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Sun H, Wacharasin C, Hengudomsub P. Change in resilience among spousal caregivers of patients with newly-diagnosed advanced cancer over the first six months posttreatment in China. J Psychosom Res 2024; 183:111538. [PMID: 38823371 DOI: 10.1016/j.jpsychores.2023.111538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 06/03/2024]
Abstract
OBJECTIVE A longitudinal observational study was conducted and aimed to examine the change in resilience among spousal caregivers of newly-diagnosed advanced cancer patients over the first six months after initial treatment. METHODS In total, 312 Chinese spousal caregivers who were taking care of their patients with newly-diagnosed advanced cancer were recruited. The level of resilience was measured using the Connor-Davidson Resilience Scale at the first month post-initial treatment (T1), three-month post-initial treatment (T2), and six-month post-initial treatment (T3). Latent growth modeling analyses were performed to examine changes in resilience using Mplus 8.3. RESULTS The mean scores of resilience in spousal caregivers were 54.01 ± 7.68 at T1, 56.20 ± 6.38 at T2, and 57.97 ± 6.70 at T3, respectively. Results of latent growth modeling indicated that spousal caregivers showed a significant increase in their resilience scores over the first six months post-treatment (Mean slope = 1.98, p < 0.001). Furthermore, a significant individual variation in the rate of changes in resilience scores allowed spouses to be categorized into two groups: 42.9% participants with fast growth and 57.1% participants with slight growth. CONCLUSION Our findings highlight the importance that new knowledge about change patterns of resilience in the nursing field is beneficial to reveal different psychosomatic health. Acknowledging that resilience is a dynamic process that changes over time, it is crucial for healthcare providers to monitor the psychological adjustment and focus of vulnerable caregivers, particularly spouses.
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Affiliation(s)
- Haiyan Sun
- Faculty of Nursing, Burapha University, Chon Buri 20131, Thailand; School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu 224005, PR China
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Fladeboe KM, Stock NM, Heike CL, Evans KN, Junkins C, Stueckle L, O'Daffer A, Rosenberg AR, Yi-Frazier JP. Feasibility and Acceptability of the Promoting Resilience in Stress Management-Parent (PRISM-P) Intervention for Caregivers of Children with Craniofacial Conditions. Cleft Palate Craniofac J 2024; 61:1125-1133. [PMID: 36802967 DOI: 10.1177/10556656231157449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVES Few evidence-based psychosocial programs exist within craniofacial care. This study (a) assessed feasibility and acceptability of the Promoting Resilience in Stress Management-Parent (PRISM-P) intervention among caregivers of children with craniofacial conditions and (b) described barriers and facilitators of caregiver resilience to inform program adaptation. DESIGN In this single-arm cohort study, participants completed a baseline demographic questionnaire, the PRISM-P program, and an exit interview. PARTICIPANTS Eligible individuals were English-speaking legal guardians of a child <12-years-old with a craniofacial condition. INTERVENTION PRISM-P included 4 modules (stress-management, goal-setting, cognitive-restructuring, meaning-making) delivered in 2 one-on-one phone or videoconference sessions 1-2 weeks apart. MAIN OUTCOME MEASURES Feasibility was defined as >70% program completion among enrolled participants; acceptability was defined as >70% willingness to recommend PRISM-P. Intervention feedback and caregiver-perceived barriers and facilitators of resilience were summarized qualitatively. RESULTS Twenty caregivers were approached and 12 (60%) enrolled. The majority were mothers (67%) of a child <1-year-old diagnosed with a cleft lip and/or palate (83%) or craniofacial microsomia (17%). Of these, 8 (67%) completed PRISM-P and 7 (58%) completed interviews; 4 (33%) were lost-to-follow-up before PRISM-P and 1 (8%) before the interview. Feedback was highly positive, with 100% willing to recommend PRISM-P. Perceived barriers to resilience included uncertainty about their child's health; facilitators included social support, parental identity, knowledge, and control. CONCLUSIONS PRISM-P was acceptable among caregivers of children with craniofacial conditions but not feasible based on program completion rates. Barriers and facilitators of resilience support the appropriateness of PRISM-P for this population and inform adaptation.
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Affiliation(s)
- Kaitlyn M Fladeboe
- Department of Pediatrics. University of Washington School of Medicine, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Carrie L Heike
- Department of Pediatrics. University of Washington School of Medicine, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Kelly N Evans
- Department of Pediatrics. University of Washington School of Medicine, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Courtney Junkins
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Laura Stueckle
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Alison O'Daffer
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Palliative Care, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Joyce P Yi-Frazier
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
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Fisher RS, Dattilo TM, DeLone AM, Basile NL, Kenney AE, Hill KN, Chang HF, Gerhardt CA, Mullins LL. The study of psychosocial outcomes of parents bereaved by pediatric illness: a scoping review of methodology and sample composition. J Pediatr Psychol 2024; 49:207-223. [PMID: 38423530 DOI: 10.1093/jpepsy/jsae008] [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: 08/05/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE Parents of children who died of a medical condition experience a range of psychosocial outcomes. The current scoping review aims to summarize the outcomes assessed, methodology, and sample characteristics of recent psychosocial research conducted with this population. METHODS Included studies were limited to peer-reviewed, psychosocial outcomes research published between August 2011 and August 2022, written in English, and including caregiver study participants of children who died of a medical condition. Data sources were scholarly journal articles from 9 electronic databases, including Scopus, Web of Science, Academic Search Primer, ProQuest Research Library, PubMed, Embase, PsycINFO, Psychology & Behavioral Sciences Collection, and Health Source: Nursing/Academic Edition. The Mixed Methods Appraisal Tool-2018 evaluated methodological quality. RESULTS The study sample included 106 studies, most of which were either qualitative (60%) or quantitative (29%). Mixed-methods studies (8%) and randomized clinical trials (2%) were also identified. Study quality was variable, but most studies met all quality criteria (73%). Studies primarily represented cancer populations (58%), White participants (71%), and mothers (66%). Risk-based psychosocial outcomes (e.g., grief) were more commonly assessed than resilience-based outcomes. CONCLUSIONS The current scoping review revealed that recent research assessing the psychosocial outcomes of bereaved parents is limited in the representation of diverse populations, primarily qualitative, of broadly strong methodological quality, and oriented to psychosocial risk. To enhance the state of the science and inform evidence-based psychosocial services, future research should consider varied methodologies to comprehensively assess processes of risk and resilience with demographically and medically diverse populations.
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Affiliation(s)
- Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Taylor M Dattilo
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Alexandra M DeLone
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Ansley E Kenney
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Kylie N Hill
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Hui-Fen Chang
- William E. Brock Memorial Library, Oklahoma State University, Stillwater, OK, United States
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
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Zhang Y, Hu Y, Yang M. The relationship between family communication and family resilience in Chinese parents of depressed adolescents: a serial multiple mediation of social support and psychological resilience. BMC Psychol 2024; 12:33. [PMID: 38238813 PMCID: PMC10797894 DOI: 10.1186/s40359-023-01514-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 12/28/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Family resilience plays a crucial role in helping depressed adolescents overcome challenges. However, studies examining family resilience in depressed adolescents are currently scarce. This study, guided by the family resilience framework, aimed to investigate the serial-multiple mediation of social support and psychological resilience between family communication and family resilience in Chinese families of depressed adolescents. METHODS In 229 parents of adolescents with major depressive disorder, 20.1% comprises of fathers, while 79.9% comprises of mothers. The mean age of depressed adolescents was 14.84 (±1.76) years, and the mean age of parents of these depressed adolescents was 43.24 (±4.67) years. The Family Resilience Assessment Scale (FRAS), the Psychological Resilience of Parents of Special Children Questionnaire, and the Social Support Rating Scale, Family Assessment Device (FAD) were used to collected data. Descriptive, univariate, and Pearson correlation analyses were used in preliminary analyses. To explore mediation, we employed a serial-multiple mediation model (PROCESS model 6). RESULTS Family communication was positively correlated with family resilience, social support, and psychological resilience. Mediation analysis revealed indirect effects of family communication on family resilience, which were mediated solely by either social support or psychological resilience, or through multiple mediation pathways involving both social support and psychological resilience. CONCLUSIONS Family communication positively and directly affects the family resilience of depressed adolescents, and a higher level of social support and psychological resilience can help improve family resilience. These findings not only provide empirical evidence supporting the family resilience framework but also have practical implications for future family interventions targeting depressed adolescents.
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Affiliation(s)
- Yinying Zhang
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, People's Republic of China
| | - Yiwen Hu
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, People's Republic of China
| | - Min Yang
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, People's Republic of China.
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Longcoy LTH, Wu WW, Wei CJ, Doorenbos AZ. Examining the Role of Resilience, Posttraumatic Growth, and Quality of Life in Women with Breast Cancer: A Serial Multiple Mediator Model Approach. Semin Oncol Nurs 2023; 39:151441. [PMID: 37149439 PMCID: PMC10524348 DOI: 10.1016/j.soncn.2023.151441] [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: 10/16/2022] [Revised: 02/21/2023] [Accepted: 04/05/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES It is unclear how resilience and posttraumatic growth help women with breast cancer face cancer-related symptom distress. This study included both resilience and posttraumatic growth as mediators in a serial multiple mediator model to examine changes in the relationship between symptom distress and quality of life among women with breast cancer. DATA SOURCES We conducted the descriptive, cross-sectional study in Taiwan. Data were collected using a survey that assessed symptom distress, resilience, posttraumatic growth, and quality of life. A serial multiple mediator model examined one direct and three specific indirect effects of symptom distress on quality of life through resilience and posttraumatic growth. All 91 participants reported the presence of symptom distress and moderate levels of resilience. Quality of life was significantly associated with symptom distress (b = -1.04), resilience (b = 0.18), and posttraumatic growth (b = 0.09). The indirect effect of symptom distress on quality of life through resilience alone was statistically significant (b = -0.23, 95% CI -0.44 to -0.07) and statistically greater than the specific indirect effect through resilience and posttraumatic growth combined (b = -0.21, 95% CI -0.40 to -0.05). CONCLUSION Resilience plays a unique role in reducing the impact of symptom distress on the quality of life among women with breast cancer. IMPLICATIONS FOR NURSING PRACTICE Given the importance of resilience to quality of life, oncology nurses can assess the resilience of women with breast cancer and help identify available internal, external, and existential resources to strengthen their resilience.
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Affiliation(s)
- Li-Ting H Longcoy
- Postdoctoral Fellow, College of Nursing, University of Illinois Chicago, Chicago, Illinois
| | - Wei-Wen Wu
- Associate Professor; School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Chung-Jen Wei
- Associate Professor; Department of Public Health, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ardith Z Doorenbos
- Professor; College of Nursing, University of Illinois Chicago, Chicago, Illinois
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Scarponi D, Sarti P, Rivi V, Colliva C, Marconi E, Pession A, Blom JMC. Emotional, Behavioral, and Physical Health Consequences in Caregivers of Children with Cancer: A Network Analysis Differentiation in Mothers' and Fathers' Reactivity. Cancers (Basel) 2023; 15:3496. [PMID: 37444606 DOI: 10.3390/cancers15133496] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/14/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Pediatric cancer presents mental and physical challenges for patients and their caregivers. However, parental distress has been understudied despite its negative impact on quality of life, disability, and somatic disorders. Parents of oncopediatric patients experience high levels of suffering with their resilience tested throughout their children's illness. Identifying at-risk parents and offering specific treatments is crucial and urgent to prevent or alleviate negative outcomes. METHODS This study used statistical and network analyses to examine symptom patterns assessed by the Kellner Symptom Questionnaire in 16 fathers and 23 mothers at different time points: diagnosis, treatment, and discharge. RESULTS The results indicated significantly higher distress levels in parents of oncopediatric children compared to the control reference population. Gender-specific differences in symptom profiles were observed at each time point, and symptoms showed a gradual but non-significant decrease over time. CONCLUSIONS The network analysis yielded valuable insights that, when applied in clinical practice, can guide the implementation of timely treatments to prevent and manage parental distress, thus addressing long-term, stress-related issues in primary caregivers of children diagnosed and treated for cancer.
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Affiliation(s)
- Dorella Scarponi
- Unità Operativa Pediatria Pession, IRSSC S. Orsola, 40138 Bologna, Italy
| | - Pierfrancesco Sarti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Veronica Rivi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | | | - Elisa Marconi
- Clinical Psychology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Radiation Oncology Unit, Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Andrea Pession
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Johanna M C Blom
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Centre for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Steiner JM, Blakeney EAR, Baden AC, Freeman V, Yi-Frazier J, Curtis JR, Engelberg RA, Rosenberg AR. Definitions of resilience and resilience resource use as described by adults with congenital heart disease. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2023; 12:100447. [PMID: 37693226 PMCID: PMC10486316 DOI: 10.1016/j.ijcchd.2023.100447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Background Adult congenital heart disease (ACHD) is a lifelong illness that presents ongoing challenges to quality of life. Fostering personal resilience resources to sustain well-being can enhance patients' psychosocial health. Objective We aimed to describe patients' resilience experiences: how they understand, develop, and utilize resilience resources in managing ACHD. Methods We conducted a qualitative study of patients with ACHD. Participants were recruited using maximum variation sampling. Individual, semi-structured interviews were conducted June 2020 to August 2021. We queried approaches to managing ACHD-related stress and experiences with resilience and analyzed responses with thematic analysis. Results Participant (N = 25) median age was 32 years (range 22-44); 52% identified as female and 72% non-Hispanic white. Participants' anatomic ACHD was moderate (56%) or complex (44%); physiologically, 76% were functional class C or D. Participants described various resilience resources, which map to an established resilience framework: 1) internal resources: maintaining positivity, self-directed activity, and setting goals; 2) external resources: social support; 3) existential resources: purpose, gratitude, and cultivating health. Even among participants who reported feeling unfamiliar (8/25) with the term "resilience," all participants shared experiences reflecting resilience developed while living with ACHD. Conclusion ACHD-relevant resilience resources may help patients and clinicians navigate ACHD-related stress and promote psychosocial well-being.
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Affiliation(s)
- Jill M. Steiner
- Division of Cardiology, Department of Medicine & Cambia
Palliative Care Center of Excellence, University of Washington, 1959 NE Pacific St.,
Seattle, WA, 98195, USA
| | - Erin Abu-Rish Blakeney
- Department of Biobehavioral Nursing and Health Informatics,
School of Nursing, University of Washington, 1959 NE Pacific St., Seattle, WA,
98195, USA
| | - Andrea Corage Baden
- Division of General Internal Medicine, Department of
Medicine, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195,
USA
| | - Vea Freeman
- Division of Cardiology, Department of Medicine, University
of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Joyce Yi-Frazier
- Division of Hematology/Oncology, Department of Pediatrics,
Palliative Care and Resilience Lab, Seattle Children’s Research Institute,
1920 Terry Ave, Seattle, WA, 98101, USA
| | - J. Randall Curtis
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine & Cambia Palliative Care Center of Excellence, University
of Washington, Harborview Medical Center, 325 9th A, Seattle, WA,
98104, USA
| | - Ruth A. Engelberg
- Department of Psychosocial Oncology and Palliative Care,
Dana-Farber Cancer Institute & Department of Pediatrics, Harvard Medical School,
450 Brookline Ave, Boston, MA, 02215, USA
| | - Abby R. Rosenberg
- Department of Psychosocial Oncology and Palliative Care,
Dana-Farber Cancer Institute & Department of Pediatrics, Harvard Medical School,
450 Brookline Ave, Boston, MA, 022155, USA
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O'Daffer A, Comiskey L, Scott SR, Zhou C, Bradford MC, Yi-Frazier JP, Rosenberg AR. Protocol for the promoting resilience in stress management (PRISM) intervention: a multi-site randomized controlled trial for adolescents and young adults with advanced cancer. BMC Palliat Care 2023; 22:60. [PMID: 37189149 DOI: 10.1186/s12904-023-01179-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) with cancer are at high risk of poor psychosocial outcomes, and evidence-based interventions designed to meet their psychosocial and communication needs are lacking. The main objective of this project is to test the efficacy of a new adaptation of the Promoting Resilience in Stress Management intervention for AYAs with Advanced Cancer (PRISM-AC). METHODS/DESIGN The PRISM-AC trial is a 2-arm, parallel, non-blinded, multisite, randomized controlled trial. 144 participants with advanced cancer will be enrolled and randomized to either usual, non-directive, supportive care without PRISM-AC ("control" arm) or with PRISM-AC ("experimental" arm). PRISM is a manualized, skills-based training program comprised of four 30-60 min, one-on-one sessions targeting AYA-endorsed resilience resources (stress-management, goal-setting, cognitive-reframing, and meaning-making). It also includes a facilitated family meeting and a fully equipped smartphone app. The current adaptation includes an embedded advance care planning module. English- or Spanish-speaking individuals 12-24 years old with advanced cancer (defined as progressive, recurrent, or refractory disease, or any diagnosis associated with < 50% survival) receiving care at 4 academic medical centers are eligible. Patients' caregivers are also eligible to participate in this study if they are able to speak and read English or Spanish, and are cognitively and physically able to participate. Participants in all groups complete surveys querying patient-reported outcomes at the time of enrollment and 3-, 6-, 9-, and 12-months post-enrollment. The primary outcome of interest is patient-reported health-related quality of life (HRQOL) and secondary outcomes of interest include patient anxiety, depression, resilience, hope and symptom burden, parent/caregiver anxiety, depression and health-related quality of life, and family palliative care activation. We will conduct intention-to-treat analysis to compare the group means of primary and secondary outcomes between PRISM-AC arm and control arm with regression models. DISCUSSION This study will provide methodologically rigorous data and evidence regarding a novel intervention to promote resilience and reduce distress among AYAs with advanced cancer. This research has the potential to offer a practical, skills-based curriculum designed to improve outcomes for this high-risk group. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03668223, September 12, 2018.
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Affiliation(s)
| | - Liam Comiskey
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Samantha R Scott
- Seattle Children's Research Institute, Seattle, WA, USA
- University of Denver, Denver, CO, USA
| | - Chuan Zhou
- Seattle Children's Research Institute, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
| | | | | | - Abby R Rosenberg
- Dana-Farber Cancer Institute, 450 Brookline Ave, JF7, Boston, MA, 02215, USA.
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Chung JOK, Li WHC, Ho LLK, Cheung AT. The Association of Resilience with Way of Coping, Psychological Well-Being and Quality of Life in Parents of Children with Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105765. [PMID: 37239492 DOI: 10.3390/ijerph20105765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Evidence shows that resilience is crucial to maintain psychological well-being and quality of life in the face of stress and adversity. However, the relationships between resilience and psychological well-being and factors associated with quality of life in Hong Kong Chinese parents of children with cancer are underexplored. This study aimed to examine the interrelationships among resilience, ways of coping, psychological well-being, and quality of life among Chinese parents of children with cancer, and identify factors associated with their quality of life. A cross-sectional study was conducted with 119 Chinese parents of children with cancer at the Hong Kong Children's Hospital between January 2020 and March 2022. Parents' resilience level, ways of coping, depressive symptoms, state anxiety scores, perceived social support, and quality of life were assessed. Participating parents (n = 119) included 98 mothers (82.4%) and 11 parents were from single-parent families (9.2%). Almost half (47.9%) of the parents were potentially at risk for depression. The results showed that participants from single-parent families reported statistically significantly lower levels of resilience (p < 0.001), more depressive symptoms (p < 0.001), and poorer quality of life (p < 0.001) than those who lived with their partners (married). In addition, parents who adopted problem-focused coping strategies reported statistically significantly higher levels of resilience (p < 0.001), fewer depressive symptoms (p < 0.001), and better quality of life (p < 0.001) than those who adopted emotion-focused coping strategies. A multiple regression analysis revealed that resilience (p < 0.001) was associated with quality of life among parents of children with cancer. This study provides further support that resilience is an important factor associated with quality of life in parents of children with cancer. Assessing resilience in parents is an important prerequisite for designing appropriate interventions to increase their resilience and enhance their quality of life.
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Affiliation(s)
| | - William Ho Cheung Li
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Laurie Long Kwan Ho
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Ankie Tan Cheung
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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10
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Önal G, Huri M, Karakükçü M, Demir HA. The Resilience Scale for Parents of Children with Cancer: Scale development and psychometric evaluation. Psychooncology 2023. [PMID: 37060214 DOI: 10.1002/pon.6137] [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: 12/18/2022] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVE This study aimed to develop a Resilience Scale for Parents of Children with Cancer (RSP-CC) designed specifically for parents of children with cancer and to evaluate its psychometric properties. METHODS Based on the Resilience Model for Families of Children with Cancer, items were created after an extensive literature review and evaluated through expert consultation and a pilot study. Psychometric evaluation was conducted with the parents of 601 children with cancer in the pediatric hematology oncology services of different hospitals in the Ankara and Kayseri provinces in Turkey. RESULTS A 4-factor structure was illustrated by exploratory factor analysis and confirmed by confirmatory factor analysis, explaining 62.192% of the total variance. In the reliability analysis of the scale, Interclass correlation = 0.993 and Cronbach's alpha = 0.994 were found for the scale. Robust correlation coefficients were found between test-retest, and the correlation between the two measurements was statistically significant (r = 0.990; p ˂ 0.001). As a result, the validity of a 24-item scale structure consisting of 4 dimensions was validated. CONCLUSIONS It may be said that the RSP-CC meets the necessary criteria to examine the resilience in parents of children aged 0-18 with a cancer diagnosis, and its psychometric properties are reasonable sufficient.
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Affiliation(s)
- Gözde Önal
- Department of Occupational Therapy, Ankara Medipol University, Ankara, Turkey
| | - Meral Huri
- Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
| | | | - Hacı Ahmet Demir
- Department of Pediatric Hematology and Oncology, Private Ankara Memorial Hospital, Ankara, Turkey
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O'Daffer A, Comiskey L, Scott SR, Zhou C, Bradford MC, Yi-Frazier JP, Rosenberg AR. Protocol for The Promoting Resilience in Stress Management (PRISM) Intervention: a multi-site randomized controlled trial for adolescents and young adults with advanced cancer. RESEARCH SQUARE 2023:rs.3.rs-2748874. [PMID: 37066150 PMCID: PMC10104275 DOI: 10.21203/rs.3.rs-2748874/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background Adolescents and young adults (AYAs) with cancer are at high risk of poor psychosocial outcomes, and evidence-based interventions designed to meet their psychosocial and communication needs are lacking. The main objective of this project is to test the efficacy of a new adaptation of the Promoting Resilience in Stress Management intervention for AYAs with Advanced Cancer (PRISM-AC). Methods/design: The PRISM-AC trial is a 2-arm, parallel, non-blinded, multisite, randomized controlled trial. 144 participants with advanced cancer will be enrolled and randomized to either usual, non-directive, supportive care without PRISM-AC ("control" arm) or with PRISM-AC ("experimental" arm). PRISM is a manualized, skills-based training program comprised of four 30-60 minute, one-on-one sessions targeting AYA-endorsed resilience resources (stress-management, goal-setting, cognitive-reframing, and meaning-making). It also includes a facilitated family meeting and a fully equipped smartphone app. The current adaptation includes an embedded advance care planning module. English- or Spanish-speaking individuals 12-24 years old with advanced cancer (defined as progressive, recurrent, or refractory disease, or any diagnosis associated with < 50% survival) receiving care at 4 academic medical centers are eligible. Patients' caregivers are also eligible to participate in this study if they are able to speak and read English or Spanish, and are cognitively and physically able to participate. Participants in all groups complete surveys querying patient-reported outcomes at the time of enrollment and 3-, 6-, 9-, and 12-months post-enrollment. The primary outcome of interest is patient-reported health-related quality of life (HRQOL) and secondary outcomes of interest include patient anxiety, depression, resilience, hope and symptom burden, parent/caregiver anxiety, depression and health-related quality of life, and family palliative care activation. We will conduct intention-to-treat analysis to compare the group means of primary and secondary outcomes between PRISM-AC arm and control arm with regression models. Discussion This study will provide methodologically rigorous data and evidence regarding a novel intervention to promote resilience and reduce distress among AYAs with advanced cancer. This research has the potential to offer a practical, skills-based curriculum designed to improve outcomes for this high-risk group. Trial registration: ClinicalTrials.gov Identifier NCT03668223, September 12, 2018.
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House TR, Rosenberg AR, Zimmerman CT, Barton KS, Wightman A. Caregiver perspectives of dialysis initiation for children with kidney disease: a qualitative study. Pediatr Nephrol 2022; 37:2457-2469. [PMID: 35181825 PMCID: PMC10433404 DOI: 10.1007/s00467-022-05472-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND To better support family-centered care surrounding dialysis initiation, greater understanding of caregiver experience is necessary. METHODS Using thematic analysis, we conducted a secondary analysis of semi-structured interview data from a qualitative study of caregivers of children receiving dialysis recruited from 3 pediatric centers. Prominent themes in caregiver experience of caring for a child initiating dialysis were identified. RESULTS Thirty-five caregivers participated. Three major themes emerged from qualitative analysis: (1) parenting disrupted - caregivers experienced an acute disruption in their parenting role due to the unexpected, emergent circumstances and vast information accompanying their child's diagnosis; (2) redefining parenting - caregivers sought to reestablish their innate parental role and foster their evolving medical provider role through reassurance that their child could survive, communication with the medical team, and engaging in care plan development; and (3) leveraging dual identities - to positively impact their child's experience and enable flourishing, caregivers leveraged their established caregiver role and newly realized medical provider role through voicing their perspectives, watching over their child's care, and preparing for future changes in their child's health. If caregivers' evolution was not nurtured and enabled, acute fluctuations in their child's care could contribute to future disruption and need to restore their parental role. However, if caregiver development was fostered, caregivers acquired increased ability to prepare for vacillations in their child's care. CONCLUSIONS Improving delivery of family-centered care and support of caregivers at dialysis initiation will require directed efforts by nephrology care teams to foster caregiver evolution and resilience and respond to the family's changing experience of kidney disease. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Taylor R House
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA.
| | - Abby R Rosenberg
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA
| | - Cortney T Zimmerman
- Department of Pediatric Psychology, Texas Children's Hospital, 6701 Fannin Street 16th Floor, Houston, TX, 77030, USA
| | - Krysta S Barton
- Seattle Children's Research Institute, 1920 Terry Ave, M/S CURE-4, PO Box 5371, Seattle, WA, 98145, USA
| | - Aaron Wightman
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA
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Maryam D, Wu LM, Su YC, Hsu MT, Harianto S. The journey of embracing life: Mothers' perspectives of living with their children with retinoblastoma. J Pediatr Nurs 2022; 66:e46-e53. [PMID: 35718669 DOI: 10.1016/j.pedn.2022.06.004] [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: 03/22/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to explore the experience and views of mothers with children who have been diagnosed with retinoblastoma. DESIGN AND METHODS A descriptive qualitative study was conducted in the period of 2019-2021. Interviews were conducted with 21 mothers of children diagnosed with retinoblastoma in Indonesia. Data were collected by semi-structured interviews and examined by content analysis. RESULTS Mothers evolved from a sense of unacceptability to accepting challenges and gaining inner strength. Three themes were identified: 1) physical and psychological suffering, 2) awareness of changes and demands, and 3) keep moving forward. Mothers developed positive adaptive mechanisms for coping with the problems associated with having a child with retinoblastoma. Psychological adjustment and religious beliefs were key elements in their journeys toward embracing life in the moment. CONCLUSION Findings illuminated psychological adaptation and coping strategies of mothers with seriously ill children and highlighted how difficulties and cultural norms shaped the adaptative process. Religion and health beliefs played varied and important roles in helping mothers to manage their stress and enhance their coping strategies. PRACTICE IMPLICATIONS Our findings revealed that it is important to routinely assess social support, traditional health beliefs, and spirituality on mothers, facilitate mentoring to help mothers find their inner strengths, and develop intervention programs designed to promote psychological adjustment without delaying treatment.
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Affiliation(s)
- Dewi Maryam
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC, and Dr Soetomo Hospital, Surabaya, Indonesia.
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, and Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
| | - Yi-Ching Su
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| | - Min-Tao Hsu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| | - Susilo Harianto
- Faculty of Nursing, Airlangga University, Surabaya Indonesia, Faculty of Vocational, Airlangga Indonesia, Mulyorejo, Surabaya 60115, Indonesia.
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Steineck A, Bradford MC, O'Daffer A, Fladeboe KM, O'Donnell MB, Scott S, Yi-Frazier JP, Rosenberg AR. Quality of Life in Adolescents and Young Adults: The Role of Symptom Burden. J Pain Symptom Manage 2022; 64:244-253.e2. [PMID: 35649460 PMCID: PMC9378571 DOI: 10.1016/j.jpainsymman.2022.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022]
Abstract
CONTEXT Adolescents and young adults (AYAs) with cancer report worse health-related quality of life (HRQOL) than other age groups. Symptom burden is a modifiable predictor of HRQOL. OBJECTIVES The objective of this study was to identify which symptoms are most burdensome to AYAs with advanced cancer. METHODS In this observational study, English-speaking individuals aged 12-25 years undergoing treatment for advanced cancer completed assessments of symptom burden (Memorial Symptom Assessment Scale) and HRQOL (Pediatric Quality of Life Inventory Generic Form and Cancer Module; minimal clinically important difference 4.4). We dichotomized participants as having low (<7) or high (≥7) symptom prevalence. Mixed regression models estimated HRQOL differences between groups. For individual symptoms, unadjusted mixed models estimated HRQOL reductions. RESULTS N = 58 AYAs completed baseline surveys. The median age was 17 years (IQR 15-19), 58% were male, 59% identified as white, and 44% were diagnosed with leukemia/lymphoma. High symptom prevalence was associated with a mean generic HRQOL 7 points lower (95% CI: -11, -3; P < 0.01) and cancer-specific HRQOL score 12 points lower (95% CI: -17, -7; P < 0.01) than low symptom prevalence. The most prevalent symptoms were fatigue (71%), pain (58%), and difficulty sleeping (58%). Fatigue (-8), difficulty concentrating (-7), and mouth sores (-6) were associated with the greatest generic HRQOL score reductions. Dysphagia (-12), difficulty concentrating (-12), and sadness (-11) were associated with the greatest cancer-specific HRQOL score reductions. CONCLUSION The symptom experience among AYAs with advanced cancer is unique. Separate evaluation of AYA's symptoms may optimize management and improve HRQOL.
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Affiliation(s)
- Angela Steineck
- Seattle Children's Hospital (A.S.), Cancer and Blood Disorders Center, Seattle, Washington, USA; Seattle Children's Research Institute (A.S., A.O., K.M.F., M.B.O., J.P.Y-F., A.R.R.), Center for Clinical and Translational Research, Seattle, Washington, USA; University of Washington School of Medicine (A.S.), Department of Pediatrics, Seattle, Washington, USA; University of Washington (A.S., K.M.F., M.B.O., A.R.R.), Cambia Palliative Care Center of Excellence, Seattle, Washington, USA; MACC Fund Center for Cancer and Blood Disorders (A.S.), Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Miranda C Bradford
- Core for Biostatistics (M.C.B.), Epidemiology, and Analytics in Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Alison O'Daffer
- Seattle Children's Research Institute (A.S., A.O., K.M.F., M.B.O., J.P.Y-F., A.R.R.), Center for Clinical and Translational Research, Seattle, Washington, USA
| | - Kaitlyn M Fladeboe
- Seattle Children's Research Institute (A.S., A.O., K.M.F., M.B.O., J.P.Y-F., A.R.R.), Center for Clinical and Translational Research, Seattle, Washington, USA; University of Washington (A.S., K.M.F., M.B.O., A.R.R.), Cambia Palliative Care Center of Excellence, Seattle, Washington, USA
| | - Maeve B O'Donnell
- Seattle Children's Research Institute (A.S., A.O., K.M.F., M.B.O., J.P.Y-F., A.R.R.), Center for Clinical and Translational Research, Seattle, Washington, USA; University of Washington (A.S., K.M.F., M.B.O., A.R.R.), Cambia Palliative Care Center of Excellence, Seattle, Washington, USA
| | - Samantha Scott
- Department of Psychology (S.S.), University of Denver, Denver, Colorado, USA
| | - Joyce P Yi-Frazier
- Seattle Children's Research Institute (A.S., A.O., K.M.F., M.B.O., J.P.Y-F., A.R.R.), Center for Clinical and Translational Research, Seattle, Washington, USA
| | - Abby R Rosenberg
- Seattle Children's Hospital (A.S.), Cancer and Blood Disorders Center, Seattle, Washington, USA; Seattle Children's Research Institute (A.S., A.O., K.M.F., M.B.O., J.P.Y-F., A.R.R.), Center for Clinical and Translational Research, Seattle, Washington, USA; University of Washington School of Medicine (A.S.), Department of Pediatrics, Seattle, Washington, USA; University of Washington (A.S., K.M.F., M.B.O., A.R.R.), Cambia Palliative Care Center of Excellence, Seattle, Washington, USA.
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Eraslan P, İlhan A, Eraslan E, Karacin C, Çakmak Öksüzoğlu ÖB. The Relationship Between Caregiver Burden and Posttraumatic Growth in Caregivers of Patients With Metastatic Cancer. Cureus 2022; 14:e23622. [PMID: 35494993 PMCID: PMC9049763 DOI: 10.7759/cureus.23622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Abstract
Objective In this study, we aimed to examine the effect of post-traumatic growth and depressive symptoms on caregiver burden in caregivers of cancer patients. Methods This was a single-center cross-sectional observational descriptive study conducted at a medical oncology clinic. The study included 214 caregivers of cancer patients. Participants were assessed with a sociodemographic information form, the Turkish versions of the Zarit Caregiver Burden Scale (ZCBS), the Posttraumatic Growth Inventory (PTGI), and the Beck Depression Inventory (BDI). Results The mean ZCBS, PTGI, and BDI scores were 42.7 ±13.8, 67.8 ±22.3, and 13.5 ±9.8, respectively. There was a negative correlation (r=-0.407, p<0.001) between the ZCBS and the PTGI total scores, a positive correlation (r=0.636, p<0.001) between the ZCBS total and BDI scores, and a negative correlation (r=-0.426, p<0.001) between the PTGI total and BDI scores. Age, gender, income level, and history of psychiatric treatment were not independent predictive factors for the ZCBS total scores. PTGI total score (B=-0.107, 95% CI: -0.178 to -0.037, p=0.003) and BDI score (B=0.776, 95% CI: 0.602-0.950, p<0.001) were independent predictive factors for ZCBS total scores. Conclusions Our study revealed a significant negative relationship between caregiver burden and PTGI in caregivers of metastatic cancer patients, and it was found that depression negatively affects burden in caregivers. Posttraumatic growth can be a protective buffer against the burden of care and depression among caregivers.
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Luo Y, Wang A, Zeng Y, Zhang J. A latent class analysis of resilience and its relationship with depressive symptoms in the parents of children with cancer. Support Care Cancer 2022; 30:4379-4387. [DOI: 10.1007/s00520-022-06860-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/21/2022] [Indexed: 11/25/2022]
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Luo Y, Li HCW, Xia W, Cheung AT, Ho LLK, Chung JOK. The Lived Experience of Resilience in Parents of Children With Cancer: A Phenomenological Study. Front Pediatr 2022; 10:871435. [PMID: 35707743 PMCID: PMC9189362 DOI: 10.3389/fped.2022.871435] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Resilience is vital in parents of children with cancer as it can promote parental well-being and minimize maladaptation in the face of the children's cancer. Although existing quantitative studies investigated the influence factors of resilience in the parents, it has not been fully explored about the factors contributing to the resilience of parents and how they respond to and cope with their children's cancer. OBJECTIVE To investigate the lived experience of resilience in the parents of children with cancer from a qualitative perspective to complement existing findings in quantitative studies. METHODS A phenomenological approach was used. Purposive sampling was performed to recruit parents of children with cancer from two tertiary hospitals in mainland China, followed by one-to-one semi-structured interviews. All of the interviews were audio-recorded and data were analyzed using thematic analysis. RESULTS Twenty-three parents, comprising 15 mothers and eight fathers, of children with cancer participated in the interview. Four themes were identified: positive and negative experiences of their children's disease, going through hardships, perceived competence and perceived social support. The most prominent facilitating factor of resilience was the presence of positive attitudes toward the children's cancer, while low level of confidence was the main obstacle. CONCLUSION This study identified certain factors that affect resilience in parents of children with cancer. The findings of this study provide important implications for the development of targeted resilience training programs to enhance resilience in parents of children with cancer. It is crucial for future interventions to focus on cultivating parental resilience to promote parents' mental well-being and improve their quality of life. CLINICALTRIALSGOV ID NCT03631485; URL: https://clinicaltrials.gov/ct2/show/NCT03631485.
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Affiliation(s)
- Yuanhui Luo
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ho Cheung William Li
- Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei Xia
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Ankie Tan Cheung
- Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Laurie Long Kwan Ho
- Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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Taib F, Beng KT, Chan LC. The Challenges, Coping Mechanisms, and the Needs of the Inhospital Parents Caring for Children with Life-limiting Neurological Disorders: A Qualitative Study. Indian J Palliat Care 2021; 27:483-489. [PMID: 34898942 PMCID: PMC8655653 DOI: 10.25259/ijpc_3_21] [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: 07/10/2021] [Accepted: 09/29/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives Parents who have children with complex lifelong and life-limiting neurological conditions experienced many stresses and anxieties throughout their lives as caregivers. However, this information is still very limited. The study aimed to explore the challenges faced by parents with children who have complex neurological conditions, their coping strategies, needs, and expectations. Materials and Methods A semi-structured, in-depth interviews were conducted in the either Malay or English language among the parents of children with complex lifelong neurological conditions and have been on long-term in-patient hospital care. The interviews were audio-recorded and transcribed for thematic analysis. The qualitative study was conducted from October to November 2016 at the Paediatric Institute of Hospital Kuala Lumpur. Grounded theory was used to examine the qualitative data with inductive and deductive types of coding. The transcripts were read repeatedly to allow familiarity to the themes presented by the participants. Further discussions were conducted among the researchers to triangulate the information. Results A total of 11 parents were interviewed for this study. The thematic analysis resulted in 8 challenges: Physical wellbeing, Environment, Relationship, Financial, Occupational, Rational, Mental, and Spiritual. Coping strategies comprised problem focused issues related to the key challenges in the caregivers' context. Similar to the needs and expectations, the key themes were derived from the key understandings of the challenges and looking at the palliative care impacts for these children. Conclusion There are various challenges faced by parents of children with life-limiting neurological disorders. Physical, Environment, Relationship, Financial, Occupational, Rational, Mental, and Spiritual Wellbeing can be a platform for the assessment of the caregivers' needs and the planning for palliative care support.
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Affiliation(s)
- Fahisham Taib
- Department of Paediatrics, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Khoo Teik Beng
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Lee Chee Chan
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
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Eche IJ, Yusufov M, Isibor DA, Wolfe J. A systematic review and meta-analytic evaluation of psychosocial interventions in parents of children with cancer with an exploratory focus on minority outcomes. Pediatr Blood Cancer 2021; 68:e29328. [PMID: 34523798 DOI: 10.1002/pbc.29328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/28/2021] [Accepted: 08/13/2021] [Indexed: 11/11/2022]
Abstract
Parents of children with cancer are prone to psychosocial distress, yet little is known about intervention response among diverse parents. Our systematic review and meta-analysis evaluated the efficacy of psychosocial interventions on anxiety and depression among parents of children with cancer and explored race and/or ethnicity differences in the efficacy of these interventions. Twenty articles met inclusion. The aggregate effect size on anxiety (-0.01, 95% CI: -0.95, 0.93, p = .97) and depression (-0.56, 95% CI: -1.65, 0.54, p = .32) showed micro to medium effects, with larger negative effect sizes indicating that anxiety and depression scores after treatment were lower for parents in intervention group as compared to control group. Neither aggregate effect size was statistically significantly different from zero. Due to underrepresentation of minorities, we could not perform subgroup or moderator analyses. Several efficacious psychosocial interventions were found to reduce parental anxiety. Future studies to examine psychosocial interventions in minority parents are warranted.
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Affiliation(s)
- Ijeoma Julie Eche
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Miryam Yusufov
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
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Venkatraman K, Vijayalakshmi V, Sudarsanam N, Manoharan A. Designing Dynamic Interventions to Improve Adherence in Pediatric Long-Term Treatment - The Role of Perceived Value of the Physician by Primary Caregivers. HEALTH COMMUNICATION 2021; 36:1825-1840. [PMID: 32731759 DOI: 10.1080/10410236.2020.1796284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Primary Caregivers are the fulcrum in the physician-caregiver-child triad. Existing literature discusses static multi-component interventions in detail. In long-term treatments, dynamic intervention design is needed as the environment and situations of the families are dynamic. The objectives of this study are (a) to identify the components of the primary caregiver's perception of the physician's value with reference to the effectiveness of consultation and relationships with the former and with the child; (b) to establish the role of this perception in designing dynamic interventions, and (c) to describe the perception's potential influence on adherence. A PRISMA, chronological, and morphological analysis of the literature is carried out about caregivers' adherence in the pediatric long-term treatment context. We define communication and consultation as the functional, whereas relationship as the emotional component of the caregiver's perception of the physician. We propose a theoretical model that incorporates intervention as an integral component of care. Adherence happens as a response to changing situations and hence fluctuates. Hence, a dynamic intervention design to benefit the child should be incorporated into care through the caregiver-physician bridge. Future research should explore how intervention needs change and the driving reasons for understanding the static and dynamic components of interventions.
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Affiliation(s)
| | - V Vijayalakshmi
- Department of Management Studies, Indian Institute of Technology, Madras
| | - Nandan Sudarsanam
- Department of Management Studies, Indian Institute of Technology, Madras
| | - Anand Manoharan
- Department of Clinical Research, Kanchi Kamakoti CHILDS Trust Hospital
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Luo Y, Xia W, Cheung AT, Ho LLK, Zhang J, Xie J, Xiao P, Li HCW. Effectiveness of a Mobile Device-Based Resilience Training Program in Reducing Depressive Symptoms and Enhancing Resilience and Quality of Life in Parents of Children With Cancer: Randomized Controlled Trial. J Med Internet Res 2021; 23:e27639. [PMID: 34847060 PMCID: PMC8669578 DOI: 10.2196/27639] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/21/2021] [Accepted: 10/05/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Caring for children with cancer can be a stressful experience for parents and may have negative effects on their physical and psychological well-being. Although evidence has shown that resilience is associated with positive psychological well-being, few interventions have been specifically designed to enhance the resilience of parents of children with cancer. OBJECTIVE The aim of this study is to examine the effectiveness of a mobile device-based resilience training program in reducing depressive symptoms and enhancing resilience and quality of life (QoL) in parents of children with cancer. METHODS Parents of children diagnosed with cancer were recruited from the pediatric oncology wards of 3 tertiary hospitals in China. The participants were randomly assigned to either the experimental group (52/103, 50.5%) to undergo an 8-week mobile device-based resilience training program or to the control group (51/103, 49.5%) to receive an 8-week program of placebo information. The study outcomes included resilience, depressive symptoms, and QoL, as measured by the Connor-Davidson Resilience Scale, the Self-Rating Depression Scale, and the Short Form of the 6-Dimension Health Survey, respectively. All data were collected at baseline and at 2 and 6 months of follow-up. The data analysis followed the intention-to-treat principle. A generalized estimating equation was used to examine the effects of the intervention. RESULTS The participants were mostly female (72/103, 69.9%), and their mean age was 33.6 (SD 5.2) years. The participants in the experimental group showed significantly higher levels of resilience (mean 67.96, SD 15.8 vs mean 58.27, SD 19.0; P<.001) and lower levels of depressive symptoms (mean 40.17, SD 9.9 vs mean 46.04, SD 10.9; P<.001) than those in the control group at 6 months of follow-up. The intervention showed statistically significant effects in improving resilience (β=6.082; P=.01) and decreasing depressive symptoms (β=-2.772; P=.04) relative to the control group. The QoL score in the experimental group was higher than that in the control group at 6 months of follow-up (mean 0.79, SD 0.2 vs mean 0.76, SD 0.3; P=.07); however, no statistically significant intervention effect was detected (β=.020; P=.38). CONCLUSIONS The mobile device-based resilience training program effectively enhanced resilience and alleviated depressive symptoms in parents of children with cancer. It is highly recommended that health care professionals incorporate this resilience training program when providing psychological care to parents of children with cancer. TRIAL REGISTRATION Clinical.Trials.gov NCT04038242; http://clinicaltrials.gov/ct2/show/NCT04038242.
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Affiliation(s)
- Yuanhui Luo
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Wei Xia
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Ankie Tan Cheung
- Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Laurie Long Kwan Ho
- Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Jingping Zhang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jianhui Xie
- Department of Nursing, Hunan Children's Hospital, Changsha, China
| | - Pin Xiao
- Department of Hematology, Hunan Children's Hospital, Changsha, China
| | - Ho Cheung William Li
- Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
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Park M, Choi EK, Lyu CJ, Han JW, Hahn SM. Family resilience factors affecting family adaptation of children with cancer: A cross-sectional study. Eur J Oncol Nurs 2021; 56:102078. [PMID: 34847403 DOI: 10.1016/j.ejon.2021.102078] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 05/29/2021] [Accepted: 11/20/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Pediatric cancer impacts all family members, including parents and siblings, who strive to adjust to a multitude of changes brought about by the illness. Family resilience is an important factor in the successful adaptation of families of children with cancer. Therefore, we aimed to identify risk and protective factors for family resilience at the child, family, and community levels that affect the adaptation of families of children with cancer. METHOD This study employed a descriptive survey design, and data were collected from 111 parents of children undergoing treatment for cancer between April and May 2020 at a university hospital in South Korea. Based on Patterson's family resilience model, risk factors-severity of child's condition, parental depression, and stigma and discrimination-and protective factors-the child's temperament, family communication skills, and supportive health services-for family adaptation were analyzed using multiple regression analyses. RESULTS Among family resilience factors affecting the adaptation of families of children with cancer, parental depression (ß = -0.290, p = 0.004) and family communication skills (ß = 0.403, p < 0.001) were identified as risk and protective factors, respectively. These variables accounted for 29.3% of the variance in family adaptation (F = 7.503, p < 0.001). CONCLUSIONS There is a need to develop strategies such as intervention programs that focus on reducing parental depression and strengthening family communication skills to promote the adaptation of families to pediatric cancer.
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Affiliation(s)
- Mina Park
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Eun Kyoung Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
| | - Chuhl Joo Lyu
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Woo Han
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Min Hahn
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
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González-Flores CJ, García-García G, Lerma A, Pérez-Grovas H, Meda-Lara RM, Guzmán-Saldaña RME, Lerma C. Resilience: A Protective Factor from Depression and Anxiety in Mexican Dialysis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11957. [PMID: 34831713 PMCID: PMC8620979 DOI: 10.3390/ijerph182211957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/02/2021] [Accepted: 11/11/2021] [Indexed: 12/11/2022]
Abstract
Depression and anxiety are highly prevalent psychological disorders in end-stage renal disease (ESRD) that have a negative clinical impact. The purpose of our study was to identify factors associated with the presence of depression and anxiety, in a sample of ESRD patients treated with hemodialysis. We included 187 patients from two dialysis facilities, age 18-65 years. Beck's depression and anxiety inventories, KDQOL36 questionnaire, the cognitive distortion scale and the Mexican scale of resilience were used. Socio-demographic and clinical information was obtained from medical records. Depression was present in 143 (76.4%) patients. Patient with depression were older (33 (26-52) years vs. 30 (24.43) years, p = 0.025), had a lower education level (36% vs. 9%, p = 0.001), used more medications (67% vs. 36%, p = 0.001), had a comorbidity (75% vs. 41%, p = 0.001), and a higher proportion were waiting for a kidney transplant. Anxiety was present in 112 (59.8%) cases. By multivariate analysis, depression was independently associated with lower education, absence of previous kidney transplant, anxiety, higher cognitive distortion, lower psychological resilience, and lower quality of life scores. In conclusion, lower psychological resilience, lower education level, and higher cognitive distortions are factors associated with depression and anxiety in ESRD patients.
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Affiliation(s)
| | - Guillermo García-García
- Nephrology Department, Civil Hospital de Guadalajara Fray Antonio Alcalde, Guadalajara 44280, Mexico;
| | - Abel Lerma
- Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, San Juan Tilcuautla 42160, Mexico; (A.L.); (R.M.E.G.-S.)
| | | | - Rosa M. Meda-Lara
- Departments of Basic Psychology and Medical Clinics, Health Sciences Center, University of Guadalajara, Guadalajara 44340, Mexico;
| | - Rebeca M. E. Guzmán-Saldaña
- Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, San Juan Tilcuautla 42160, Mexico; (A.L.); (R.M.E.G.-S.)
| | - Claudia Lerma
- National Institute of Cardiology Ignacio Chávez, México City 14080, Mexico;
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Lin Q, Dong F, Xue Y, Yu Q, Ren J, Zeng L. Predictors of posttraumatic growth of the family members of neurosurgical intensive care unit patients: A cross-sectional study. Intensive Crit Care Nurs 2021; 68:103134. [PMID: 34750040 DOI: 10.1016/j.iccn.2021.103134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/26/2021] [Accepted: 08/12/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Confronted with the potentially traumatic experience of a patients intensive care unit hospitalisation, family members may show positive changes associated with growth in addition to negative impact. This study aimed to identify the level of posttraumatic growth of the family members of neurosurgical intensive care unit patients and to explore its relation to positive personality characteristics, such as gratitude, resilience and hope. DESIGN AND SETTING A cross-sectional study involving 340 family members of patients admitted to the neurosurgical intensive care unit at a general tertiary hospital in Shanghai, China. METHODS Before the patients' hospital discharge, the participants completed questionnaires, assessing posttraumatic growth (PTG Inventory), social support (Social Support Rating Scale), resilience (Chinese version of the Connor-Davidson Resilience Scale), hope (Herth Hope Index) and gratitude (Gratitude Questionnaire Six-Item Form). RESULTS The mean total posttraumatic growth score was 73.38 (14.02). Hope, gratitude, resilience and social support showed a positive correlation with the posttraumatic growth Inventory scores. There were significant differences in the posttraumatic growth scores of the family members of neurosurgical intensive care patients with respect to their different religious beliefs, payment methods, family relationship quality and presence of chronic diseases among family members. Multiple linear regression analysis showed that gratitude, resilience and social support were independent predictors of the posttraumatic growth Inventory score. CONCLUSION Family members may experience some degree of posttraumatic growth during hospitalisation of patients in the neurosurgical intensive care units. Gratitude, social support and resilience are predictive factors for posttraumatic growth.
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Affiliation(s)
- Qi Lin
- Department of Nursing, Shanghai Jiao Tong University Affiliated Sixth People's Hospital. Shanghai, China
| | - Fanghui Dong
- Department of Nursing, Shanghai Jiao Tong University Affiliated Sixth People's Hospital. Shanghai, China
| | - Yiwei Xue
- Intensive Care Unit, Shanghai Jiao Tong University Affiliated Sixth People's Hospital. Shanghai, China
| | - Qunya Yu
- General Surgery Department, Shanghai Jiao Tong University Affiliated Sixth People's Hospital. Shanghai, China
| | - Junhong Ren
- Ophthalmology Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University. Shanghai, China
| | - Li Zeng
- Neurosurgical Intensive Care Unit, Shanghai Tenth People's Hospital, School of Medicine, Tongji University. Shanghai, China; Department of Nursing, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
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Durante A, Ahtisham Y, Cuoco A, Boyne J, Brawner B, Juarez-Vela R, Vellone E. Informal caregivers of people with heart failure and resilience: A convergent mixed methods study. J Adv Nurs 2021; 78:264-275. [PMID: 34668214 DOI: 10.1111/jan.15078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/07/2021] [Accepted: 09/30/2021] [Indexed: 02/03/2023]
Abstract
AIM To develop a comprehensive understanding of resilience and its associated factors among informal caregivers of people with heart failure. DESIGN Transnational multicentre convergent mixed methods approach. METHODS This study was conducted in three European countries: Italy, Spain and the Netherlands; during February 2017 and December 2018. In total, 195 caregivers completed the Connor-Davidson Resilience Scale, Caregiver Burden Inventory and Hospital Anxiety and Depression Scale. From a nested sample 50 caregivers participated in semi-structured face-to-face interviews. Data were analysed using qualitative content analysis, multiple regression and joint displays. RESULTS The caregivers' mean age was over 60 years. The quantitative results showed that caregivers experienced anxiety and depression regardless of a good score of resilience and moderate level of burden. Regression analysis showed that the resilience was associated with caregiver depression. From qualitative findings three resilience inhibiting (psychological outlook, physical weariness and affective state) and two promoting factors (community interconnectedness and self-comforting activities) were generated. Mixed analysis confirmed that depression decreased caregivers' resilience. CONCLUSIONS Caregivers of people with heart failure experience continuous stress and anxiety resulting in reduced resilience. Collaborative efforts are needed to build multifaceted interventions and programs to enhance caregivers' resilience by targeting the factors identified in this study. IMPACT The quality of informal caregiving is affected by the resilience of caregivers. No research has explored the resilience levels and its factors in this population. Depression, psychological outlook, physical weariness and affective state are negative factors of caregivers' resilience. Personal strategies combined with social and community support and belongingness enhance caregivers' resilience. Community care organizations and hospitals could establish alliances to develop programs for enhancing caregivers' resilience.
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Affiliation(s)
- Angela Durante
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Roma, Italy
| | - Younas Ahtisham
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, Canada
| | - Angela Cuoco
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Roma, Italy
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bridgette Brawner
- M. Louise Fitzpatrick College of Nursing at Villanova University, Philadelphia, Pennsylvania, USA
| | | | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Roma, Italy
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Chung JOK, Li WHC, Wei X, Cheung AT, Ho LLK, Chan GCF. Translation and psychometric evaluation of the Chinese version of the resilience scale for children with cancer. Health Qual Life Outcomes 2021; 19:232. [PMID: 34600543 PMCID: PMC8487328 DOI: 10.1186/s12955-021-01865-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To test the psychometric properties of a traditional Chinese version of the Resilience Scale for Children (RS-10) and examine its factorial structure via a confirmatory factor analysis (CFA). METHODS One hundred and eighty-six Hong Kong Chinese children with cancer were recruited in the paediatric oncology units of two public acute-care hospitals in Hong Kong to participate in this cross-sectional study. The psychometric properties of the traditional Chinese version of the RS-10 were assessed, namely its content equivalence, convergent and discriminant validity, construct validity, internal consistency and test-retest reliability. RESULTS The newly translated traditional Chinese version of the RS-10 demonstrated adequate internal consistency (Cronbach's α = .83, McDonald's Ω = .80), excellent test-retest reliability (.89), good content equivalence (CVI = 96%) and appropriate convergent (r = - .52, P = .01) and discriminant validity (r = .61, P = .01). The CFA results demonstrated that there was a good fit between the factor structure of the Chinese version of the RS-10 and the observed data (χ2/df = 2.34, TLI = .951, RMSEA = .053, CFI = .962, GFI = .948, SRMR = .052), thereby confirming the construct validity of this instrument. CONCLUSIONS The traditional Chinese version of the RS-10 was found to be a reliable and valid tool for assessing the resilience of Hong Kong Chinese children with cancer. The newly developed traditional Chinese version of the RS-10 is an appropriate clinical research tool for evaluating the effectiveness of nursing interventions in enhancing the resilience of and promoting mental well-being in children with cancer. Trial registration NCT03544190.
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Affiliation(s)
- Joyce Oi Kwan Chung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - William Ho Cheung Li
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, Hong Kong.
| | - Xia Wei
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, Hong Kong
| | - Laurie Long Kwan Ho
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, Hong Kong
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Rosenberg AR, Steiner J, Lau N, Fladeboe K, Toprak D, Gmuca S, O'Donnell MB, Smith K, Brown CE, Yi-Frazier JP. From Theory to Patient Care: A Model for the Development, Adaptation, and Testing of Psychosocial Interventions for Patients With Serious Illness. J Pain Symptom Manage 2021; 62:637-646. [PMID: 33677072 PMCID: PMC8418616 DOI: 10.1016/j.jpainsymman.2021.02.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 10/22/2022]
Abstract
Psychosocial and supportive care interventions are a cornerstone of palliative care science, yet there is little published guidance regarding how to develop, test, adapt, and ultimately disseminate evidence-based interventions. Our objective was to describe the application of a single intervention-development model in multiple populations of patients with serious illness. Specifically, we use the "Promoting Resilience in Stress Management" (PRISM) intervention as an exemplar for how the Obesity Related Behavioral Intervention Trials (ORBIT) intervention-development model may be applied to: 1) create an initial palliative care intervention; 2) adapt an existing intervention for a new patient-population; 3) expand an existing intervention to include new content; and, 4) consider dissemination and implementation of a research-proven intervention. We began by identifying key psychological and social science theories and translating them a testable clinical hypothesis. Next, we conducted observational studies and randomized trials to design, refine, and standardize PRISM within unique patient-populations. We moved backwards in the ORBIT model when necessary to adapt or expand PRISM content and delivery-strategies to meet patient-reported needs. Finally, we began to explore PRISM's effectiveness using Dissemination and Implementation research methods. Key lessons include the need to ground intervention-development in evidence-based theory; involve patient, clinician, and other stakeholders at every phase of development; "meet patients where they are at" with flexible delivery strategies; invest in the time to find the right scientific premise and the right intervention content; and, perhaps most importantly, involve an interdisciplinary research team.
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Affiliation(s)
- Abby R Rosenberg
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
| | - Jill Steiner
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Nancy Lau
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Child Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Kaitlyn Fladeboe
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Demet Toprak
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Sabrina Gmuca
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Division of Rheumatology, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania and Center for Pediatric Clinical Effectiveness and PolicyLab at Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maeve B O'Donnell
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA
| | - Kiska Smith
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA
| | - Crystal E Brown
- Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Joyce P Yi-Frazier
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA
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The Role of Beliefs and Psychological Factors in Caring of Patients With Cancer: The Lived Experiences of Informal Caregivers. Holist Nurs Pract 2021; 35:248-256. [PMID: 34407022 DOI: 10.1097/hnp.0000000000000468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cancer affects not only the patient but also family members as informal caregivers. In order for family caregivers to achieve balance and improve their caregiving roles, it is essential to identify the beliefs and psychological aspects affecting them. The present study was carried out qualitatively with a descriptive phenomenological design in 2020. The main participants in this study were selected from one of the major referral centers for cancer patients in West Azerbaijan Province, located in northwestern, Iran. Twenty-two family caregivers were selected through a purposive sampling method. Data analysis showed that the 3 main themes of "emotional and religious preconceptions," "feeling committed to caring for beloveds," and "resilience" played a prominent role in family caregivers. These factors led to caregivers' commitment to and responsibility for care. Holistic care necessitates consideration of all aspects of human life. The results of this study led to an understanding of the complex tendencies and feelings of family caregivers. Based on the results, it was found that care is influenced by beliefs, religious preconceptions, sociocultural, and psychological factors. Identifying these variables helps medical staff share planning, interventions, and counseling with family caregivers and address issues that affect them.
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Psychological interventions for enhancing resilience in parents of children with cancer: a systematic review and meta-analysis. Support Care Cancer 2021; 29:7101-7110. [PMID: 34131847 DOI: 10.1007/s00520-021-06344-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Caring for children with cancer is considerably stressful for parents and may negatively affect their physical and psychological well-being. Resilience plays a pivotal role in maintaining psychological well-being in the face of stress and adversity. The aim of this systematic review was to evaluate the effectiveness of psychological interventions in promoting resilience among parents of children with cancer. METHODS Five English databases and two Chinese databases were subjected to a systematic search from inception to March 2020. The methodological quality of the included randomised controlled trials was evaluated using the Cochrane risk of bias tool (RoB 2.0). Meta-analyses and descriptive analyses were used. Subgroup analyses of the intervention modes and time since diagnosis were also conducted. RESULTS Five studies involving 308 participants were included. The systematic review identified three types of psychological intervention, namely resilience training, self-disclosure and peer support, which had different essential components and characteristics. The meta-analyses of three randomised controlled trials revealed that the psychological interventions enhanced parents' resilience with a large effect size (Hedges' adjusted g 0.92; 95% CI 0.22, 1.62; p = .01). CONCLUSION Evidence supports the effectiveness of psychological interventions for enhancing resilience in the parents of children with cancer. Healthcare professionals can incorporate evidence-based psychological interventions to enhance resilience to help these parents better navigate adversity, adapt to their children's situations and improve their psychological well-being.
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Dufter SA, Hübner J, Ahmadi E, Zomorodbakhsch B. Traits of cancer patients and CAM usage. J Cancer Res Clin Oncol 2021; 147:3685-3692. [PMID: 33811274 PMCID: PMC8557154 DOI: 10.1007/s00432-021-03605-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
Background The use of Complementary Alternative Medicine (CAM) Methods is increasing and therefore gaining importance also in conventional western medicine. Identifying personal traits to make out by whom and why CAM is used can help physicians in successful physician–patient interaction, and thus improve patient’s compliance and trust towards their physician. Patients and methods A questionnaire was passed on to cancer patients in an ambulant clinical and a rehabilitation setting. Multiple regression analyses were run to examine possible predictors for CAM use, such as gender, age, level of education, spirituality, attentiveness, self-efficacy and resilience. To differentiate within CAM users, two dependent variables were created: “holistic and mind–body methods”, such as Yoga, meditation or Homeopathy and “material based methods”, such as food supplements or vitamins. Results Higher level of education, younger age and religion-independent attentiveness were significant predictors for the use of “material based methods”. Female gender, higher education and religious spirituality were detected as significant predictors for “holistic and mind–body methods”. Conclusion This study is among the first to take a more detailed look at how numerous personal traits are associated with the use of CAM methods and differentiate between the applied methods. Our finding should be considered by conventional health care providers and could be integrated into a holistic assessment, to offer information about complementary medicine and meeting patients’ needs.
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Affiliation(s)
| | - Jutta Hübner
- Klinik Für Innere Medizin II, Am Klinikum 1, 07747, Jena, Germany
| | - Emadaldin Ahmadi
- Klinik Für Innere Medizin II, Am Klinikum 1, 07747, Jena, Germany
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Luo YH, Li WHC, Cheung AT, Ho LLK, Xia W, He XL, Zhang JP, Chung JOK. Relationships between resilience and quality of life in parents of children with cancer. J Health Psychol 2021; 27:1048-1056. [PMID: 33522296 DOI: 10.1177/1359105321990806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
CLINICALTRIALS.GOV ID NCT03631485.
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Affiliation(s)
- Y H Luo
- University of Hong Kong, Hong Kong
| | - W H C Li
- University of Hong Kong, Hong Kong
| | | | - L L K Ho
- University of Hong Kong, Hong Kong
| | - W Xia
- University of Hong Kong, Hong Kong
| | - X L He
- People's Hospital of Hunan Province, China
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Barakat LP, Madden RE, Vega G, Askins M, Kazak AE. Longitudinal predictors of caregiver resilience outcomes at the end of childhood cancer treatment. Psychooncology 2021; 30:747-755. [PMID: 33432694 DOI: 10.1002/pon.5625] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Caregiver resilience in the context of childhood cancer treatment has been described using cross-sectional and retrospective studies, but little is known about prospective predictors of resilience outcomes. We examined associations of demographics, cancer-related variables, and intrapersonal and interpersonal factors at diagnosis (family psychosocial risk, perceived social support, and healthcare self-efficacy) and psychosocial services provided during treatment with caregiver resilience outcomes at the end of treatment. METHODS For a study validating a family psychosocial risk screener, 314 primary caregivers completed the measures at diagnosis of their child (aged 0-17 years) and when cancer treatment ended. Resilience outcomes were ratings of distress, posttraumatic stress, and posttraumatic growth. Multiple regression analyses evaluated the relative contribution of hypothesized predictors. RESULTS Caregivers endorsed clinically significant distress, moderate posttraumatic growth, and low posttraumatic stress based on norms. Posttraumatic growth was not associated with posttraumatic stress or distress, which were significantly associated with each other. Over and above resilience at diagnosis, family psychosocial risk was associated with resilience at the end of treatment. Perceived social support, healthcare self-efficacy, and psychosocial services provided demonstrated associations with resilience in univariate analyses, but demographics and cancer-related variables did not. CONCLUSIONS Resilience and family psychosocial risk at diagnosis were the strongest predictors of caregiver resilience outcomes at the end of the treatment. Intrapersonal and interpersonal predictors were weaker and varied by resilience measure. Consistent with psychosocial standards of care, broad evaluation of caregiver risks, resources, and resilience processes and outcomes is recommended at diagnosis and through the treatment trajectory including the end of treatment.
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Affiliation(s)
- Lamia P Barakat
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rebecca E Madden
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Gabriela Vega
- Nemours Children's Health System, Orlando, Florida, USA
| | - Martha Askins
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anne E Kazak
- Nemours Children's Health System, Orlando, Florida, USA.,Sidney Kimmel Medical School, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Psychosocial Factors Predicting Resilience in Family Caregivers of Children with Cancer: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020748. [PMID: 33477253 PMCID: PMC7830523 DOI: 10.3390/ijerph18020748] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/02/2020] [Accepted: 12/09/2020] [Indexed: 01/10/2023]
Abstract
Chronic diseases in childhood can affect the physical and mental health of patients and their families. The objective of this study was to identify the sociodemographic and psychosocial factors that predict resilience in family caregivers of children with cancer and to define whether there are differences in the levels of resilience derived from these sociodemographic variables. Three hundred and thirty family caregivers of children with cancer, with an average age of 32.6 years were interviewed. The caregivers responded to a battery of tests that included a questionnaire of sociodemographic variables, the Measuring Scale of Resilience, the Beck Depression Inventory, the Inventory of Quality of Life, the Beck Anxiety Inventory, an interview of caregiver burden and the World Health Organization Well-Being Index. The main findings indicate that family caregivers of children with cancer reported high levels of resilience, which were associated positively with quality of life, psychological well-being and years of study and associated negatively with depression, anxiety and caregiver burden. The variables that predicted resilience in families of children with cancer were quality of life, psychological well-being, depression and number of children. Family caregivers who were married and Catholic showed higher resilience scores. We conclude that being a caregiver in a family with children with cancer is associated with symptoms of anxiety and with depressive episodes. These issues can be overcome through family strength, well-being, quality of life and positive adaptation processes and mobilization of family resources.
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Jia Y, Shi J, Sznajder KK, Yang F, Cui C, Zhang W, Yang X. Positive effects of resilience and self-efficacy on World Health Organization Quality of Life Instrument score among caregivers of stroke inpatients in China. Psychogeriatrics 2021; 21:89-99. [PMID: 33295027 DOI: 10.1111/psyg.12635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/31/2020] [Indexed: 12/14/2022]
Abstract
AIM Stroke is one of the major health challenges affecting life expectancy and quality of life around the world. However, there is limited reporting on the status of some caregivers, including Chinese caregivers of stroke inpatients. Limited information is available on evaluations using the World Health Organization Quality of Life Instrument (WHOQOL) and the effects of resilience and self-efficacy on WHOQOL score. Therefore, we conducted research to assess the role of resilience on the WHOQOL and to investigate the role of self-efficacy as a mediator between resilience and WHOQOL score among Chinese caregivers of stroke inpatients. METHODS This cross-sectional study to gather data from north-east and south-east China was conducted from June 2019 to October 2019. Over 380 caregivers of stroke inpatients at two general public hospitals were interviewed face-to-face. About 305 caregivers (80.26%) completed the questionnaire, which included the Ego Resilience Scale, the General Self-Efficacy Scale, and the brief version of the WHOQOL and asked about demographic characteristics. This study also examined factors associated with WHOQOL score and used linear regression analysis and structure equation modelling to construct direct and indirect models, respectively. RESULTS After adjustment for demographic characteristics, both resilience and self-efficacy were positively associated with all WHOQOL domains. Structure equation modelling revealed that self-efficacy mediated the relationship between resilience and WHOQOL score among caregivers of stroke inpatients. CONCLUSION Chinese caregivers of stroke inpatients exhibited good social health but poor physical, psychological, and environmental health. It is necessary for promoting resilience and improving WHOQOL score through the mediating effect of self-efficacy. These results suggest that interventions in health care focused on both enhancing resilience and providing self-efficacy training could effectively improve WHOQOL score.
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Affiliation(s)
- Yajing Jia
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Jing Shi
- Department of Medical Oncology, First Hospital of China Medical University, Shenyang, China
| | - Kristin K Sznajder
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Fengzhi Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Can Cui
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Weiyu Zhang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Xiaoshi Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
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Mezgebu E, Berhan E, Deribe L. Predictors of Resilience Among Parents of Children with Cancer: Cross-Sectional Study. Cancer Manag Res 2020; 12:11611-11621. [PMID: 33235494 PMCID: PMC7678500 DOI: 10.2147/cmar.s276599] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/04/2020] [Indexed: 12/31/2022] Open
Abstract
Purpose Resilience is an ability to overcome adversities in response to a potentially traumatic event. It relieves parents’ discomfort and builds personal capacity when facing a stressful situation like childhood cancer. Therefore, the study’s objective is to assess the magnitude of resilience and its predictors among the parents of children with cancer at Jimma medical center, Ethiopia, 2020. Methods The institutional-based cross-sectional design was employed on 126 parents of children with cancer at Jimma Medical Center. All study populations who attend the hospital from February 25 to April 25, 2020, and fulfill the inclusion criteria were included. Data were entered into Epi data version 4.6.0.2 and analyzed by SPSS version 25. Descriptive analysis was used to describe the study variables. Furthermore, linear regression analysis was calculated to assess predictors of resilience. Results The level of resilience among parents’ children with cancer were a mean scored 51.41±12.02. In this study, factors associated with resilience were receiving support from friends (β=5.67, 95% CI=1.58, 9.77; P=0.007), attend recreational activities (β=13.8, 95% CI=5.32, 22.37; P=0.03) and receiving health information from health care professionals (β=6.37; 95% CI= (1.75, 11.00), P=0.007), parents depression (β= −0.827, 95% CI= (−1.619,-0.034), P=0.041) and parents stress (β =−0.88,95% CI (−1.54,-0.23), P=0.031). Conclusion The magnitude of resilience among parents of children with cancer was low relative to other studies. Support from friends, attending recreational activities, and receiving health information from health care professionals were positively associated with resilience. In contrast, parents’ depression and stress were negatively associated with resilience.
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Affiliation(s)
| | - Emebet Berhan
- Addis Ababa University College of Health Science, School of Nursing and Midwifery, Addis Ababa, Ethiopia
| | - Leul Deribe
- Addis Ababa University College of Health Science, School of Nursing and Midwifery, Addis Ababa, Ethiopia
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Chung JOK, Li WHC, Cheung AT, Ho LLK, Xia W, Chan GCF, Lopez V. Relationships among resilience, depressive symptoms, self-esteem, and quality of life in children with cancer. Psychooncology 2020; 30:194-201. [PMID: 32916019 DOI: 10.1002/pon.5548] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/16/2020] [Accepted: 09/07/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the interrelationships among resilience, self-esteem, and depressive symptoms and determine whether resilience was a factor associated with quality of life for Hong Kong Chinese children with cancer. METHODS We used a cross-sectional study design. Participants were 138 Hong Kong Chinese children (aged 7-14 years) who were admitted to the pediatric oncology units of an acute public hospital. The resilience, depressive symptoms, self-esteem, and quality of life of participating children were assessed. The primary outcome was the association between resilience and quality of life in children with cancer. RESULTS In total, 72 boys and 66 girls were recruited for this study (mean age 10.6 years). The mean levels of resilience, depressive symptoms, self-esteem, and quality of life were 23.4, 30.0, 23.0, and 63.6, respectively. There was a statistically significant strong positive correlation between resilience and quality of life (r = 0.60, p < 0.01), indicating that greater resilience was associated with better quality of life. Children with cancer from single-parent families, those diagnosed with a brain tumor, and those who received multiple treatments reported significantly lower levels of resilience, self-esteem, and quality of life, and greater depressive symptoms than other children (all p's < 0.001). Results of a multiple regression analysis revealed that resilience (p < 0.001) was a strong factor associated with quality of life among children with cancer. CONCLUSIONS It is essential that healthcare professionals implement interventions to boost the resilience of children with cancer, thereby enhancing their quality of life.
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Affiliation(s)
| | | | - Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | - Wei Xia
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | - Violeta Lopez
- School of Nursing, Hubei University of Medicine, Shiyan, China
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Conway Keller M, King C, Hart L, Engelke K, Needham A, Holden E, Foy K, Lucas R. The end of cancer treatment experience for children, adolescents, and their parents: A systematic review of the literature. J Psychosoc Oncol 2020; 38:573-591. [DOI: 10.1080/07347332.2020.1769795] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Mary Conway Keller
- Division of Hematology-Oncology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Courtney King
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Leigh Hart
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Karina Engelke
- Division of Hematology-Oncology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Andrew Needham
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Elizabeth Holden
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Kelly Foy
- Division of Hematology-Oncology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Ruth Lucas
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
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Brickell TA, Wright MM, Lippa SM, Sullivan JK, Bailie JM, French LM, Lange RT. Resilience is associated with health-related quality of life in caregivers of service members and veterans following traumatic brain injury. Qual Life Res 2020; 29:2781-2792. [DOI: 10.1007/s11136-020-02529-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2020] [Indexed: 11/30/2022]
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Toprak D, Nay L, McNamara S, Rosenberg AR, Rosenfeld M, Yi-Frazier JP. Resilience in adolescents and young adults with cystic fibrosis: A pilot feasibility study of the promoting resilience in stress management intervention. Pediatr Pulmonol 2020; 55:638-645. [PMID: 31794160 PMCID: PMC8685161 DOI: 10.1002/ppul.24574] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/26/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Disease burden in cystic fibrosis (CF) impacts quality of life, distress, and treatment adherence. The promoting resilience in stress management (PRISM), is a brief patient-focused intervention to promote resilience in adolescents and young adults (AYAs), which may mitigate the negative outcomes, and is proven to be feasible and acceptable in other diseases. OBJECTIVE Our aim was to test the feasibility and acceptability of PRISM among AYAs with CF in addition to collecting pilot data regarding patient-reported resilience, distress, and quality of life. METHODS Eligible English speaking, 12 to 21 year patients admitted to the hospital were enrolled. We defined feasibility as 80% completion of all sessions. Acceptability was defined qualitatively based on feedback about timing, content and delivery of intervention. As an exploratory aim, questionnaires measuring resilience (Connor-Davidson resilience scale), distress (Kessler-6 scale), and disease-specific health-related quality of life (CF questionnaire-revised [CFQ-R]) were given at baseline and postintervention. RESULTS 10 out of 17 (59%) patients consented to participate. Eight were Caucasian, eight female with age range 13 to 20 years (median: 18). Nine completed all PRISM sessions with universally positive feedback. Health perception and respiratory domain scores of the CFQ-R improved (47.2-65.1; 95% confidence interval [CI], 2.6-35.6; 50.9-61.9; 95% CI, 1.7-19.9, respectively), however in the setting of inpatient exacerbation treatment it would be hard to attribute these changes to PRISM. CONCLUSION PRISM was feasible and highly acceptable among AYAs with CF. Future research is needed to test the efficacy of PRISM among a larger group of patients with CF in a multicenter trial.
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Affiliation(s)
- Demet Toprak
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
| | - Laura Nay
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
| | - Sharon McNamara
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
| | - Abby R Rosenberg
- Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington.,Division of Hematology and Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Division of Bioethics and Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Margaret Rosenfeld
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
| | - Joyce P Yi-Frazier
- Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
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Palacio G C, Krikorian A, Gómez-Romero MJ, Limonero JT. Resilience in Caregivers: A Systematic Review. Am J Hosp Palliat Care 2019; 37:648-658. [DOI: 10.1177/1049909119893977] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background: Resilience is a multidimensional construct that explains why people facing the consequences of adversity and stress can have a positive outcome, emphasizing adjustment to experiences that are perceived as threatening. Objective: The aim of this study is to review the construct of resilience and associated variables in caregivers of patients with chronic, advanced illness and at the end of life. Methods: The review included studies published between January 2009 and January 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide reporting. The Medline, ScienceDirect, HINARI, PsychINFO, and SciELO databases were used for bibliographic exploration to identify research studies that examined the impact of resilience on adaptation and overall well-being in caregivers of patients with chronic and advanced illness. Results: A total of 23 quantitative and qualitative studies were identified whose aim was to describe the role of resilience in adaptation and coping in caregivers. In these studies, resilience was associated with a positive impact on the quality of life and emotional distress. Communication and social support increase resilient coping strategies. In most selected articles, the sampling strategy used was convenience sampling. Data collection used evaluation scales related to resilience and associated variables for quantitative studies, and semistructured interviews were used for qualitative studies. Conclusion: Promoting a resilient coping style in caregivers reduces the distress that normally results from illness-related changes in the biopsychosocial and spiritual dimensions. A resilient coping style can diminish the risk of stress and burden, and promote adaptation in the caregiver.
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Affiliation(s)
- Carolina Palacio G
- Instituto de Cancerología, Clínica las Americas, Medellín, Colombia
- School of Psychology, Universidad Autónoma de Barcelona, Barcelona, Spain
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana in Medellín, Colombia
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | - Alicia Krikorian
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana in Medellín, Colombia
| | - María José Gómez-Romero
- School of Psychology, Universidad Autónoma de Barcelona, Barcelona, Spain
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
- Egarsat Mutua Colaboradora con la Seguridad Social n 276, Terrassa, Barcelona, Spain
| | - Joaquín T. Limonero
- School of Psychology, Universidad Autónoma de Barcelona, Barcelona, Spain
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
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The relationship between the positive aspects of caring and the personal growth of caregivers of patients with advanced oncological illness : Postraumattic growth and caregiver. Support Care Cancer 2019; 28:3007-3013. [PMID: 31823055 DOI: 10.1007/s00520-019-05139-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 10/16/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Examine the relationship between the positive aspects of care and the personal growth of caregivers of patients with advanced oncological illness. METHODS This research was a quantitative study with a transversal design. One hundred (100) informal caregivers filled out self-applied questionnaire on resilience, aspects of care, emotional distress, spirituality, and posttraumatic growth. Descriptive statistics were applied to the data, later correlation, and regression, and comparative analyses were conducted. RESULTS The participants were mainly women (86%) with an average care period of 12 months. The average age was 46.52 years. The highest scores were evidenced in positive aspects of caretaking, spirituality, personal growth, and distress, while the lowest score was seen in questions related to resilience. There was a negative inverse correlation among emotional distress, resilience, spirituality, and posttraumatic growth (p < .05) and a positive correlation among resilience, spirituality, posttraumatic growth, and the positive aspects of caretaking (p < .01). There were significant differences among the items related to emotional distress, resilience, and posttraumatic growth. The linear regression analysis showed that as resilience, spirituality, and the positive aspects of care increased, so did posttraumatic growth. SIGNIFICANT RESULTS To promote the perception of benefits among caregivers, resilience and the identification of meaning in the caregiving experience of patients with advanced oncological illness can be considered protective factors favoring adaptation and reducing negative moods.
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Zens TJ, Kopecky KE, Schwarze ML, Suwanabol PA. Surgery Hurts: Characterizing the Experience of Pain in Surgical Patients as Witnessed by Medical Students. JOURNAL OF SURGICAL EDUCATION 2019; 76:1506-1515. [PMID: 31060970 DOI: 10.1016/j.jsurg.2019.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/16/2019] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The patient experience around surgical care is poorly characterized. Medical students have a unique position on the surgical team, which allows them to observe patient experiences that may otherwise be overlooked. The objective of this study was to characterize surgical patients' experience with pain as witnessed by medical students. STUDY DESIGN At the end of an 8-week surgical clerkship, we asked all third-year medical students to write a reflective essay describing one surgical patient in pain. We collected 341 essays over a 4-year period and used qualitative content analysis to explore the students' reports of pain experienced by surgical patients. RESULTS When asked to tell a story about a surgical patient in pain, medical students report vivid descriptions of physical agony, emotional distress, and patient regret. For example, "Throughout the procedure our patient cried out and writhed in agony from the searing pain in his chest," and "The patient was practically shedding tears, complaining of pain, as [we] changed her dressing." The students' accounts reveal wide-ranging physical and emotional suffering among surgical patients, including alterations in self-image and feelings of vulnerability. Pain and suffering were intensified when patients felt they had lost control, in settings of uncertain prognosis and with unexpected outcomes. CONCLUSIONS Students' descriptions of the surgical patient's experience are disturbingly graphic. They expose suffering ranging from generalized discomfort to anguish and excruciating pain. These data suggest that surgical patients have substantial unmet needs with respect to symptom management and emotional support that, if better addressed, could improve the patient experience.
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Affiliation(s)
- Tiffany J Zens
- Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Kimberly E Kopecky
- Department of Surgery, Stanford University, Stanford, California; Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Margaret L Schwarze
- Department of Surgery, University of Wisconsin, Madison, Wisconsin; Department of Medical History and Bioethics, University of Wisconsin, Madison, Wisconsin
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Nouzari R, Najafi SS, Momennasab M. Post-Traumatic Growth among Family Caregivers of Cancer Patients and Its Association with Social Support and Hope. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2019; 7:319-328. [PMID: 31641681 PMCID: PMC6779924 DOI: 10.30476/ijcbnm.2019.73959.0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Cancer not only is a traumatic experience for the patients, but also can affect the family caregivers. Post-traumatic growth (PTG) refers to positive psychological changes experienced by people as a result of a struggle in dealing with traumatic events in life. Both the patients and their caregivers may experience PTG. The present study aimed to assess the extent of PTG in caregivers of patients with gastrointestinal cancer and to examine the relationship between the PTG dimensions and both the social support (SS) and hope.
Methods: The present descriptive correlational study was conducted during May-August 2018 in Shiraz, Iran. The target population included 112 caregivers who visited hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Data collection instruments included a demographic information form, post-traumatic growth inventory, social support appraisals scale, and Miller hope scale. The data were analyzed using the SPSS software (version 23.0). P<0.05 was considered statistically significant.
Results: The mean score for PTG, hope, and SS was 75.41±16.49, 190.95±24.20, and 89.10±12.84, respectively. A significant positive correlation was found between PTG and both SS (P<0.001, r=0.59) and hope (P<0.001, r=0.70). The results of the multiple regression analysis showed a significant relationship between PTG, SS, and hope (P<0.001). Hope had a higher effect on PTG (ẞ=0.62) compared to SS (ẞ=0.27).
Conclusion: The results showed a good level of PTG among the caregivers and the experience of stressful situations positively affected their psychological condition. The positive change was associated with the perceived SS and hope.
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Affiliation(s)
- Razieh Nouzari
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Saeed Najafi
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Cousineau TM, Hobbs LM, Arthur KC. The Role of Compassion and Mindfulness in Building Parental Resilience When Caring for Children With Chronic Conditions: A Conceptual Model. Front Psychol 2019; 10:1602. [PMID: 31428005 PMCID: PMC6690403 DOI: 10.3389/fpsyg.2019.01602] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 06/25/2019] [Indexed: 01/20/2023] Open
Abstract
Compassion- and mindfulness-based interventions (CMBIs) and therapies hold promise to support parent resilience by enabling adaptive stress appraisal and coping, mindful parenting, and perhaps crucially, self-compassion. These contemplative modalities have recently been expanded to parents of children with chronic illness, building on successful applications for adults facing stress, chronic pain, or mental illness, and for healthcare professionals in response to caregiver burnout resulting from their work. The design and adaptation of interventions and therapies require a conceptual model of parent resilience in the context of childhood chronic illness that integrates mindfulness and compassion. The objective of this paper is to propose and describe such a model. First, we review the need for parent support interventions for this population. Second, we introduce a Model of Compassion, Mindfulness, and Resilience in Parental Caregiving. We highlight the mindful parenting approaches, guiding theories for adaptive coping, and family resilience frameworks that informed our model. Third, we describe a case of a parent to illustrate a practical application model. Finally, we outline future directions for intervention development and research to examine the impact of CMBIs on parent resilience.
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Affiliation(s)
- Tara M. Cousineau
- Counseling and Mental Health Services, Harvard University, Cambridge, MA, United States
- Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA, United States
| | - Lorraine M. Hobbs
- Youth, Family and Educational Programs, UCSD Center for Mindfulness, San Diego, CA, United States
| | - Kimberly C. Arthur
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, United States
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Svavarsdottir EK, Tryggvadottir GB. Predictors of quality of life for families of children and adolescents with severe physical illnesses who are receiving hospital-based care. Scand J Caring Sci 2019; 33:698-705. [PMID: 31058346 DOI: 10.1111/scs.12665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/08/2019] [Indexed: 11/30/2022]
Abstract
AIM There is strong evidence regarding the impact of medical treatments on hospitalised children and their families after being diagnosed with a serious illness. Even though survival rates have increased for children and adolescents with illnesses such as cancer, kidney, liver and gastrointestinal diseases, lengthy medical procedures and symptom management may have an impact on the well-being and quality of life for families. Little is known, however, about promoting family quality of life in hospital-based paediatric settings. The main purpose of this study was to evaluate the predictors of quality of life (QOL) across physical health conditions among families of children and adolescents with cancer, kidney, liver and gastrointestinal diseases. Further, to evaluate the difference in perception on QOL among families of children with cancer compared to families of children with kidney, liver and gastrointestinal diseases. METHOD The study design was cross-sectional. Thirty-eight families of children with cancer, kidney, liver or gastrointestinal diseases participated at a University Hospital. Data were collected using valid and reliable instruments to measure the study variables from March 2015 to May 2016. FINDINGS The main result from the stepwise regression analysis indicated perceived family support and illness beliefs, significantly predicted quality of life of the family; approximately 41% of the variance in the families' perception of their quality of life was explained by the model. CONCLUSIONS The findings emphasise the importance of supporting and maintaining quality of life for families of children with physical illnesses. RELEVANCE TO CLINICAL PRACTICE Family level interventions within the healthcare system are needed for families of children with severe physical illnesses, since that can result in better outcomes for the child or adolescent and their family. Such an intervention would need to emphasise therapeutic conversations within a relational context, highlighting illness management, illness beliefs, and cognitive and emotional family support.
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Affiliation(s)
- Erla Kolbrun Svavarsdottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
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Jarvis JM, Choong K, Khetani MA. Associations of Participation-Focused Strategies and Rehabilitation Service Use With Caregiver Stress After Pediatric Critical Illness. Arch Phys Med Rehabil 2019; 100:703-710. [PMID: 30578773 PMCID: PMC6435394 DOI: 10.1016/j.apmr.2018.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/10/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE(S) Determine the associations between having participation-focused strategies and receiving rehabilitation services in the pediatric intensive care unit (PICU) with caregiver stress over 6 months post-PICU discharge. DESIGN Substudy of a data from Wee-Cover, a prospective cohort study. SETTING Two PICU sites. PARTICIPANTS Caregivers (N=168) of children 1-17 years old admitted into a PICU for ≥48 hours. MAIN OUTCOME MEASURES Data were collected from caregivers at enrollment and 3 and 6 months post-PICU discharge. Caregiver stress was assessed using the Pediatric Inventory for Parents. Having strategies to support their child's participation in home-based activities was assessed using the Participation and Environment Measure (PEM). In PEM, caregivers report on strategies used to support their child's participation in home-based activities. Data were dichotomized (yes, no) to denote having participation-focused strategies and if their child received PICU rehabilitation services. Additional covariates were history of a preexisting condition, child age, length of PICU stay, and change in functional capacities at PICU discharge. RESULTS History of a preexisting condition, time, and change in functional capacities significantly predicted caregiver stress frequency and difficulty. The interaction of having strategies-by-rehabilitation-by-time significantly predicted caregiver stress frequency and difficulty. CONCLUSION(S) Results highlight the role of early rehabilitation and the importance of working with caregivers to develop participation-focused strategies to support their child's functioning post-PICU. Families of children with a preexisting condition or those who experience a decrease in function during a PICU stay are susceptible to higher levels of stress and may be a priority population to target for rehabilitation services.
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Affiliation(s)
- Jessica M Jarvis
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL
| | - Karen Choong
- Department of Pediatrics, Critical Care, Epidemiology and Biostatistics, McMaster University, Hamilton, ON
| | - Mary A Khetani
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL.
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Habibpour Z, Mahmoudi H, Nir MS, Areshtanab HN. Resilience and its Predictors among the Parents of Children with Cancer: A Descriptive-Correlational Study. Indian J Palliat Care 2019; 25:79-83. [PMID: 30820107 PMCID: PMC6388604 DOI: 10.4103/ijpc.ijpc_128_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Context: As a common debilitating illness, cancer is among the leading causes of child mortality in developed and developing countries. Cancer diagnosis for children is considerably stressful for their parents. Resilience is a key factor behind effective coping with cancer-related problems. This study evaluated resilience and its predictors among the parents of children with cancer. Aim: This study evaluated resilience and its predictors among the parents of children with cancer. Settings and Design: This cross-sectional descriptive-analytical study was conducted in 2017 on 400 parents of children with cancer in Tabriz Children's Hospital, Iran. Methods: A demographic questionnaire and the Connor-Davidson Resilience Scale were used to collect the data. Parents were conveniently recruited from Tabriz Children's Hospital. Statistical Analysis: Data were analyzed using the SPSS for Windows program (v. 16) via descriptive and inferential statistical methods. Results: The mean score of parents’ resilience was 66.83 ± 14.28. Fathers obtained significantly higher resilience scores than mothers (P < 0.001). The predictors of parents’ resilience were financial status, parents’ gender, fathers’ employment status, and children's gender. Conclusion: The parents of cancer-afflicted children, particularly their mothers, have low resilience and therefore may be at risk for different physical and mental health problems. Health-care providers need to identify at-risk parents and provide them with greater psychological and educational support.
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Affiliation(s)
- Zeinab Habibpour
- Department of Medical-surgical Nursing, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Hosein Mahmoudi
- Trauma Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.,Behavioral Sciences Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Masoud Sirati Nir
- Department of Psychiatric Nursing, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Hossein Namdar Areshtanab
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Taylor MF, Pooley JA. Life is precious: Sarcoma/giant-cell tumors survivors' perspectives on their psychological journey. J Psychosoc Oncol 2018; 36:681-699. [PMID: 30372404 DOI: 10.1080/07347332.2018.1498425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Although surviving bone resection/limb salvage surgery treatment is the beginning of the journey towards recovery, the importance of providing patients with post-operative psychological support is often overlooked by health professionals. Hence, patients typically are left to their own devices in terms of ensuring their mental health and well-being. Methodological Approach and Participants: This qualitative analysis of seven long-term sarcoma survivors' reflective journal entries provides insights into the different phases of distress, resilience building, resilient growth and advice-giving that they moved through during their survivorship journey. INTERPRETATION Our findings identify the fragility of patient resilience and highlight areas for future research.
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Affiliation(s)
- Myra Frances Taylor
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia
| | - Julie Ann Pooley
- b School of Arts and Humanities , Edith Cowan University , Joondalup , Australia
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Jayawickreme E, Rivers J, Rauthmann JM. Do We Know How Adversity Impacts Human Development? RESEARCH IN HUMAN DEVELOPMENT 2018. [DOI: 10.1080/15427609.2018.1495515] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Navea Martín A, Tamayo Hernández JA. Características de la resiliencia familiar en pacientes oncológicos pediátricos: una revisión sistemática. PSICOONCOLOGIA 2018. [DOI: 10.5209/psic.61431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introducción: la resiliencia familiar consiste en la adaptación positiva a la adversidad, implicando el cambio de su dinámica y su funcionamiento, permitiendo resolver cualquier estresor que se encuentre durante la vida de sus miembros. Objetivo: conocer las características de la resiliencia familiar en el ámbito de la oncología pediátrica. Método: mediante una revisión sistemática, se realiza una búsqueda en las bases de datos Medline, SCOPUS/Sciencedirect, Academic Search complete, Psychology and Behavioral Sciences Collection, CINAHL y E-Journals, para conocer las últimas investigaciones acerca de modelos, variables, instrumentos e intervenciones de resiliencia familiar, obteniéndose 13 artículos. Resultados: un 84,7% de las investigaciones son de tipo cuantitativo y presentan factor de impacto. La mayor parte de los estudios utilizan la Escala Connor-Davidson Resilience y obtienen que la mayoría de las familias de niños con cáncer son resilientes. Dos artículos presentan modelos de resiliencia familiar. Conclusión: El constructo de resiliencia familiar es complejo y es estudiado desde diferentes perspectivas. Un modelo que resuma todos los aspectos que influyen en el mismo, puede ayudar a la intervención del psicólogo con las familias de niños con cáncer.
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