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Tulpin M, Scherrens AL, Van Driessche A, Verhofstadt LL, Kreicbergs U, Goubert L, Beernaert K. "A sincere 'how are you?' is already a sign of acknowledgement that you're there too." - Interview study on the support needs of adolescents and young adults (AYAs) living with a parent with cancer. Eur J Oncol Nurs 2024; 70:102602. [PMID: 38810585 DOI: 10.1016/j.ejon.2024.102602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 04/04/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE Parental cancer brings changes and challenges which affect the whole family. Evidence shows heightened psychosocial risk among the offspring. Research among adolescents and young adults (AYAs) facing parental cancer has mainly focused on these psychosocial problems. As a reaction, there has been an increase in research on the needs of this population, since this knowledge is crucial for developing appropriate support. Despite this increase, some AYAs are still underrepresented, namely those over eighteen years old and those who have a parent with incurable cancer. Moreover, the factors hampering or fostering access to and receipt of support addressing their needs are under-investigated. Increasing our understanding of these issues is crucial to developing more effective support interventions for these young people. Our aim was therefore to gain insight into the perceived support needs of AYAs who have a parent with cancer, including the mentioned underrepresented subgroups, and the perceived factors facilitating or hindering their use of support. METHODS We conducted semi-structured interviews with 17 AYAs who have a parent with cancer of any type and stage, which were analyzed using conventional Qualitative Content Analysis (QCA). RESULTS Six main categories emerged from the data, encompassing various subcategories: 1) Needs surrounding the time of disclosure, 2) Information needs, 3) Informal support needs, 4) Need for effective personal coping strategies, 5) Formal support needs, and 6) Contextual and medical factors affecting support needs. AYAs perceived family members, friends and teachers as important sources of informal support, but lacked contact with peers who also have a parent with cancer. They expressed a need for formal informational and emotional support from their parent's medical team, (onco)psychologists, and their general practitioner. AYAs faced barriers in accessing formal support. A proactive attitude from healthcare providers and information about available support would help them meet their needs. Furthermore, we shed new light on needs and issues in post-secondary education. CONCLUSIONS AYAs who are living with their parent with cancer experience informational, emotional, and practical needs in multiple contexts, such as the home, school, leisure and hospital environment. They identify their informal and formal network as important key figures in addressing these needs.
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Affiliation(s)
- Marthe Tulpin
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium; End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium & Ghent University, Ghent, Belgium.
| | - Anne-Lore Scherrens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium & Ghent University, Ghent, Belgium
| | - Anne Van Driessche
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium & Ghent University, Ghent, Belgium
| | - Lesley L Verhofstadt
- Family Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ulrika Kreicbergs
- Population, Policy & Practice Department, University College London, London, United Kingdom
| | - Liesbet Goubert
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Kim Beernaert
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium & Ghent University, Ghent, Belgium
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Fisher CL, Campbell-Salome G, Bagautdinova D, Wright KB, Forthun LF, Bacharz KC, Mullis MD, Wolf B, Pereira DB, Spiguel L, Bylund CL. Young Adult Caregiving Daughters and Diagnosed Mothers Navigating Breast Cancer Together: Open and Avoidant Communication and Psychosocial Outcomes. Cancers (Basel) 2023; 15:3864. [PMID: 37568680 PMCID: PMC10417340 DOI: 10.3390/cancers15153864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 01/01/1970] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
For many diagnosed mothers and their daughters, breast cancer is a shared experience. However, they struggle to talk about cancer. This is particularly true when the daughter is in adolescence or young adulthood, as they tend to be more avoidant, which is associated with poorer biopsychosocial outcomes. When daughters are their mother's caregivers, daughters' burden and distress are heightened. Young adult caregiving daughters (YACDs) are the second most common family caregiver and encounter more distress and burden than other caregiver types. Yet, YACDs and their diagnosed mothers receive no guidance on how to talk about cancer. Thirty-nine mother/YACD pairs participated in an online survey to identify challenging topics and strategies for talking about cancer, and to explore associations between openness/avoidance and psychosocial outcomes. YACDs and mothers reported the same challenging topics (death, treatment-related issues, negative emotions, relational challenges, YACDs' disease risk) but differed on why they avoided the topic. YACDs and mothers identified the same helpful approaches to navigate conversations (openness, staying positive, third-party involvement, avoidance). Avoidance was correlated with more distress whereas openness was correlated with better psychosocial outcomes. These results provide a psychosocial map for a mother-YACD communication skills intervention, which is key to promoting healthy outcomes.
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Affiliation(s)
- Carla L. Fisher
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (M.D.M.); (C.L.B.)
| | | | - Diliara Bagautdinova
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL 32611, USA;
| | - Kevin B. Wright
- Department of Communication, College of Humanities and Social Sciences, George Mason University, Fairfax, VA 22030, USA;
| | - Larry F. Forthun
- Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL 32611, USA;
| | - Kelsey C. Bacharz
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA; (K.C.B.); (D.B.P.)
| | - M. Devyn Mullis
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (M.D.M.); (C.L.B.)
| | - Bianca Wolf
- Department of Communication Studies, University of Puget Sound, Tacoma, WA 98416, USA;
| | - Deidre B. Pereira
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA; (K.C.B.); (D.B.P.)
| | - Lisa Spiguel
- Department of Surgery, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Carma L. Bylund
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (M.D.M.); (C.L.B.)
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Geertz W, Frerichs W, Inhestern L, Bergelt C. Supportive and psychosocial peer-group interventions for children and adolescents of parents with cancer: A systematic review. PATIENT EDUCATION AND COUNSELING 2023; 114:107844. [PMID: 37331281 DOI: 10.1016/j.pec.2023.107844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Children and adolescents are highly affected by their parents` cancer disease. This review aims to summarize peer-group interventions for children and adolescents of cancer patients, where those affected have the opportunity to exchange and normalize their feelings among equals. METHODS A systematic review searching four different databases (MEDLINE, PsycInfo, CINAHL and Web of Science) was conducted. We included studies investigating psychosocial peer-group interventions for offspring of cancer patients. A narrative synthesis summarised the characteristics of the interventions and the findings on effects and evaluation. RESULTS Ten articles on seven different peer-group interventions were analysed. Research designs and intervention concepts were heterogeneous. Overall, high acceptance, feasibility and positive effects of peer-group support were reported. Significant effects were found in six studies, e.g. in relation to psychological well-being, quality of life and coping skills. CONCLUSION Peer-group interventions are an accepted and helpful form of support. Providing children and adolescents of cancer patients for example with psychoeducation, community and coping strategies, thereby impacting on psychological well-being. PRACTICE IMPLICATIONS For comprehensive care, it seems to be important to offer support throughout the parent's cancer journey and to offer support flexibly as needed through group services as well as individual sessions.
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Affiliation(s)
- Wiebke Geertz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Wiebke Frerichs
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Medical Psychology, University Medicine Greifswald, Germany
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Allison KR, Patterson P, McDonald FE, Bibby K, Ciarrochi J, Tracey D, Hayes LL, Wright A, Konings S, Davis E, Hulbert-Williams NJ, Wakefield CE, White K. Truce: Feasibility and acceptability of an Acceptance and Commitment Therapy-based intervention for adolescents and young adults impacted by parental cancer. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Mjøsund NH, Eide T, Kufås E, Faugli A, Eilertsen G. Mental health promotion as perceived by Norwegian adolescents with somatically ill parents - an interpretative phenomenological analysis. Health Psychol Behav Med 2023; 11:2213298. [PMID: 37201175 PMCID: PMC10187081 DOI: 10.1080/21642850.2023.2213298] [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: 04/12/2022] [Accepted: 05/03/2023] [Indexed: 05/20/2023] Open
Abstract
Objective Having a somatically ill parent can influence adolescents' daily lives and mental health. This study aimed to explore the lived experiences of mental health promotion among adolescents with a somatically ill parent, based on a salutogenic orientation. Methods Individual interviews with 11 adolescents (13-18 years of age) with a somatically ill parent were conducted. The data were analysed according to interpretative phenomenological analysis. Results A superordinate theme, feeling at home in a house of mental health-promoting conversations, frames the participants' perceptions of a prominent mental health promotion experience, including decisive characteristics of the significant conversation partners and different important conversation contexts. The metaphor of feeling at home expresses that the participants ascribe the conversations taking place there as promoting mental health. The themes elucidate the superordinate theme: (a) significant conversation partners characterised by the three subthemes: (i) being available, (ii) being competent and (iii) being caring and (b) rooms reflecting conversation contexts containing four subthemes: (i) room of increased knowledge, (ii) room of disclosure, (iii) room for meeting points and (iv) room for breaks. Conclusion Adolescents with a somatically ill parent perceived that conversations about important topics with significant others with special characteristics in distinct contexts promoted mental health.
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Affiliation(s)
- Nina Helen Mjøsund
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
- Nina Helen Mjøsund Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, NO3004, Norway
| | - Torill Eide
- University of South-Eastern Norway – Campus Drammen, Drammen, Norway
| | - Elin Kufås
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Anne Faugli
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Grethe Eilertsen
- University of South-Eastern Norway – Campus Drammen, Drammen, Norway
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Granrud MD, Sandsdalen T, Anderzén-Carlsson A, Steffenak AKM. Public health nurses’ experiences working with children who are next of kin: a qualitative study. BMC Health Serv Res 2022; 22:1427. [PMCID: PMC9703408 DOI: 10.1186/s12913-022-08841-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/16/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
There are a substantial number of children who are the next of kin of parents suffering from illness or substance abuse. These children can experience emotional and behavioral problems and may need support from professionals. In Norway, the specialist health service in hospitals is required to have a designated practitioner in each department to ensure support for and follow up of children who are next of kin; however, this is not regulated by law in the health care in the municipalities. The aim of this study was to explore public health nurse’s experiences working with children who are next of kin.
Methods
Qualitative interviews were conducted with 10 public health nurses working in the child health clinic and the school health service in four municipalities. Data were analysed using content analysis. Reporting of this study is conducted in accordance to COREQ’s checklist.
Results
The analysis resulted in one main theme: ‘Lack of guidelines and routines among public health nurses working with children who are next of kin’. The main theme consisted of four categories: (1) identifying children who are next of kin are incidental; (2) public health nurses must be observant and willing to act; (3) communication is an important tool; and (4) follow up over time is not always provided.
Conclusion
The public health nurses experienced uncertainty concerning how to identify and follow up children who are next of kin but were vigilant and willing to act in the children’s best interest. Doing so necessitated collaboration with other professionals. The need for guidelines around the role and responsibilities for the public health nurse were emphasized. The knowledge provided by the current study offers valuable insight into strengths and limitations in the support of children who are next of kin and can inform stakeholders in organizing sustainable support for this group.
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Fisher CL, Kastrinos A, Curley A, Canzona MR, Piemonte N, Wolf B, Pipe T. Helping Diagnosed Mothers and Their Adolescent-Young Adult Daughters Navigate Challenging Breast Cancer Conversations. CANCER CARE RESEARCH ONLINE 2022; 2:e025. [PMID: 38239410 PMCID: PMC10795856 DOI: 10.1097/cr9.0000000000000025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Background Mothers diagnosed with breast cancer describe daughters as a critical source of support. Talking about breast cancer is especially distressing and challenging for mothers and their adolescent-young adult (AYA) daughters. Objective The over-arching study aim was to generate findings to integrate into an intervention to enhance diagnosed mothers' and AYA daughters' communication skills by identifying approaches they find helpful when talking about cancer. Methods We recruited 27 women (12 dyads). Diagnosed mothers and their AYA daughters (aged 18-29) participated in individual, in-depth, semi-structured interviews. Transcripts were thematically analyzed. Mothers'/daughters' perspectives were compared/ triangulated. Results Both mothers and daughters identified 3 approaches that helped them navigate cancer communication: (mothers) initiate conversations, keep communication positive, and limit cancer conversations. Only mothers reported it was helpful to downplay the seriousness of cancer. Only daughters identified it was important for them to reframe their perspective of mothers' disclosures. Conclusions Findings provide clinicians like nurses and families with a "psychosocial map" of communication approaches and associated strategies mothers and AYA daughters can use to talk about breast cancer in ways that promote daughters' comfort and/or alleviate distress. Implications for Practice Findings capture communication skills to focus on when tailoring developmentally focused interventions targeting diagnosed mothers and AYA daughters. Nurses can translate findings into practice to help patients talk to AYA daughters about cancer, thereby promoting a family-centered cancer care approach. What Is Foundational: AYA daughters are especially distressed talking about cancer with their diagnosed mothers. They can both use communication strategies to enhance their communal coping.
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Affiliation(s)
- Carla L. Fisher
- University of Florida, College of Journalism and Communications & College of Medicine, UF Health Cancer Center, Gainesville, Florida
| | | | - Alana Curley
- University of Florida, College of Journalism and Communications & College of Medicine, UF Health Cancer Center, Gainesville, Florida
| | - Mollie R. Canzona
- Wake Forest University, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nicole Piemonte
- Creighton University, School of Medicine, Phoenix Regional Campus, Phoenix, Arizona
| | - Bianca Wolf
- University of Puget Sound, Tacoma, Washington
| | - Teri Pipe
- Arizona State University, Phoenix, Arizona
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Hauskov Graungaard A, Hafting M, Davidsen AS, Lykke K. How is my child doing - parental understanding of their children when a parent has cancer. J Psychosoc Oncol 2021; 41:43-58. [PMID: 34961424 DOI: 10.1080/07347332.2021.2013386] [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: 01/31/2023]
Abstract
To explore the difficulties parents face when understanding their children's reactions to parental cancer and parents' reactions to their children's perceived needs. Qualitative interviews with cancer patients and their partners. Eleven patients and seven partners took part. Their children were aged 1-15 years. Eight patients were mothers and cancer was diagnosed median 28 (7-104) months ago. Inductive analysis with systematic text condensation. Parents were groping in the dark when understanding their children's reactions. They observed signs of distress in their children, but often avoided communication about emotional reactions. We suggest parental difficulties in containing own and children's emotions as an important cause for this situation. Parents lacked relevant support offers for the family as a unit. Identification of children's difficulties cannot be based on parental evaluation alone. We suggest family support as part of standard care for patients with minor children.
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Affiliation(s)
- Anette Hauskov Graungaard
- Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Denmark
| | | | - Annette Sofie Davidsen
- Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Kirsten Lykke
- Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Denmark
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Knutsson S, Golsäter M, Enskär K. The meaning of being a visiting child of a seriously ill parent receiving care at the ICU. Int J Qual Stud Health Well-being 2021; 16:1999884. [PMID: 34775932 PMCID: PMC8604516 DOI: 10.1080/17482631.2021.1999884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/25/2020] [Accepted: 10/26/2021] [Indexed: 10/30/2022] Open
Abstract
PURPOSE Children's visits to the ICU are still restricted, and more focus on the child's own needs and experiences are needed. The aim of this study is to illustrate the meaning of being a visiting child of a seriously ill parent receiving care at the ICU. METHOD A qualitative descriptive design was used, with open-ended interviews with seven children (6-18 years) performed and analysed using a phenomenological research approach. FINDINGS Being a visiting child of a seriously ill parent receiving care at the ICU is described as a life situation taking place in an unfamiliar environment, characterized by a heartfelt, genuine desire to be there, in an interdependence entailing offering a loved one the help they need while at the same time being seen in a compassionate way and being able to share, revealing a sudden awakening of an inner truth of reality and a sense of a healing wisdom of understanding. CONCLUSIONS The children felt good when they visited their ill parent, but at the same time not fully involved, and desired a more compassionate, caring approach by the nurses. Improvements are needed in how to approach visiting children in a more individual and caring way.
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Affiliation(s)
- Susanne Knutsson
- Child, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Marie Golsäter
- Child Health Services, Region Jönköping County, Jönköping, Sweden; and Department of Health, Medicine and Caring, Linköping University, Linköping, Sweden
| | - Karin Enskär
- Department of Women´s and Children´s health, Malmö University, Malmö, Sweden
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Steffenak AKM, Anderzén-Carlsson A, Opheim E, Sandsdalen T. Community-based support for children who are next-of-kin for a parent experiencing illness or disability - a scoping review. BMC Health Serv Res 2021; 21:1250. [PMID: 34798870 PMCID: PMC8603592 DOI: 10.1186/s12913-021-07270-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Children who are next-of-kin, for a parent who experience illness or disability, need support. In Norway, guidelines, routines and structured approaches in the community health services are lacking regarding involving children in the care of a parent and for services when supporting children as next-of-kin. Additionally, no existing international review has focused on support from community health and social services for children who are next-of-kin to a parent regardless of the specific illness or disability. Aims This scoping review examined the current knowledge regarding the types of community health and social services support to children 0 to 17 years old living with a parent experiencing illness or disability. The review also identified children’s support preferences and needs. Methods The scoping review involved five stages; identifying research question; identifying relevant articles; selecting articles; charting the data and finally, collating, summarizing and reporting the results. Results Articles which included community health and social services interventions and children’s preferences or needs for support were included. The foci of interventions included preventive education, peer support, psychosocial support, and interventions focusing on family communication and recovery planning. Articles focusing on children’s preferences or need for support described their wish to be recognized as a next-of-kin, having someone to talk to and professional and peer support. Conclusion The review highlighted the importance of children receiving support according to their preferences. It is important to elicit children’s voices, to ensure community health and social services are developed for and tailored to this population.
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Affiliation(s)
| | - Agneta Anderzén-Carlsson
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Elin Opheim
- Inland Norway University of Applied Sciences, Faculty of Health and Social Sciences, Elverum, Norway
| | - Tuva Sandsdalen
- Inland Norway University of Applied Sciences, Faculty of Health and Social Sciences, Elverum, Norway
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Illness unpredictability and psychosocial adjustment of adolescent and young adults impacted by parental cancer: the mediating role of unmet needs. Support Care Cancer 2021; 30:145-155. [PMID: 34241699 PMCID: PMC8636435 DOI: 10.1007/s00520-021-06379-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/19/2021] [Indexed: 11/14/2022]
Abstract
Purpose Given the large number of adolescents and young adults (AYAs) impacted by parental cancer and the potential for negative psychosocial outcomes in this vulnerable population, this study examined the mediating role of offspring unmet needs with regard to parental cancer and the relation between AYAs psychosocial adjustment and perceived illness unpredictability. Methods A total of 113 AYAs (aged 11–24 years) living with a parent diagnosed with cancer completed a questionnaire assessing illness unpredictability, offspring unmet needs, and psychosocial adjustment (i.e., health-related quality of life and internalizing problems). Results Higher offspring unmet needs were associated with lower health-related quality of life (r = –0.24**) and higher internalizing problems (r = 0.21*). Offspring unmet needs mediated the relation between illness unpredictability and health-related quality of life (standardized indirect effect = –0.100* [–0.183, –0.018]) but not internalizing problems (standardized indirect effect = 0.067 [–0.015, 0.148]). In particular, higher illness unpredictability was related to higher unmet needs (β = 0.351**) which, in turn, predicted lower health-related quality of life (β = –0.286**). Conclusion These findings identify offspring unmet needs and illness unpredictability as implicated in AYAs positive psychosocial adjustment to parental cancer. Given that AYAs are at greater risk of elevated psychosocial difficulties, interventions should target offspring unmet needs and perception of illness unpredictability to mitigate the adverse effects of parental cancer.
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Eide T, Faugli A, Kufås E, Mjøsund NH, Eilertsen G. Mental health as perceived by Norwegian adolescents living with parental somatic illness: Living in an earthquake zone. Int J Qual Stud Health Well-being 2021; 15:1783064. [PMID: 32597347 PMCID: PMC7482674 DOI: 10.1080/17482631.2020.1783064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose Severe parental somatic illnesses can influence the entire family, including adolescents’ everyday life, psychosocial functioning and health. Within salutogenesis, it is highlighted that stressor life events, such as parental somatic illness, might lead to a chain of events that can produce tension. There is a lack of in-depth understanding regarding how adolescents living in a situation with a severely somatically ill parent (SIP) perceive their own mental health. The aim of this study was therefore to explore the lived experience of Norwegian adolescents living with an SIP, and their perception of the parental illness’ influence on their mental health. Methods Interpretative phenomenological analysis was used. In-depth interviews were conducted with 11 adolescents (aged 13–18 years) who had an SIP. Two adolescents with an SIP participated in study preparation and data analysis. Results Adolescents perceived parental somatic illness as a multifaceted influence on their mental health as it represented both personal and relational strain and growth. Their perceptions can be conceptualized by the super-ordinate theme “living in an earthquake zone”, and by two themes, “inner shakes—but not falling apart” and “relational aftershocks—gains and losses”. Conclusion For adolescents, parental somatic illness means personal and relational strain and growth.
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Affiliation(s)
- Torill Eide
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway , Drammen, Norway
| | - Anne Faugli
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust , Drammen, Norway
| | - Elin Kufås
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust , Drammen, Norway
| | - Nina Helen Mjøsund
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust , Drammen, Norway
| | - Grethe Eilertsen
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway , Drammen, Norway
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Chin JC, Lin MH. Children's experiences of living with maternal breast cancer: A qualitative study. J Adv Nurs 2021; 77:3446-3457. [PMID: 33905553 DOI: 10.1111/jan.14866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/12/2021] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Abstract
AIMS To investigate the experiences of Taiwanese school-aged children coping with maternal breast cancer. DESIGN A qualitative interview study. METHODS A cohort of 10 boys and 12 girls aged 6 to 13 years (mean age, 9.86 years) whose mothers were diagnosed with breast cancer in the last 2 years were recruited from patient networks in Taiwan. Data were collected from February to June 2019 via semi-structured individual interviews. Their responses were subjected to content analysis. RESULTS Content analysis yielded six themes: (1) reluctance to share feelings with others; (2) recognizing changes in the tone of family life; (3) casting the cause of breast cancer onto oneself; (4) engaging in active coping; (5) maturing and gaining life lessons; and (6) family communication matters. CONCLUSION The findings shed light on how family processes and cultural beliefs shape children's experiences. School-aged children came to terms with the significance of maternal breast cancer from a broad context of family experiences over time, and thus gained insights into their self-expectations and future aspirations. IMPACT Healthcare professionals can help school-aged children develop a rational view of breast cancer pathogenesis. In addition, we suggest nursing interventions to support a family-oriented approach to coping. Such interventions should address changes in family processes to improve coping abilities of children and the entire family.
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Affiliation(s)
- Jui-Chih Chin
- Department of Early Childhood Education, University of Taipei, Taipei City, Taiwan
| | - Miao-Hui Lin
- Department of Early Childhood Education, National University of Tainan, Tainan, Taiwan
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Marín-Chollom AM, Revenson TA. Cultural values as a resilience resource for Latino/a adolescents and young adults coping with parental cancer. J Psychosoc Oncol 2021; 40:26-44. [PMID: 33576717 DOI: 10.1080/07347332.2021.1881197] [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: 10/22/2022]
Abstract
Purpose: Although research on how adolescents and young adults (AYAs) cope with their own cancer is expanding, there is little knowledge on how AYAs cope with a parent's cancer. And, thus, little evidence-based knowledge for how to deliver services. Moreover, most research has been with majority White populations. To fill this gap, we examined whether the cultural values of familismo (familism) and espíritu (spirit) moderate the association between stress appraisals and coping with psychological distress among Latino/AYAs facing a parent's cancer.Design: Cross-sectional, observational.Sample: Thirty eight adolescents and young adults between the ages of 12 and 25 whose mother had breast cancer.Methods: Participants completed standardized measures. Generalized estimating equation analysis was used to analyze the nested data.Results: There was a protective pattern of familismo and espíritu against symptoms of depression. AYAs experienced psychological distress, but those with higher levels of familismo and espíritu fared better than those with lower levels, regardless of the coping strategies they used.Implications: Psychosocial interventions for Latino/a AYAs coping with parental cancer should incorporate or strengthen these values.
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Affiliation(s)
- Amanda M Marín-Chollom
- Department of Psychological Science, Central Connecticut State University, New Britain, Connecticut, USA
| | - Tracey A Revenson
- Department of Psychology, Hunter College, New York, New York, USA.,Psychology, The Graduate Center, City University of New York, New York, New York, USA
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15
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Golsäter M, Knutsson S, Enskär K. Children's experiences of information, advice and support from healthcare professionals when their parent has a cancer disease - experiences from an oncological outpatient department. Eur J Oncol Nurs 2021; 50:101893. [PMID: 33465701 DOI: 10.1016/j.ejon.2020.101893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/01/2020] [Accepted: 12/24/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE This study was carried out in order to evaluate children's experiences after taking part in the pilot clinical intervention "See Me" aimed at supporting children as relatives. METHOD A qualitative explorative design with interviews was chosen, with analyses using an inductive approach. Interviews were conducted with 19 children (9 aged 7-12 years and 10 aged 13-18 years). The younger children were asked to draw a picture of a person in hospital, using the Child Drawing: hospital (CD:H) instrument to measure the child's level of anxiety. The older children completed the Caring Professional Scale (CPS) as a measure of the caring approach in their encounter with the nurse. RESULTS The interviews with the children show that: they felt expected and welcomed at the hospital; they needed knowledge about their parent's situation; they needed information and participation based on their individual situation; and they needed the nurse to offer them information and support. The results from the pictures showed that one child had above-average levels of anxiety. The older children reported that the nurses were Competent Practitioners, but to a lesser degree that they were Compassionate Healers. CONCLUSIONS The results of this pilot study indicate that the structure of "See Me" could be used as a starting point to ensure that children as relatives receive information, advice, and support. Further the results indicate that both CD:H and CPS could be used to evaluated children's experiences of support when a parent has a long-term illness.
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Affiliation(s)
- Marie Golsäter
- CHILD, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden and Linköping University, Linköping, Sweden.
| | - Susanne Knutsson
- CHILD, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Karin Enskär
- CHILD, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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16
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Khanjari S, Mianji M, Hakim Shooshtari M, Haghani H. Impact of Coping Skills Training on the Quality of Life Among the Daughters of Mothers with Breast Cancer. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2020; 8:333-344. [PMID: 33178856 PMCID: PMC7648854 DOI: 10.30476/ijcbnm.2020.83048.1132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Background Cancer affects the quality of life (QoL) of patients and their families. The purpose of this study was to determine the effect of coping skills training on the QoL among daughters of mothers with breast cancer. Methods In this quasi-experimental pre-test/post-test design, data were collected from 70 participants (35 in each of the control and education groups) from January 2016 to July 2017 in Imam Khomeini and Rasole-e-Akram Hospitals in Tehran. The education group participated in a workshop and group discussion (groups of 5 to 8 participants) with the presence of a pediatric psychiatrist and two pediatric nurses, and then a follow up program was performed. The Pediatric Quality of Life Inventory version 4.0 was used in this study in two stages of pre-test (before education) and post-test (four weeks later). Data were analyzed through SPSS, version 21 using independent t-test and paired t-test for comparison of the mean scores of the two groups, with the significance level of 0.05. Results After the education, there were significantly improved scores of the QoL in the dimensions of physical functioning (P<0.001), emotional functioning (P<0.001), and school functioning (P<0.001) in the study group compared to the control group. The social functioning did not show a significant change (P<0.083). Conclusion The findings of the study confirm that coping skills training can lead to the improvement of QoL in adolescent daughters of mothers with breast cancer. Healthcare professionals must provide the mothers and daughters with information about breast cancer and instruments to handle their situation to promote the daughters' QoL.
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Affiliation(s)
- Sedigheh Khanjari
- Nusing Care Research Center, Department of Pediatrics, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Mianji
- Department of Pediatrics, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Hakim Shooshtari
- Mental Health Research Center, Tehran Institute of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Haghani
- Biostatistics, School of Management and Information Technology, Iran university of Medical Sciences, Tehran, Iran
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Shands ME, Lewis FM. Parents With Advanced Cancer: Worries About Their Children's Unspoken Concerns. Am J Hosp Palliat Care 2020; 38:920-926. [PMID: 33107327 DOI: 10.1177/1049909120969120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Parents with advanced cancer struggle initiating conversations with their children about the cancer. When parents do not have the tools to talk with their children, they silently watch their children attempt to navigate their illness but can only wonder but not know what their children are thinking. The objective of the current study is to describe, from parents living with advanced cancer, the worries and concerns parents wonder their child holds, but has not spoken, about the parent's cancer. METHODS Twenty-seven parents with incurable cancer enrolled in a 5 session telephone intervention pilot study during which they were asked, "What questions do you have about what your child is thinking or feeling about the cancer?" Data were transcribed and inductively coded using content analysis methods adapted from grounded theory. RESULTS Analysis yielded 14 categories of parent concerns organized into 6 larger conceptual domains: Being Concerned and Scared about My Cancer; Worrying about Me; Changing How We Talk and Live Day-to-Day; Not Knowing What Will Happen; Having Unanswered Questions about My Cancer; and Understanding My Disease Is Terminal. CONCLUSIONS Study results add to our understanding of the magnitude of the emotional burden parents with advanced cancer carry as they struggle to balance their diagnosis and treatment and their life as parents.
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Konings S, McDonald FEJ, Patterson P. Supporting parents impacted by cancer: Development of an informational booklet for parents with cancer who have adolescent and young adult children. Psychooncology 2020; 29:2101-2104. [PMID: 32658378 DOI: 10.1002/pon.5475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 11/12/2022]
Affiliation(s)
| | - Fiona E J McDonald
- Canteen Australia, Sydney, New South Wales, Australia.,Cancer Nursing Research Unit, The University of Sydney, Sydney, New South Wales, Australia
| | - Pandora Patterson
- Canteen Australia, Sydney, New South Wales, Australia.,Cancer Nursing Research Unit, The University of Sydney, Sydney, New South Wales, Australia
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19
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Eklund R, Kreicbergs U, Alvariza A, Lövgren M. Children's Self-Reports About Illness-Related Information and Family Communication When a Parent Has a Life-Threatening Illness. JOURNAL OF FAMILY NURSING 2020; 26:102-110. [PMID: 31931660 DOI: 10.1177/1074840719898192] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Children's experiences of information and family communication when a parent has a life-threatening illness have been sparsely studied, though such information is important for the child's wellbeing. The aim of this study was to explore children's reports of illness-related information and family communication when living with a parent with a life-threatening illness. Forty-eight children, aged 7 to 19 years, were recruited from four specialized palliative home care units in Stockholm, Sweden. All but one child reported that someone had told them about the parent's life-threatening illness; however, two thirds wanted more information. A quarter of the teenagers reported that they had questions about the illness that they did not dare to ask. Half of the children, aged 8 to 12, reported that they felt partially or completely unable to talk about how they felt or show their feelings to someone in the family. Interventions are needed that promote greater family communication and family-professional communication.
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Affiliation(s)
- Rakel Eklund
- Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Ulrika Kreicbergs
- Ersta Sköndal Bräcke University College, Stockholm, Sweden
- The Department of Women's and Children's Health, Paediatric Oncology and Haematology, Karolinska Institute, Stockholm, Sweden
| | - Anette Alvariza
- Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Capio Palliative Care, Dalen Hospital, Stockholm, Sweden
| | - Malin Lövgren
- Ersta Sköndal Bräcke University College, Stockholm, Sweden
- The Department of Women's and Children's Health, Paediatric Oncology and Haematology, Karolinska Institute, Stockholm, Sweden
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20
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Fletcher C, Wilson C, Flight I, Gunn K, Patterson P. Illness Cognitions Among Adolescents and Young Adults Who Have a Parent with Cancer: a Qualitative Exploration Using the Common-Sense Model of Self-regulation as a Framework. Int J Behav Med 2019; 26:531-541. [PMID: 31161590 DOI: 10.1007/s12529-019-09793-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Individuals construct beliefs about an illness based on their own perceptions, interpretation, and understanding of the illness and its treatment. These beliefs (collectively referred to as "illness cognitions" or "representations") can have implications for psychological outcomes in family members and carers of an individual with an illness. The aim of this study was to explore young people's perceptions of their parent's cancer using the Common-Sense Model of Self-Regulation as a theoretical framework. METHODS Semi-structured, one-on-one interviews were conducted with young people who had a parent diagnosed with cancer. Interview transcripts were analysed using deductive thematic analysis techniques. RESULTS Eleven young people aged 15-24 years participated in the study. Major themes aligned with the dimensions of the Common-Sense Model of Self-Regulation. Young people described their experiences with parental cancer with reference to cognitive representations (beliefs about the illness identity, their understanding or coherence of the illness, and consequences, curability or controllability, timeline, and cause of the illness) and emotional representations (emotional beliefs and subjective feelings about the illness). CONCLUSIONS Findings indicate that young people's perceptions of their parent's cancer can be usefully described within the framework of the Common-Sense Model of Self-Regulation. Future research should investigate the relationships between young people's illness cognitions, coping strategies, and psychological adjustment following their parent's cancer diagnosis. This will provide valuable insights for the development of interventions that target specific types of illness cognitions associated with maladaptive coping strategies and poor adjustment.
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Affiliation(s)
- Chloe Fletcher
- Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia.
| | - Carlene Wilson
- Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia.,Olivia Newton-John Cancer Wellness and Research Centre, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Ingrid Flight
- Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia
| | - Kate Gunn
- Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia.,University of South Australia Cancer Research Institute, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia
| | - Pandora Patterson
- CanTeen Australia, 75 King Street, Newtown, NSW, 2042, Australia.,Cancer Nursing Research Unit, University of Sydney, Camperdown, NSW, 2006, Australia
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21
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Weeks N, McDonald FEJ, Patterson P, Konings S, Coad J. A summary of high quality online information resources for parents with cancer who have adolescent and young adult children: A scoping review. Psychooncology 2019; 28:2323-2335. [PMID: 31709669 DOI: 10.1002/pon.5274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Parents with cancer want information about maintaining family functioning despite cancer. This scoping review assesses what online information resources are available to help parents with cancer maintain family functioning, the quality of the available information, and whether resources provide specific advice for parents of adolescent and young adult (AYA) children. METHODS To identify available relevant English-language online information resources, we imitated a parental online information search using three search engines (Google, Yahoo, and Bing). Online resources from the last 10 years for parents with cancer addressing family functioning were included. These resources were rated using the DISCERN instrument-a tool for rating the reliability and quality of health information resources. RESULTS 684 results were screened and 33 online information resources from the USA, UK, Australia, Canada, and Ireland met the inclusion criteria. Average DISCERN quality was 54/80 (95% CI:50-58), which is typical for online health information. The highest rated resources provided information for parents on supporting their AYA children's needs for information and support with feelings, but few comprehensively covered other specific AYA needs. Details on resource weaknesses as identified by the DISCERN are presented. CONCLUSIONS Several high-quality resources for parents with cancer were identified from multiple countries, allowing health professionals internationally to direct patients with cancer to relevant high quality online information. Highlighted limitations in resource quality and scope will guide future resource development and revision, ensuring more comprehensive high quality information is available to support families affected by parental cancer internationally.
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Affiliation(s)
| | - Fiona E J McDonald
- CanTeen Australia, Sydney, Australia.,Cancer Nursing Research Unit, The University of Sydney, Sydney, Australia
| | - Pandora Patterson
- CanTeen Australia, Sydney, Australia.,Cancer Nursing Research Unit, The University of Sydney, Sydney, Australia
| | | | - Jane Coad
- The University of Nottingham, Nottingham, UK
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Golsäter M, Enskär K, Knutsson S. Parents’ perceptions of how nurses care for children as relatives of an ill patient- Experiences from an oncological outpatient department. Eur J Oncol Nurs 2019; 39:35-40. [DOI: 10.1016/j.ejon.2019.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
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23
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Dalton L, Rapa E, Ziebland S, Rochat T, Kelly B, Hanington L, Bland R, Yousafzai A, Stein A. Communication with children and adolescents about the diagnosis of a life-threatening condition in their parent. Lancet 2019; 393:1164-1176. [PMID: 30894272 DOI: 10.1016/s0140-6736(18)33202-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 11/27/2022]
Abstract
Many adults diagnosed with a life-threatening condition have children living at home; they and their partners face the dual challenge of coping with the diagnosis while trying to maintain a parenting role. Parents are often uncertain about how, when, and what to tell their children about the condition, and are fearful of the effect on their family. There is evidence that children are often aware that something is seriously wrong and want honest information. Health-care professionals have a key role in supporting and guiding parents and caregivers to communicate with their children about the diagnosis. However, the practical and emotional challenges of communicating with families are compounded by a scarcity of evidence-based guidelines. This Review considers children's awareness and understanding of their parents' condition, the effect of communication around parental life-threatening condition on their wellbeing, factors that influence communication, and the challenges to achieving effective communication. Children's and parents' preferences about communication are outlined. An expert workshop was convened to generate principles for health-care professionals, intended as practical guidance in the current absence of empirically derived guidelines.
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Affiliation(s)
- Louise Dalton
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Elizabeth Rapa
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sue Ziebland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Tamsen Rochat
- Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Human Sciences Research Council, Johannesburg, South Africa
| | - Brenda Kelly
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Lucy Hanington
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ruth Bland
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Institute of Health and Wellbeing, Glasgow, UK; University of Glasgow and Royal Hospital for Children, Glasgow, UK
| | | | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK; School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
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Golsäter M, Enskär K, Knutsson S. Contributing to making the school a safe place for the child: School nurses' perceptions of their assignment when caring for children having parents with serious physical illness. Nurs Open 2017; 4:267-273. [PMID: 29085652 PMCID: PMC5653391 DOI: 10.1002/nop2.92] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 08/07/2017] [Indexed: 11/17/2022] Open
Abstract
Aim To explore how school nurses perceive their assignment when caring for children having parents with serious physical illness. Design An explorative inductive qualitative design. Method The study is based on interviews with 16 school nurses. The interviews were subjected to qualitative content analysis. Results The main category, “Contribute in making the school a safe place for the child”, reveals how the school nurses try to contribute to making the school a safe place for a child when his/her parent has a serious physical illness. They support children through individual support, as well as at an overall level in the school health team to make the school, as an organization, a safe place. Routines and collaboration to recognize the child when his/her parent has become ill is described as crucial to accomplishing this assignment.
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Affiliation(s)
- Marie Golsäter
- CHILD -Research Group Department of Nursing Science School of Health and Welfare Jönköping University Jönköping Sweden.,Futurum Academy for Health and Care Region Jönköping County Jönköping Sweden
| | - Karin Enskär
- CHILD -Research Group Department of Nursing Science School of Health and Welfare Jönköping University Jönköping Sweden
| | - Susanne Knutsson
- CHILD -Research Group Department of Nursing Science School of Health and Welfare Jönköping University Jönköping Sweden
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Walczak A, McDonald F, Patterson P, Dobinson K, Allison K. How does parental cancer affect adolescent and young adult offspring? A systematic review. Int J Nurs Stud 2017; 77:54-80. [PMID: 29035733 DOI: 10.1016/j.ijnurstu.2017.08.017] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To i) identify and synthesise evidence published since 2007 regarding the impact of parental cancer on adolescent and young adult offspring, ii) identify methodological and evidence gaps addressed during this period and iii) highlight those requiring further attention. DESIGN A systematic review and thematic synthesis of peer reviewed literature regarding the impact of parental cancer upon AYA offspring. DATA SOURCES Online searches of CINAHL, Embase, Medline, PsychInfo and Scopus databases were conducted. Reference lists of included articles were screened and additional searches by prominent authors were performed. REVIEW METHODS Study selection, data extraction and quality analysis was undertaken by three independent researchers. Extracted study data was iteratively reviewed and discussed to achieve consensus regarding thematic synthesis of included studies. RESULTS Database and hand-searching yielded 1730 articles, 54 of which were included in the final synthesis. Included studies are discussed with respect to the following themes: i) study design and quality; ii) measurement and sampling; iii) positive and negative aspects of parental cancer; iv) needs; v) communication and information; vi) coping strategies; vii) interventions; and viii) family functioning and other predictors. Twenty-nine studies reported negative impacts related to parental cancer, while eight identified positive outcomes related to post-traumatic growth. Five returned null or mixed findings. Unmet needs were frequently explored and a new validated measure developed. Communication and information were particularly important for offspring, though these needs were often unmet and parents wanted guidance regarding discussions with their children. Offspring may adopt a variety of coping strategies, some of which appear maladaptive, and may cycle between different approaches. Few evaluations of interventions were identified, and further work in this area is needed. Further evidence has emerged that poorer family functioning and other family and illness-related factors predict worse psychosocial outcomes for offspring, however evidence for other predictors such as age and gender remain mixed. CONCLUSIONS Additional evidence for the negative psychosocial impact of parental cancer on adolescent and young adult offspring, their needs, and factors predicting psychosocial outcomes has emerged in the last decade. However, substantial gaps and methodological issues remain and evidence for the development, efficacy or implementation of interventions for this population is very limited. There is also a clear need for greater focus on bereaved and young adult offspring and those from non-western cultural groups, who remain under-represented in research conducted to date.
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Affiliation(s)
| | - Fiona McDonald
- Canteen Australia, NSW, Australia; Cancer Nursing Research Unit, University of Sydney, NSW, Australia
| | - Pandora Patterson
- Canteen Australia, NSW, Australia; Cancer Nursing Research Unit, University of Sydney, NSW, Australia
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Golsäter M, Henricson M, Enskär K, Knutsson S. Are children as relatives our responsibility? – How nurses perceive their role in caring for children as relatives of seriously ill patients. Eur J Oncol Nurs 2016; 25:33-39. [DOI: 10.1016/j.ejon.2016.09.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 08/31/2016] [Accepted: 09/12/2016] [Indexed: 11/27/2022]
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Gullbrå F, Smith-Sivertsen T, Graungaard AH, Rortveit G, Hafting M. How can the general practitioner support adolescent children of ill or substance-abusing parents? A qualitative study among adolescents. Scand J Prim Health Care 2016; 34:360-367. [PMID: 27845596 PMCID: PMC5217276 DOI: 10.1080/02813432.2016.1253819] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES To explore significant experiences of adolescents as next of kin that the general practitioner (GP) should identify and recognize. DESIGN Qualitative study with focus-group interviews. SUBJECTS AND SETTING Three focus-group interviews were conducted with a total of 15 Norwegian adolescents each with an ill or substance-abusing parent. The participants were recruited from existing support groups. RESULTS The adolescents' days were dominated by unpredictability in their family situation and their own exhausting efforts to keep up an ordinary youth life. Mostly, they consulted GPs for somatic complaints. In encounters with the GP, they wanted to be met both as a unique person and as a member of a family with burdens. Their expectations from the GP were partly negatively formed by their experiences. Some had experienced that both their own and their parent's health problems were not addressed properly. Others reported that the GP did not act when he or she should have been concerned about their adverse life situation. The GP may contribute to better long-term psychosocial outcomes by ensuring that the adolescents receive information about the parent's illness and have someone to talk to about their feelings and experiences. In addition, the GP may help by supporting their participation in relieving activities. CONCLUSION Burdened adolescents seek a GP most often for somatic complaints. The GP has a potential to support them by taking the initiative to talk about their life situation, and by recognizing their special efforts. Key points Little is known about how a general practitioner can support adolescents with ill or substance-abusing parents. Adolescents experience unpredictability in life and strive to find balance between their own needs and the restrictions caused by parental illness. In encounters with adolescents having ill parents, the GP should take the initiative to talk about their family situation. The GP may help them by recognizing their experiences and struggles, give information, offer talks and support coping strategies.
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Affiliation(s)
- Frøydis Gullbrå
- Uni Research Health, Research Unit for General Practice, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- CONTACT Frøydis Gullbrå Research Unit for General Practice, Uni Research Health, Bergen Kalfarveien 31, 5018 Bergen, Norway
| | | | | | - Guri Rortveit
- Uni Research Health, Research Unit for General Practice, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Marit Hafting
- Uni Research Health, Regional Research Centre for Child and Adolescent Mental Health West, Bergen, Norway
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Gullbrå F, Smith-Sivertsen T, Rortveit G, Anderssen N, Hafting M. Ill and substance-abusing parents: how can the general practitioner help their children? A qualitative study. BMC FAMILY PRACTICE 2016; 17:154. [PMID: 27821069 PMCID: PMC5100102 DOI: 10.1186/s12875-016-0553-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/29/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Severe illness among parents may interfere with their parenting. Children having ill or substance-abusing parents are at risk of own health problems and psychosocial difficulties. The health care system should identify families in need of help and provide the help needed. For ill parents, it can be difficult to seek help and advices for their parenting. The aim of this study was to identify important factors for the general practitioner (GP) to bear in mind during encounters with ill and substance-abusing parents, to enable the GP to provide appropriate support for the children. METHOD A qualitative approach was chosen and the data material was semi-structured individual interviews with 12 parents with mental illness, substance abuse or severe somatic illness. The participants were recruited through GPs in Norway, and the interviews were performed in 2014. We used systematic text condensation for analysis. RESULTS It was important for the participants that the GP was oriented about their family and children's situation. They wanted to be regarded as competent parents in ordinary families; however, they were aware that their illness affected their parenting. They expressed a need for advice about how to inform the children of their illness and talk to them about their challenges, and, if necessary, utilize helpers who could inform the children and talk to them directly. There were often many agencies involved, and it was important that the helpers cooperated and shared information. In addition, the parents were in need of information about support services. CONCLUSION Ill parents in this study conveyed a double message to their helpers. They wanted to be considered as responsible and well-intended parents who wished the best for their children. At the same time they needed support in parenting. The GP should take the time to listen to the parents' first spontaneous description about an ordinary daily life (while realising that it may not necessarily be an accurate report), then explore their worries and needs of support.
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Affiliation(s)
- Frøydis Gullbrå
- Research Unit for General Practice, Uni Research Health, Bergen, Norway. .,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | | | - Guri Rortveit
- Research Unit for General Practice, Uni Research Health, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Norman Anderssen
- Research Unit for General Practice, Uni Research Health, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Marit Hafting
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
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How to support teenagers who are losing a parent to cancer: Bereaved young adults' advice to healthcare professionals—A nationwide survey. Palliat Support Care 2016; 15:313-319. [DOI: 10.1017/s1478951516000730] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTObjective:The loss of a parent to cancer is considered one of the most traumatic events a teenager can experience. Studies have shown that teenagers, from the time of diagnosis, are already extremely worried about the consequences of a parent's cancer but tend to be left to manage these concerns on their own. The present study aimed to explore young adults' advice to healthcare professionals on how to support teenagers who are losing a parent to cancer.Methods:This work derives from a Swedish nationwide survey and employs a qualitative approach with a descriptive/interpretive design to obtain answers to an open-ended question concerning advice to healthcare professionals. Of the 851 eligible young adults who had lost a parent to cancer when they were 13–16 years of age within the previous 6 to 9 years, 622 participated in our survey (response rate = 73%). Of these 622 young adults, 481 responded to the open-ended question about what advice to give healthcare professionals.Results:Four themes emerged: (1) to be seen and acknowledged; (2) to understand and prepare for illness, treatment, and the impending death; (3) to spend time with the ill parent, and (4) to receive support tailored to the individual teenager's needs.Significance of Results:This nationwide study contributes hands-on suggestions to healthcare staff regarding attitudes, communication, and support from the perspective of young adults who, in their teenage years, lost a parent to cancer. Teenagers may feel better supported during a parent's illness if healthcare professionals take this manageable advice forward into practice and see each teenager as individuals; explain the disease, its treatments, and consequences; encourage teenagers to spend time with their ill parent; and recommend sources of support.
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Jeppesen E, Bjelland I, Fosså SD, Loge JH, Dahl AA. Health-related quality of life in teenagers with a parent with cancer. Eur J Oncol Nurs 2016; 22:46-53. [PMID: 27179892 DOI: 10.1016/j.ejon.2016.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/04/2016] [Accepted: 03/06/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Health-related quality of life (HRQoL) in teenagers exposed to parental cancer has shown divergent results as an outcome measure. In this study we wanted to: 1) compare the HRQoL of teenagers exposed to parental cancer (CASES) with normative European HRQoL data (NORMs) measured close to parental diagnosis and treatment; 2) study changes in the HRQoL of CASES from baseline to follow-up; 3) explore sex differences in the HRQoL of CASES; and 4) explore eventual confounders of HRQoL of CASES at baseline. METHODS Forty-five families with one parent diagnosed with primary invasive cancer were included, these families had 69 teenagers. At the follow-up, 26 families with 29 teenagers complied. Both parents and teenagers filled in electronic questionnaires over the Internet. HRQoL in teenagers was self-rated by the KIDSCREEN-27 at baseline and follow-up, and the responses were compared to a European normative sample (NORMs). RESULTS 1) The teenagers scored significantly lower on the Physical well-being dimension compared to the NORMs at baseline, while no significant differences were observed concerning the four other HRQoL dimensions. 2) Some significant improvements were observed on HRQoL dimensions from baseline to follow-up. 3) CASES girls showed a trend towards lower HRQoL scores compared to boys. 4) Parental cancer-related characteristics and family function were not related to teenagers' HRQoL, but so were teenagers' self-esteem. CONCLUSIONS At group level, living with a parent who receives curative treatment for a recently diagnosed cancer affects teenagers' HRQoL to certain extent. Self-esteem is a confounder to teenagers' HRQoL in our sample.
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Affiliation(s)
- Elisabeth Jeppesen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ingvar Bjelland
- Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Sophie D Fosså
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jon H Loge
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Norway; Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Alv A Dahl
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
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The well-being of children impacted by a parent with cancer: an integrative review. Support Care Cancer 2016; 24:3235-51. [PMID: 27079580 DOI: 10.1007/s00520-016-3214-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 04/05/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE This paper reviewed the peer-reviewed scientific literature on well-being of children impacted by a parent with cancer. METHOD An integrative review of peer-reviewed literature between 2000 and 2015 regarding parental cancer and its impact on families was conducted by searching relevant databases using predefined key search terms. A thematic analysis was undertaken on literature that met inclusion criteria. RESULTS Forty-nine studies met the criteria for this review, and five major themes were established: impact of cancer, communication, coping strategies, parenting factors mediating impact, and support services. There was considerable variability in study design, methodological approaches, and findings. In the majority of studies, children were significantly impacted by the parent's cancer diagnosis and exhibited distress. Daughters appeared to experience worsened mental health, and sons experienced a greater totality of internalizing and externalizing problems. Children of all ages were impacted by their parent's cancer diagnosis and initiated a number of coping strategies in response. Despite this, a significant number of studies revealed that parents underestimated the impact that their cancer had on their children. Family functioning, as well as the ill parents' gender, coping strategies, cancer severity, and mental and physical health mediated their children's well-being. Parent-child communication was a key element in supporting children. CONCLUSION Parental cancer may impact children's long-term well-being. Further investigations are needed in this area. Additionally, review of support programs and interventions are warranted in terms of their uptake and impact on families affected by a parent's cancer.
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Abstract
BACKGROUND Socially constructed disablement has marginalized young people in families where a parent has younger onset dementia (YOD). This has contributed to inadequate societal support for their complex situation. Impacts on such young people include significant involvement with mental health services for themselves. In this paper, we explored the young people's lived experiences in these families and the influencing factors to enable these young people to be included and supported within their community. METHODS In this qualitative research study, the social model of disability was used as the theoretical framework in conducting a thematic analysis of interviews with 12 participants. RESULTS Three themes emerged; invisibility highlighting the issues of marginalization; connectivity foregrounding the engagement of young people with family, friends and their social networks, and being empowered through claiming their basic human right to receive the age appropriate support they needed. CONCLUSION The current plight of young people living with a parent with YOD demands a fundamental shift by society in developing inclusive cross-sectorial cooperation linking service providers across youth and dementia sectors. This requires working in partnership with the service users responding to the identified needs of individual family members.
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Ellis S, Wakefield C, Antill G, Burns M, Patterson P. Supporting children facing a parent's cancer diagnosis: a systematic review of children's psychosocial needs and existing interventions. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12432] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2015] [Indexed: 11/29/2022]
Affiliation(s)
- S.J. Ellis
- Behavioural Sciences Unit, proudly supported by the Kids with Cancer Foundation; Kids Cancer Centre; Sydney Children's Hospital; Randwick NSW Australia
- Discipline of Paediatrics; School of Women's and Children's Health; UNSW Medicine; University of New South Wales; Sydney NSW Australia
| | - C.E. Wakefield
- Behavioural Sciences Unit, proudly supported by the Kids with Cancer Foundation; Kids Cancer Centre; Sydney Children's Hospital; Randwick NSW Australia
- Discipline of Paediatrics; School of Women's and Children's Health; UNSW Medicine; University of New South Wales; Sydney NSW Australia
- Cancer Institute of NSW; Alexandria NSW Australia
| | | | - M. Burns
- Behavioural Sciences Unit, proudly supported by the Kids with Cancer Foundation; Kids Cancer Centre; Sydney Children's Hospital; Randwick NSW Australia
- Discipline of Paediatrics; School of Women's and Children's Health; UNSW Medicine; University of New South Wales; Sydney NSW Australia
| | - P. Patterson
- Research, Evaluation and Social Policy; CanTeen Australia; Sydney NSW Australia
- Faculty of Nursing; Sydney Medical School; University of Sydney; Sydney NSW Australia
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Patterson P, McDonald FEJ, Ciarrochi J, Hayes L, Tracey D, Wakefield CE, White K. A study protocol for Truce: a pragmatic controlled trial of a seven-week acceptance and commitment therapy program for young people who have a parent with cancer. BMC Psychol 2015; 3:31. [PMID: 26353784 PMCID: PMC4564955 DOI: 10.1186/s40359-015-0087-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 08/13/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This paper presents the rationale and study protocol for a pragmatic controlled effectiveness trial of Truce, a prevention-based selective intervention targeting the significant mental health needs of young people who have a parent with cancer. METHODS/DESIGN Truce is a seven week, facilitated, face-to-face group program. The design is a 2 groups (intervention vs control) x 3 (pre-treatment vs post-treatment vs 2 month follow-up) repeated measures. Allocation to groups will be dependent upon recruitment; when groups have sufficient numbers, they will be assigned to the intervention condition, but participants recruited without a viable group will be assigned to the wait-list control condition. Eligible participants are young people aged 14 to 22 years who have a parent diagnosed with cancer within the last 5 years. Wait-list controls are offered the opportunity to participate in the program once they have completed their follow-up questionnaires. The target sample size is 65 participants in each condition. The primary hypothesis is that participants in the intervention will show significant reductions in distress and increases in psychological well-being relative to participants in the wait-list control group, and these effects will continue through two-month follow-up. Mixed-models analysis of variance will be used to measure differences between the two conditions. Secondary analyses will focus on variables which may relate to the effectiveness of the intervention: ACT-related concepts of experiential avoidance and mindfulness, family functioning, unmet needs and demographic variables. We will also assess program fidelity and satisfaction. DISCUSSION The development and evaluation of a manualised intervention for young people with a parent with cancer responds to a gap in the provision of empirically-based psychological support for this vulnerable group. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12615000761561. Registered 22(nd) July 2015.
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Affiliation(s)
- Pandora Patterson
- Research, Evaluation and Social Policy, CanTeen, Sydney, Australia.
- Cancer Nursing Research Unit, Faculty Nursing, University of Sydney, Sydney, Australia.
| | - Fiona E J McDonald
- Research, Evaluation and Social Policy, CanTeen, Sydney, Australia.
- Cancer Nursing Research Unit, Faculty Nursing, University of Sydney, Sydney, Australia.
| | - Joseph Ciarrochi
- Institute of Positive Psychology and Education, Australian Catholic University, Sydney, Australia.
| | - Louise Hayes
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.
| | - Danielle Tracey
- School of Education, University of Western Sydney, Sydney, Australia.
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, Australia.
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.
| | - Kate White
- Cancer Nursing Research Unit, Faculty Nursing, University of Sydney, Sydney, Australia.
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McDonald FEJ, Patterson P, White KJ, Butow PN, Costa DSJ, Kerridge I. Correlates of unmet needs and psychological distress in adolescent and young adults who have a parent diagnosed with cancer. Psychooncology 2015; 25:447-54. [DOI: 10.1002/pon.3942] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 05/29/2015] [Accepted: 07/17/2015] [Indexed: 11/09/2022]
Affiliation(s)
- F. E. J. McDonald
- CanTeen Australia; Sydney New South Wales Australia
- Cancer Nursing Research Unit, Sydney Nursing School; The University of Sydney; Sydney New South Wales Australia
| | - P. Patterson
- CanTeen Australia; Sydney New South Wales Australia
- Cancer Nursing Research Unit, Sydney Nursing School; The University of Sydney; Sydney New South Wales Australia
| | - K. J. White
- Cancer Nursing Research Unit, Sydney Nursing School; The University of Sydney; Sydney New South Wales Australia
| | - P. N. Butow
- Psycho-Oncology Co-operative Research Group (POCoG); The University of Sydney; Sydney New South Wales Australia
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED); The University of Sydney; Sydney New South Wales Australia
| | - D. S. J. Costa
- Psycho-Oncology Co-operative Research Group (POCoG); The University of Sydney; Sydney New South Wales Australia
| | - I. Kerridge
- Centre for Values, Ethics and Law in Medicine; The University of Sydney; Sydney New South Wales Australia
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Maintaining everyday life in a family with a dying parent: Teenagers' experiences of adapting to responsibility. Palliat Support Care 2015; 13:1595-601. [DOI: 10.1017/s1478951515000085] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:Teenagers are living through a turbulent period in their development, when they are breaking away from the family to form their own identities, and so they are particularly vulnerable to the stressful situation of having a parent affected by a progessive and incurable illness. The current study sought to gain more knowledge about the ways that teenagers themselves describe living in a family with a seriously ill and dying parent. More specifically, the aims were to describe how teenagers are emotionally affected by everyday life in a family with a dying parent and to determine how they attempt to adapt to this situation.Method:The study employed a descriptive and interpretive design using qualitative content analysis. A total of 10 teenagers (aged 14–19 years, 7 boys and 3 girls) participated through repeated, individual, informal interviews that were carried out as free-ranging conversations.Results:While contending with their own vulnerable developmental period of life, the teenagers were greatly affected by their parent's illness and took on great responsibility for supporting their parents and siblings, and for maintaining family life. Lacking sufficient information and support left them rather unprepared, having to guess and to interpret the vague signs of failing health on their own, with feelings of uncertainty and loneliness as a consequence.Significance of Results:Support from healthcare professionals should be designed to help and encourage parents to have open communications about their illness with their teenaged children. Our results add further support to the literature, reinforcing the need for an approach that uses a systemic perspective and considers the family to be the appropriate unit of care and offers a suitable support system.
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Chen R, Sjölander A, Valdimarsdóttir U, Varnum C, Almqvist C, Ye W, Fall K, Czene K, Fang F. Parental cancer diagnosis and child mortality—A population-based cohort study in Sweden. Cancer Epidemiol 2015; 39:79-85. [DOI: 10.1016/j.canep.2014.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/25/2014] [Accepted: 11/29/2014] [Indexed: 11/30/2022]
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