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Thermaenius I, Udo C, Alvariza A, Lundberg T, Holm M, Lövgren M. The Family Talk Intervention Among Families Affected by Severe Illness: Hospital Social Workers' Experiences of Facilitators and Barriers to its Use in Clinical Practice. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2024:1-19. [PMID: 38968160 DOI: 10.1080/15524256.2024.2364589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2024]
Abstract
Hospital social workers (HSW) play an important role in health care, providing psychosocial support to families affected by severe illness, and having palliative care needs involving dependent children. However, there are few evidence-based family interventions for HSWs to apply when supporting these families. The Family Talk intervention (FTI), a psychosocial family-based intervention, was therefore evaluated in an effectiveness-implementation study. Within the study, HSWs were educated and trained in the use of FTI in clinical practice. This study examined HSWs' experiences of barriers and facilitating factors during their initial use of FTI in clinical practice. Altogether, 10 semi-structured focus groups were held with HSWs (n = 38) employed in cancer care and specialized palliative home care for adults, pediatric hospital care, and a children's hospice. Data were analyzed using content analysis. HSWs considered FTI to be a suitable psychosocial intervention for families affected by severe illness with dependent children. However, the way in which the care was organized acted either as a barrier or facilitator to the use of FTI, such as the HSWs' integration in the team and their possibility to organize their own work. The HSWs' work environment also impacted the use of FTI, where time and support from managers was seen as a significant facilitating factor, but which varied between the healthcare contexts. In conclusion, HSWs believed that FTI was a suitable family intervention for families involving dependent children where one family member had a severe illness. For successful initial implementation, strategies should be multi-functional, targeting the care organization and the work environment.
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Affiliation(s)
- Ingrid Thermaenius
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Camilla Udo
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | - Anette Alvariza
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- Research and Development unit/Palliative care, Stockholms Sjukhem, Stockholm, Sweden
| | - Tina Lundberg
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- Medical Unit: Clinical Social Work, Karolinska University Hospital, Stockholm, Sweden
| | - Maja Holm
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- Department of Nursing Sciences, Sophiahemmet University, Stockholm, Sweden
| | - Malin Lövgren
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- Advanced Pediatric Home Care, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Karidar H, Lundqvist P, Glasdam S. The influence of actors on the content and execution of a bereavement programme: a Bourdieu-inspired ethnographical field study in Sweden. Front Public Health 2024; 12:1395682. [PMID: 38846616 PMCID: PMC11153816 DOI: 10.3389/fpubh.2024.1395682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/09/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction The death of a parent can have profound negative impacts on children, and a lack of adequate support can exacerbate negative life experiences. Aim To explore the influences of various actors on the content and execution of a bereavement programme within a Swedish context, considering relational and contextual perspectives. Methods An ethnographic field study involving six children, their parents, and eight volunteers. A theory-inspired thematic analysis was conducted, methodically inspired by Braun and Clarke, theoretically inspired by Bourdieu's concepts of position, power, and capital. Results Confidentiality obligation was an essential element in the programme, however, the premisses varied depending on actors' positions. Volunteers and researchers had different outlets to express their experiences in the program. The programme offered the children an exclusive space for talking about and sharing experiences and feelings. Simultaneously, the programme restricted the children by not allowing them to share their experiences and feelings outside the physical space. The physical settings shaped the different conditions for interactions among the actors. The sessions adopted loss-oriented approaches, where communication between volunteers and children was guided by the volunteers. However, children created strategies for additional, voiceless communication with their peers or themselves. During breaks and mingles, shared interests or spaces connected children (and adults) more than their common experience of parental bereavement. Conclusion The participants in the programme were significantly influenced by the structural framework of the programme, and their positions within the programme provided them with different conditions of possibility for (inter)acting. Children's daily activities and interests were both ways to cope with parental bereavement and connect them to other people.
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Affiliation(s)
- Hakima Karidar
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Palliative and Advanced Homecare (ASIH) Lund, Lund, Sweden
| | - Pia Lundqvist
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Stinne Glasdam
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Lövgren M, Udo C, Kreicbergs U. Is the family talk intervention feasible in paediatric oncology? An evaluation of a family-based psychosocial intervention. Acta Paediatr 2022; 111:684-692. [PMID: 34787928 DOI: 10.1111/apa.16190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/19/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022]
Abstract
AIM To examine the feasibility of a family-based psychosocial intervention, Family Talk Intervention (FTI), in paediatric oncology in terms of recruitment, retention, delivery, response rate and acceptability from the parents' perspective. METHODS This study involved 26 families affected by childhood cancer. FTI encompasses six family meetings, with the main goal being to facilitate family communication about illness-related subjects. Meeting 5 is preferably moderated by the parents. Extra meetings (7-11) can be held if needed. This paper includes observational data and surveys, and interviews with parents. RESULTS All families who started FTI underwent the full intervention and the survey response rate varied between 100% and 71% over time. Extra meetings were held with most families. The parents stated that FTI filled a gap of support to the family as a unit and described FTI as a map they could follow. Since FTI was conducted at home, this created a safe environment, which contributed to their participation. The parents valued the children's perspectives being considered, but some felt uncomfortable moderating 'the family talk' (meeting 5). CONCLUSION Family talk intervention was valued by parents, but it would benefit from being slightly modified before a large trial can be developed.
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Affiliation(s)
- Malin Lövgren
- Palliative Research Centre Department of Health Care Sciences Ersta Sköndal Bräcke University College Stockholm Sweden
- Advanced Pediatric Home Care Karolinska University Hospital Stockholm Sweden
| | - Camilla Udo
- Palliative Research Centre Department of Health Care Sciences Ersta Sköndal Bräcke University College Stockholm Sweden
- School of Education, Health and Society Dalarna University College Falun Sweden
- Center for Clinical Research Dalarna‐Uppsala University Falun Sweden
| | - Ulrika Kreicbergs
- Palliative Research Centre Department of Health Care Sciences Ersta Sköndal Bräcke University College Stockholm Sweden
- Department of Women's and Children's Health Childhood Cancer Research Unit Karolinska Institute Stockholm Sweden
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Ivéus K, Eklund R, Kreicbergs U, Lövgren M. Family bonding as a result of the family talk intervention in pediatric oncology: Siblings' experiences. Pediatr Blood Cancer 2022; 69:e29517. [PMID: 34971075 DOI: 10.1002/pbc.29517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Childhood cancer affects the whole family. Illness-related stressors increase the risk for poor family communication, affecting the family's well-being. Siblings describe worry and poor illness-related information. As there are few evaluated family interventions in pediatric oncology, this study aimed to pilot-test a family-centered intervention, the family talk intervention (FTI), in pediatric oncology. This paper examined the feasibility in terms of acceptability from the siblings' perspectives. METHODS This study derives from a pilot study of 26 families including 37 siblings recruited from one pediatric oncology center. Standard FTI comprises six meetings with the family, led by two interventionists, with the main goal to facilitate family communication on illness-related topics (e.g., prognosis, the invisibility of healthy siblings). This paper focuses on interview and survey data from siblings after participation in FTI. The study is registered at ClinicalTrials.gov (Identifier NCT03650530). RESULTS The siblings, aged 6 to 24 years, stated that the interventionists made the meetings feel like a safe environment and that it was a relief for the siblings to talk. They reported that FTI helped the family talk openly about illness-related topics, which they felt led to increased family understanding and improved relationships. The siblings described that FTI also helped them with their school situation. The majority of the siblings reported that FTI came at the right time and involved an appropriate number of meetings. CONCLUSION According to the siblings, the timing, content, and structure of FTI were appropriate. FTI showed benefits for both the siblings and each family as a whole.
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Affiliation(s)
- Kerstin Ivéus
- Lilla Erstagården Children's and Youth Hospice, Ersta Hospital, Stockholm, Sweden
| | - Rakel Eklund
- National Centre for Disaster Psychiatry, Department of Medical Science, Uppsala University, Uppsala, Sweden.,Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Ulrika Kreicbergs
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,Department of Women's and Children's Health, Pediatric Oncology and Hematology, Karolinska Institutet, Karolinska University Hospital, Astrid Lindgren Children's Hospital, Childhood Cancer Research Unit, Stockholm, Sweden
| | - Malin Lövgren
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,Advanced Pediatric Home Care, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Bergersen EB, Larsson M, Olsson C. Children and adolescents’ preferences for support when living with a dying parent – An integrative review. Nurs Open 2022; 9:1536-1555. [PMID: 35156340 PMCID: PMC8994933 DOI: 10.1002/nop2.1187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/24/2021] [Accepted: 01/30/2022] [Indexed: 11/17/2022] Open
Abstract
Aim To identify and synthesize the evidence base regarding children and adolescents’ preferences for support when living with a dying parent. Design Integrative literature review study. Methods Searches were conducted in PubMed, CINAHL, PsycINFO, the Cochrane Library, Sociological Abstracts and Scopus, between 1 October 2019 and May 2021. Data were analysed and synthesized using integrative thematic analysis according to the analysis stages specified by Whittermore and Knafl. Results Twenty‐two articles were identified. Children and adolescents’ preferences for support were described through one overarching theme, Striving to achieve control and balance, together with six subthemes; “Involvement in the sick parent's care and treatment”; “Wanting to be with the sick parent but needing respite”; “Information must be continuous and individually adapted”; “emotional and communicative support from parents and family members”; “professional, compassionate and informative support”; and “support in friendships and opportunities to maintain normality.”
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Affiliation(s)
- Emily Beatrice Bergersen
- Department of Health Sciences Faculty of Health, Science and Technology Karlstad University Karlstad Sweden
- Section for Advanced Nursing Faculty of Social and Health Sciences Inland Norway University of Applied Sciences Elverum Norway
| | - Maria Larsson
- Department of Health Sciences Faculty of Health, Science and Technology Karlstad University Karlstad Sweden
| | - Cecilia Olsson
- Department of Bachelor Education Lovisenberg Diaconal University College Oslo Norway
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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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