.H.)
| | - Catherine Habashy
- Department of Pediatrics, Children’s National Medical Center, Washington, DC 20010, USA; (C.C); (C.H.)
| | - Erica C. Kaye
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (L.J.B.); (E.C.K.)
| | - Justin N. Baker
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (L.J.B.); (E.C.K.)
- Correspondence: ; Tel.: +1-901-595-4446
| |
Collapse
|
9
|
Lim JW, Shon EJ. Decisional Conflict: Relationships Between and Among Family Context Variables in Cancer Survivors. Oncol Nurs Forum 2016; 43:480-8. [DOI: 10.1188/16.onf.480-488] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
10
|
Otis-Green S, Jones B, Zebrack B, Kilburn L, Altilio TA, Ferrell B. ExCEL in Social Work: Excellence in Cancer Education & Leadership: An Oncology Social Work Response to the 2008 Institute of Medicine Report. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:503-513. [PMID: 25146345 PMCID: PMC4339672 DOI: 10.1007/s13187-014-0717-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
ExCEL in Social Work: Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program's curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers--the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers.
Collapse
Affiliation(s)
- Shirley Otis-Green
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope National Medical Center, 1500 E. Duarte Rd., Duarte, CA, 91010, USA,
| | | | | | | | | | | |
Collapse
|
11
|
Dojeiji S, Byszewski A, Wood T. Development and pilot testing the Family Conference Rating Scale: A tool aimed to assess interprofessional patient-centred communication and collaboration competencies. J Interprof Care 2015; 29:415-20. [PMID: 26171866 DOI: 10.3109/13561820.2015.1039116] [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: 11/13/2022]
Abstract
There is a paucity of evidence-based literature on the essential communication and collaboration skills to guide health care teams in conducting and assessing their performance in the Family Conference (FC). The authors developed and collected validity evidence for a rating scale of team FC performance, the Family Conference Rating Scale (FCRS). In phase 1, essential FC communication and collaboration skills were identified through a review of existing communication tools and literature on team functioning; a draft 34-item scale was developed. In phase 2, the scale was narrowed to a 6-category, 9-point scale with descriptors of expected behaviours through an iterative process: testing of the scale on 10 FC transcripts by two experts, soliciting feedback from a focus group of seven health care providers, and testing by non-experts on 49 live FCs. In phase 3, scores on the revised scale were validated by 10 health care providers from different disciplines by rating three videos of FCs of variable quality. Raters were able to detect inter-video variation in FC quality. The reliability of the FCRS was 0.95 and the inter-rater reliability, 0.68. The FCRS may enhance the ability of health professions educators to teach and assess interprofessional patient-centred communication and collaboration competencies.
Collapse
Affiliation(s)
- Sue Dojeiji
- a Department of Medicine, Division of Physical Medicine and Rehabilitation , University of Ottawa , Ottawa , Ontario , Canada
| | - Anna Byszewski
- b Department of Medicine, Division of Geriatric Medicine , University of Ottawa , Ottawa , Ontario , Canada , and
| | - Tim Wood
- c Department of Innovation in Medical Education , University of Ottawa , Ottawa , Ontario , Canada
| |
Collapse
|
12
|
Daly MB. A Family-Centered Model for Sharing Genetic Risk. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2015; 43:545-551. [PMID: 26479564 PMCID: PMC4617664 DOI: 10.1111/jlme.12297] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The successes of the Human Genome Project have ushered in a new era of genomic science. To effectively translate these discoveries, it will be critical to improve the communication of genetic risk within families. This will require a systematic approach that accounts for the nature of family relationships and sociocultural beliefs. This paper proposes the application of the Family Systems Illness Model, used in the setting of cancer care, to the evolving field of genomics.
Collapse
Affiliation(s)
- Mary B. Daly
- Chair, Department of Clinical Genetics, Timothy R. Talbot Jr. Chair for Cancer Research, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, 609-397-9112 (home), 908-304-2236 (cell), 215-728-2791 (work), 215-214-3999 (fax)
| |
Collapse
|
13
|
Abstract
A family conference (FC) is an opportunity for the family and their physician to share their knowledge and concerns about the physical and psychosocial dimensions of care. Appropriate communication principles and practice are both important for an effective FC. The FCs guided by common sense principles and sound clinical practice (good structure, content, and process) have beneficial outcomes. (1) Creation of a therapeutic partnership so the family and medical team collaborate in the difficult task of sophisticated medical and psychosocial care of a complex illness. (2) Enhanced therapeutic management through education and support of the patient and primary caregiver (and other family members) to facilitate self-efficacy and convey realistic hope with careful sequencing of key messages. (3) Easier patient transitions from cure- to care-oriented management, with a formal (yet thoughtful and gentle) introduction to the principles and practice of modern palliative medicine.
Collapse
Affiliation(s)
- Ruth D. Powazki
- Department of Solid Tumor Oncology, Cleveland Clinic, Taussig Cancer Institute, OH, USA
- Cleveland Clinic, The Harry R. Horvitz Center for Palliative Medicine, Cleveland, OH, USA
| | - Declan Walsh
- Department of Solid Tumor Oncology, Cleveland Clinic, Taussig Cancer Institute, OH, USA
- Cleveland Clinic, The Harry R. Horvitz Center for Palliative Medicine, Cleveland, OH, USA
| |
Collapse
|
14
|
The relationship between communication and health-related quality of life in survivorship care for Chinese-American and Korean-American breast cancer survivors. Support Care Cancer 2012; 21:1157-66. [PMID: 23111944 DOI: 10.1007/s00520-012-1641-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 10/16/2012] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The purpose of this study was (1) to compare family communication, decision support (i.e., supporting the patient in making decisions), self-efficacy in patient-physician communication (i.e., patients' confidence level in communicating with physicians), and health-related quality of life (HRQOL) between Chinese-American and Korean-American breast cancer survivors (BCS) and (2) to investigate how family communication, decision support, and self-efficacy in patient-physician communication influence HRQOL for Chinese-American and Korean-American BCS. METHODS A cross-sectional design was used. A total of 157 Chinese-American (n = 86) and Korean-American (n = 71) BCS were recruited from the California Cancer Surveillance Program and area hospitals in Los Angeles County. The chronic care model was utilized. RESULTS Chinese-Americans and Korean-Americans showed a significant difference in the decision support only. Self-efficacy in patient-physician communication was directly associated with HRQOL for Chinese-Americans, whereas for Korean-Americans, family communication was related to HRQOL. The mediating effects of decision support and self-efficacy in physician-patient communication in the relationship between family communication and HRQOL were observed for Chinese-Americans only. Multiple group analysis demonstrated that the structural paths varied between Chinese-American and Korean-American BCS. CONCLUSIONS Our results provide insight into the survivorship care of Chinese-American and Korean-American BCS, allowing a better understanding of communication among survivors, family, and healthcare providers. Communication skills to manage conflict and attain consensus among them under the cultural contexts are essential to improve HRQOL for BCS.
Collapse
|
15
|
Given BA, Sherwood P, Given CW. Support for Caregivers of Cancer Patients: Transition After Active Treatment. Cancer Epidemiol Biomarkers Prev 2011; 20:2015-21. [DOI: 10.1158/1055-9965.epi-11-0611] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|