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Yaldo M, Pai AL, McGrady ME, Wallens E, Allen JM, Spraker-Perlman H, Ast A, Reeves T, Tillery Webster R. Factors influencing caregiver decisions to use complementary and integrative therapies in pediatric oncology settings: Findings from a qualitative analysis. Eur J Oncol Nurs 2024; 70:102588. [PMID: 38669955 DOI: 10.1016/j.ejon.2024.102588] [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: 12/09/2022] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
PURPOSE Complementary and integrative medicine (CIM) therapies (i.e., non-conventional Western medicine interventions) may reduce side-effects associated with pediatric oncology treatment. CIM therapies may also improve caregiver psychological and physical health that is exacerbated during pediatric cancer treatment. Despite known benefits, these therapies are not widely used within pediatric oncology populations in the United States. To guide and promote CIM use among this population, the aim of this project was to qualitatively explore factors that contribute to caregivers' decision to include CIM use in their own and child's care. METHODS Twenty caregivers of children (ages 0.5-14 years) being treated for cancer participated in this study. Each completed a demographic form and the CIM use questionnaire. Qualitative interviews followed by a card sort task were used to assess barriers and facilitators of uptake for caregivers and their child with cancer. RESULTS A number of predisposing (e.g., child age, beliefs) and needs factors (e.g., potential to treatment-related side-effects) provide insight into caregivers' decisions to use CIM for their child. Analyses also revealed the importance of enabling factors (e.g., resources) for caregiver use. Caregivers also reported benefiting from additional information about risk/benefit analysis of these therapies, and current research for CIM use in caregivers and children being treated for cancer. CONCLUSION Children may benefit from individually tailored complementary and integrative medicine consultations that explore patient history and specific needs factors to improve preference concordant care and uptake. Caregivers may benefit from support that improves enabling factors associated with care (e.g., improved accessibility).
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Affiliation(s)
- Marissa Yaldo
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ahna Lh Pai
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Meghan E McGrady
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Emma Wallens
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jennifer M Allen
- Department of Psychology, St. Louis Children's Hospital, St. Louis, MO, USA
| | - Holly Spraker-Perlman
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Allison Ast
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Tegan Reeves
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, USA
| | - Rachel Tillery Webster
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA; Comprehensive Cancer Center, St. Jude Children's Research Hospital, Memphis, TN, USA.
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Fang J, Xu LL, Liu CQ, Zhu Z, Wang MX, Liu X, Liu Q, Huang HY, Lin Y. Exploring core symptoms and interrelationships among symptoms in children with acute leukemia during chemotherapy: A network analysis. Support Care Cancer 2023; 31:578. [PMID: 37715817 DOI: 10.1007/s00520-023-08024-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/26/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE Children with acute leukemia have suffered from a considerable symptom burden during chemotherapy. However, few studies have focused on exploring the mechanisms among symptoms in children with acute leukemia. Our study aims to explore core symptoms and describe the interrelationships among symptoms in children with acute leukemia during chemotherapy. METHODS From January 2021 to March 2023, 469 children with acute leukemia were recruited from 20 Chinese cities. The Memorial Symptom Assessment Scale 10-18 (MSAS 10-18) was used to evaluate the prevalence and severity of symptoms during chemotherapy. A network analysis was performed by the R software based on 31 symptoms. Centrality indices and density were used to explore core symptoms and describe interrelationships among symptoms in the network during chemotherapy. RESULTS Worrying and feeling irritable were the central symptoms across the three centrality indices, including strength, closeness, and betweenness. Lack of energy was the most prevalent symptom; however, it was less central than other symptoms. The density of the "induction and remission" network significantly differed from other cycles' counterparts (p < 0.001). Global strength was greater in the " ≥ 8 years group " network than the " < 8 years group " network (p = 0.023). CONCLUSION Network analysis provides a novel approach to identifying the core symptoms and understanding the interrelationships among symptoms. Our study indicates the need to assess emotional symptoms in children with acute leukemia during chemotherapy, especially during the induction and remission phases, as well as in older children. Future research is imperative to construct trajectories of dynamic symptom networks and centrality indices in longitudinal data to investigate the causal relationships among symptoms.
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Affiliation(s)
- Jia Fang
- Department of Nursing, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Li-Ling Xu
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Chun-Qin Liu
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China
- Fudan University Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Fudan University, Shanghai, China
| | - Mei-Xiang Wang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xia Liu
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Qiong Liu
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Hai-Ying Huang
- Department of Nursing, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Yan Lin
- Department of Nursing, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China.
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Ogawa Y, Otani Y, Nakamura A, Hayakawa M, Tanaka K. Urgent need to establish a consultation liaison system in pediatric care. Pediatr Int 2023; 65:e15505. [PMID: 37026806 DOI: 10.1111/ped.15505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/05/2023] [Indexed: 04/08/2023]
Affiliation(s)
- Yu Ogawa
- Division of Mental Health Care, Department of Child and Adolescent Liaison, National Center for Child Health and Development, Tokyo, Japan
| | - Yui Otani
- Division of Mental Health Care, Department of Child and Adolescent Liaison, National Center for Child Health and Development, Tokyo, Japan
| | - Akio Nakamura
- Division of Mental Health Care, Department of Child and Adolescent Liaison, National Center for Child Health and Development, Tokyo, Japan
| | - Maoko Hayakawa
- Division of Mental Health Care, Department of Child and Adolescent Liaison, National Center for Child Health and Development, Tokyo, Japan
| | - Kyoko Tanaka
- Division of Mental Health Care, Department of Child and Adolescent Liaison, National Center for Child Health and Development, Tokyo, Japan
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Darabos K, Li Y, O'Hagan B, Palermo T, King-Dowling S, Jubelirer T, Huang J, Barakat LP, Schwartz LA. Trajectories of Pain Severity and Interference Among Adolescent and Young Adults With Cancer: A Microlongitudinal Study. Clin J Pain 2022; 38:443-450. [PMID: 35686575 DOI: 10.1097/ajp.0000000000001041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Cancer-related pain is a pervasive concern among adolescent and young adults (AYA) with cancer and is an emerging long-term health concern. Few studies have examined the complex contributions to pain among AYA. We aimed to fill a gap by (1) identifying subgroups of AYA with distinct patterns of pain severity and interference over time and (2) explore possible predictors of these patterns. METHODS Daily text messages over a 9-week period were used to model group-based trajectory analyses of pain severity and interference by identifying subgroups of AYA who experience common patterns of changes in pain. Demographic, medical, physical symptom burden, and psychological distress were examined as possible predictors of these patterns. RESULTS AYA were on average 16.93 years old and 2.5 years since diagnosis. Subgroups of AYA were identified for pain severity and interference over time: high variability (37.7%; 37.7%, respectively), consistent high pain (35.8%; 18.9%, respectively), and consistent low pain (26.4%; 43.4%, respectively). AYA with greater psychological distress were more likely to belong to the high consistent pain severity and interference groups. AYA with greater physical symptoms were more likely to belong to the high consistent pain interference group. No significant associations between demographic/medical characteristics and trajectory subgroups were found. CONCLUSIONS AYA with elevated physical and psychological symptoms were more likely to experience high consistent pain severity and pain interreference over time. Interventions aimed at reducing pain through focusing on teaching AYA how to alleviate physical symptoms and teaching coping skills to manage psychological distress may be beneficial.
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Affiliation(s)
- Katie Darabos
- Division of Oncology, The Children's Hospital of Philadelphia
| | - Yimei Li
- Division of Oncology, The Children's Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Bridget O'Hagan
- Division of Oncology, The Children's Hospital of Philadelphia
| | - Toyna Palermo
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | | | - Tracey Jubelirer
- Division of Oncology, The Children's Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Jing Huang
- Division of Oncology, The Children's Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Lamia P Barakat
- Division of Oncology, The Children's Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Lisa A Schwartz
- Division of Oncology, The Children's Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA
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Patton M, Stokoe M, Forbes C, Nwaroh C, Noel M, Reynolds K, Schulte F. The Intergenerational Transmission of Chronic Pain from Parents to Survivors of Childhood Cancer. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E246. [PMID: 33233437 PMCID: PMC7700439 DOI: 10.3390/children7110246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Among youth with chronic non-cancer pain, 50% have parents with chronic pain. These youth report significantly more pain interference and posttraumatic stress symptoms (PTSS), and worse health-related quality of life (HRQL) than youth whose parents do not have chronic pain. Additionally, parent chronic pain is linked to increased child anxiety and depressive symptoms. Survivors of childhood cancer (SCCs) are at risk of pain and negative psychosocial outcomes and therefore may be especially vulnerable if their parents have chronic pain. Thus, the aims of the current study were to (1) identify rates of chronic pain among parents of SCCs, (2) test group differences in psychological symptoms in parents with chronic pain versus without, and (3) test group differences in pain interference, HRQL, anxiety, depression, and PTSS in SCCs with parents with chronic pain versus without. METHODS 122 SCCs (Mean age = 15.8, SD = 4.8, 45.7% male, Mean age at diagnosis = 5.9, SD = 4.7) and their parents were recruited from across Canada to complete online questionnaires. Parents were asked if they have had pain for at least three consecutive months and completed the brief symptom inventory (BSI) as a measure of psychological symptomatology. Survivors completed the pain questionnaire, patient reported outcomes measurement information system (PROMIS)-pain interference, anxiety, and depression measures, child posttraumatic stress scale, posttraumatic stress disorder checklist for the Diagnostic and Statistical Manual of Mental Disorders, and the pediatric quality of life inventory. RESULTS Forty-three (39%) parents of SCCs reported having chronic pain. Of the 29 survivors who had chronic pain, 14 (48%) also had parents with chronic pain. Parents with chronic pain reported significantly higher scores on the BSI than parents without chronic pain, F(1, 116) = 5.07, p = 0.026. SCCs with parents with versus without chronic pain reported significantly higher PTSS F(1, 105) = 10.53, p = 0.002 and depressive symptoms F(1, 102) = 6.68, p = 0.011. No significant differences were found across the other variables tested. CONCLUSIONS Findings suggest that survivors' parents' own pain is prevalent and is related to survivors' increased depressive symptoms and PTSS, but not anxiety, pain interference, or HRQL. Future research should explore whether parents may benefit from psychological intervention after their child has been diagnosed with cancer and how this could improve outcomes for their child.
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Affiliation(s)
- Michaela Patton
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.P.); (M.N.)
| | - Mehak Stokoe
- Hematology, Oncology, and Bone Marrow Transplant Program, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada; (M.S.); (C.F.); (K.R.)
| | - Caitlin Forbes
- Hematology, Oncology, and Bone Marrow Transplant Program, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada; (M.S.); (C.F.); (K.R.)
| | - Chidera Nwaroh
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.P.); (M.N.)
| | - Kathleen Reynolds
- Hematology, Oncology, and Bone Marrow Transplant Program, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada; (M.S.); (C.F.); (K.R.)
| | - Fiona Schulte
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.P.); (M.N.)
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
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Delemere E, Maguire R. The role of Connected Health technologies in supporting families affected by paediatric cancer: A systematic review. Psychooncology 2020; 30:3-15. [PMID: 32893415 DOI: 10.1002/pon.5542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/06/2020] [Accepted: 08/31/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Families impacted by paediatric cancer are met with logistical, financial and psychological impacts, with severe acute respiratory syndrome coronavirus two creating additional barriers and stressors for these families. Connected Health (CH) may facilitate cancer care. The objective of the present study was to systematically review CH for families/informal caregivers affected by paediatric cancer. METHODS Using search terms relating to: (1) paediatric cancer, (2) family/caregivers and (3) CH, the databases of PsycINFO, Pubmed, EMBASE and Web of Science were searched. Inclusion criteria included an evaluation of CH technologies for supportive care for families/caregivers affected by paediatric cancer at any stage of treatment or survivorship. RESULTS Sixteen studies met inclusion criteria. CH was primarily web-based (n = 6), however smartphone applications (n = 5), telehealth (n = 2) and online groups (n = 3) were utilised. Intervention areas included psycho-social (n = 6), health and information provision (n = 8) and palliative care (n = 2). CONCLUSIONS While limited studies have evaluated the impact of CH on families living with paediatric cancer, emerging evidence suggests potential benefits. More evidenced-based interventions are required.
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Affiliation(s)
- Emma Delemere
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
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7
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O'Connell C, Shafran R, Camic PM, Bryon M, Christie D. What factors influence healthcare professionals to refer children and families to paediatric psychology? Clin Child Psychol Psychiatry 2020; 25:550-564. [PMID: 31023071 DOI: 10.1177/1359104519836701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aimed to investigate factors influencing referral of children with physical illness to paediatric psychology. Due to high rates of mental health problems within this population, studies have shown that referral to paediatric psychology should be increased. However, few studies have examined factors shaping healthcare professionals' referral behaviour. METHODS This study used the theory of planned behaviour to develop a questionnaire which explores factors influencing the referral of children and families to paediatric psychology. Psychometric properties of the questionnaire were examined. RESULTS The questionnaire was found to have good reliability and validity. The main constructs of the theory of planned behaviour were useful in predicting intention to refer to paediatric psychology. Specific beliefs about referral were shown to influence intention to refer. CONCLUSION Findings suggest that individual attitudes and beliefs can impact healthcare professionals' referral behaviour, indicating that multidisciplinary interventions and inter-professional education relating to the psychological aspects of illness are required.
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Affiliation(s)
- Christine O'Connell
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, UK
| | - Roz Shafran
- UCL Institute of Child Health, University College London, UK
| | - Paul M Camic
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, UK
| | - Mandy Bryon
- Great Ormond Street Hospital for Children NHS Foundation Trust, UK
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Schulte F, Patton M, Alberts NM, Kunin-Batson A, Olson-Bullis BA, Forbes C, Russell KB, Neville A, Heathcote LC, Karlson C, Racine N, Charnock C, Hocking MC, Banerjee P, Tutelman P, Noel M, Krull KR. Pain in long-term survivors of childhood cancer: A systematic review of the current state of knowledge and a call to action from the Children's Oncology Group. Cancer 2020; 127:35-44. [PMID: 33112416 PMCID: PMC7875461 DOI: 10.1002/cncr.33289] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023]
Abstract
Survivors of childhood cancer may be at risk of experiencing pain, and a systematic review would advance our understanding of pain in this population. The objective of this study was to describe: 1) the prevalence of pain in survivors of childhood cancer, 2) methods of pain measurement, 3) associations between pain and biopsychosocial factors, and 4) recommendations for future research. Data sources for the study were articles published from January 1990 to August 2019 identified in the PubMed, PsycINFO, EMBASE, and Web of Science data bases. Eligible studies included: 1) original research, 2) quantitative assessments of pain, 3) articles published in English, 4) cancers diagnosed between birth and age 21 years, 5) survivors at 5 years from diagnosis and/or at 2 years after therapy completion, and 6) a sample size >20. Seventy-three articles were included in the final review. Risk of bias was considered using the Cochrane risk of bias tool. The quality of evidence was evaluated according to Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria. Common measures of pain were items created by the authors for the purpose of the study (45.2%) or health-related quality-of-life/health status questionnaires (42.5%). Pain was present in from 4.3% to 75% of survivors across studies. Three studies investigated chronic pain according the definition in the International Classification of Diseases. The findings indicated that survivors of childhood cancer are at higher risk of experiencing pain compared with controls. Fatigue was consistently associated with pain, females reported more pain than males, and other factors related to pain will require stronger evidence. Theoretically grounded, multidimensional measurements of pain are absent from the literature.
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Affiliation(s)
- Fiona Schulte
- University of Calgary, Calgary, AB, Canada,Alberta Children’s Hospital, Calgary, AB, Canada
| | | | | | | | | | | | | | | | | | | | | | | | - Matthew C. Hocking
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA,University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Melanie Noel
- University of Calgary, Calgary, AB, Canada,Alberta Children’s Hospital, Calgary, AB, Canada
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Buchbinder D, Patel SK, Casillas JN, Nugent DJ, Neudorf S, Sender LS, Torno L, Huszti H, Zeltzer LK, Parsons SK. Parent proxy assessment of sibling quality of life following pediatric hematopoietic cell transplantation. Health Qual Life Outcomes 2019; 17:162. [PMID: 31665035 PMCID: PMC6819636 DOI: 10.1186/s12955-019-1231-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/02/2019] [Indexed: 12/11/2022] Open
Abstract
Background When a child undergoes hematopoietic cell transplantation (HCT), the impact extends to the entire family, including siblings. Assessment of the quality of life (QoL) of siblings is challenged by their general lack of availability for regular assessment by clinical providers. Thus, the use of parent proxy reporting may be useful. Our aim was to describe the QoL of siblings of HCT survivors, as reported by their parents, as well as to identify parent and family factors associated with lower sibling QoL. Methods A cross-sectional study was utilized to assess parent-reported QoL of the HCT recipient’s sibling (Short Form (SF)-10 Health Survey for Children and the Pediatric Symptom Checklist (PSC)-17). Parent QoL was assessed using the SF-12. Multivariable linear regression was used to explore hypothesized predictors of sibling QoL, including parent QoL, family impact/function (Impact on Family Scale, Family Adaptability and Cohesion Evaluation Scales, IV, and a question asking about financial problems) while adjusting for demographic and HCT characteristics. Results Ninety-seven siblings (55% males) with a mean age of 12 years (standard deviation [SD] 4 years) were assessed, representing HCT survivors, who were an average of 5 years (SD 4 years) post-HCT. Neither sibling psychosocial (mean 49.84, SD 10.70, p = 0.87) nor physical health scores (mean 51.54, SD 8.42, p = 0.08) differed from norms. Parent proxies reported behavioral/emotional problems (PSC-17 total score > 15) in 24% of siblings. While parental ratings of their own physical health (SF-12 were higher than norms (mean 53.04, SD 8.17, p = 0.0005), mental health scores were lower (mean 45.48, SD 10.45, p < 0.0001). In multivariable analysis, lower parent emotional functioning and adverse family function were associated with lower sibling QoL, as reported by parents. Conclusions While proxy-reported QoL of siblings did not differ significantly from normative data, both parent QoL and family function were associated with sibling QoL. Future research is needed to understand how siblings themselves perceive their QoL following HCT.
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Affiliation(s)
- David Buchbinder
- Department of Pediatrics and Division of Pediatric Hematology, CHOC Children's Hospital and University of California at Irvine's Chao Family Comprehensive Cancer Center, Irvine, California, USA. .,CHOC Children's Hospital, 1201 W. La Veta Avenue, Orange, CA, 92868, USA.
| | - Sunita K Patel
- Department of Cancer Control and Population Sciences, City of Hope, Duarte, California, USA
| | - Jacqueline N Casillas
- Department of Pediatrics and Division of Pediatric Hematology and Oncology, David Geffen School of Medicine at University of California at Los Angeles and University of California at Los Angeles's Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | - Diane J Nugent
- Department of Pediatrics and Division of Hematology at CHOC Children's Hospital, Orange, California, USA
| | - Steven Neudorf
- Department of Pediatrics and Division of Oncology at CHOC Children's Hospital, Orange, California, USA
| | - Leonard S Sender
- Department of Pediatrics and Division of Oncology at CHOC Children's Hospital, Orange, California, USA
| | - Lilibeth Torno
- Department of Pediatrics and Division of Oncology at CHOC Children's Hospital, Orange, California, USA
| | - Heather Huszti
- Department of Pediatrics and Division of Psychology at CHOC Children's Hospital, Orange, California, USA
| | - Lonnie K Zeltzer
- Psychiatry / Biobehavioral Science, and Division of Cancer Prevention and Control Research, David Geffen School of Medicine at University of California at Los Angeles and University of California at Los Angeles's Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | - Susan K Parsons
- Institute of Clinical Research and Health Policy Studies at Tufts Medical Center and Departments of Medicine and Pediatrics, at Tufts University School of Medicine, Boston, Massachusetts, USA
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10
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Schepers SA. Commentary: Fifty Years of Development in Pediatric Psycho-Oncology Research and Practice: How Far Have we Come? J Pediatr Psychol 2019; 44:761-763. [DOI: 10.1093/jpepsy/jsz043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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11
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Chan SF, Hoag JA, Karst JS, Bingen KM. Social adjustment of adolescent cancer patients transitioning off active treatment: A short-term prospective mixed methods study. Pediatr Blood Cancer 2019; 66:e27530. [PMID: 30426663 DOI: 10.1002/pbc.27530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/20/2018] [Accepted: 10/08/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Psychosocial follow-up in survivorship is a standard of care in pediatric oncology; however, little is known about patients' psychosocial functioning during the transition off active treatment, a unique time in the cancer journey. This study examined the social adjustment of adolescent cancer patients during this transition period, which has been understudied to date. PROCEDURE Participants were 21 patients (ages 12-18 years; age M = 14.71 years; 62% female, 81% White) with various cancer diagnoses. Patients and their parents completed the Social Competence subscale of the Youth Self-Report (YSR) and Child Behavior Checklist (CBCL), respectively, PedsQL Social Functioning subscale, and a semistructured interview 1-2 months prior to ending treatment (time 1) and 3-7 months after ending treatment (time 2). RESULTS YSR and CBCL social competence scores were within the normal range at both time points. PedsQL social functioning scores were more consistent with norms for pediatric cancer samples at time 1 and norms for healthy children at time 2, with self-reported scores significantly improving from time 1 to time 2. A subset of patients had elevated social concerns at time 1, a number that decreased by time 2. Interviews revealed both positive and negative themes related to peer relationships and support, quantity of friends, and socialization. CONCLUSIONS Most adolescent cancer patients are socially well adjusted as they transition off treatment, although a subset have elevated concerns. Interviews provide insight into complex social experiences not captured on questionnaires. Patients may benefit from screening and support during this unique time.
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Affiliation(s)
- Sherilynn F Chan
- Medical College of Wisconsin, Milwaukee, Wisconsin.,Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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13
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Sansom‐Daly UM, Wakefield CE, Bryant RA, Patterson P, Anazodo A, Butow P, Sawyer SM, McGill BC, Evans HE, Cohn RJ. Feasibility, acceptability, and safety of the Recapture Life videoconferencing intervention for adolescent and young adult cancer survivors. Psychooncology 2018; 28:284-292. [DOI: 10.1002/pon.4938] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/05/2018] [Accepted: 11/04/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Ursula M. Sansom‐Daly
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
- Nelune Comprehensive Cancer CentrePrince of Wales Hospital Sydney Australia
| | - Claire E. Wakefield
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | | | - Pandora Patterson
- Research, Evaluation and Social Policy UnitCanTeen Newtown Australia
- Cancer Nursing Research Unit, Sydney Nursing SchoolThe University of Sydney Sydney Australia
| | - Antoinette Anazodo
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
- Nelune Comprehensive Cancer CentrePrince of Wales Hospital Sydney Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence‐based Decision‐making (CeMPED), School of PsychologyUniversity of Sydney Sydney Australia
| | - Susan M. Sawyer
- Department of PaediatricsUniversity of Melbourne Melbourne Australia
- Murdoch Children's Research Institute Melbourne Australia
- Royal Children's Hospital Centre for Adolescent Health Melbourne Australia
| | - Brittany C. McGill
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | - Holly E. Evans
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | - Richard J. Cohn
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
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14
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Anderson LM, Leonard S, Jonassaint J, Lunyera J, Bonner M, Shah N. Mobile health intervention for youth with sickle cell disease: Impact on adherence, disease knowledge, and quality of life. Pediatr Blood Cancer 2018; 65:e27081. [PMID: 29693797 DOI: 10.1002/pbc.27081] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/25/2018] [Accepted: 03/06/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Adherence to illness self-management among youth with sickle cell disease (SCD) positively impacts health outcomes and decreases overall healthcare costs. Despite this, children with SCD face several barriers to adherence, with adherence rates that remain moderate to low. The current feasibility study examined the Intensive Training Program (ITP), a mobile health (mHealth) intervention for youth with SCD designed to promote disease knowledge, adherence, and patient-provider communication. PROCEDURE Youth with SCD prescribed hydroxyurea between ages 7-18 completed baseline disease knowledge and psychosocial assessments and then were provided with the ITP app. Youth participated in the 90-day ITP, during which they completed three education modules, tracked adherence through daily self-recorded videos on the app, and received video messages from providers. Participants completed poststudy knowledge, psychosocial, and feasibility questionnaires. Medication possession ratio (MPR) was obtained via pharmacy-refill rates. RESULTS Thirty-two youths (mean age = 13.0 years) participated, with an average adherence tracking rate of 0.6 (standard deviation = 0.34). All participants demonstrated increased MPR (0.57-0.74, P < 0.001, d = 0.75) and disease knowledge (59.6-88.6%, P < 0.001). There was variable engagement in the ITP; completers demonstrated significantly better SCD-related functioning (P < 0.05), higher parent-reported treatment functioning (P < 0.05), and lower pain impact than noncompleters of the ITP (P < 0.05). CONCLUSIONS Results support the ITP can feasibly be implemented to promote adherence among youth with SCD. All participants demonstrated increased adherence and disease knowledge. However, there was variable engagement and only intervention completers showed improvements in psychosocial outcomes. Further research is needed to evaluate long-term outcomes and ways to promote engagement in mHealth interventions among the youth.
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Affiliation(s)
- Lindsay M Anderson
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Sarah Leonard
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.,Department of Pediatrics, Eastern Carolina University, Greenville, North Carolina
| | - Jude Jonassaint
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Joseph Lunyera
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Melanie Bonner
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Nirmish Shah
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
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15
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Katz LF, Fladeboe K, King K, Gurtovenko K, Kawamura J, Friedman D, Compas B, Gruhn M, Breiger D, Lengua L, Lavi I, Stettler N. Trajectories of child and caregiver psychological adjustment in families of children with cancer. Health Psychol 2018; 37:725-735. [PMID: 30024229 PMCID: PMC6091867 DOI: 10.1037/hea0000619] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe the trajectory of patient and caregiver mental health from diagnosis through the first year of treatment for pediatric cancer and assess whether rates of clinically relevant symptoms were elevated compared with norms. We examined mean levels of internalizing and externalizing symptoms and posttraumatic stress symptoms (PTSS) in children with cancer, and depression, anxiety, and PTSS in caregivers during the first year of treatment; the proportion of patients and caregivers that scored in the clinical range at each time point; and the typical trajectory of symptoms in patients and caregivers and whether trajectories differed between individuals. METHOD Families (N = 159) of children newly diagnosed with cancer (Mage = 5.6 years; range = 2-18 years) participated in a short-term prospective study. Primary caregivers provided monthly reports of their own and their children's psychological adjustment. RESULTS On average, children were well-adjusted. However, compared with norms, there was a higher than expected proportion of children with clinically relevant internalizing symptoms around the time of diagnosis. On average children's symptoms declined over time, though variability was observed. Caregivers were less well-adjusted on average, with a high proportion reporting clinically relevant symptoms over time for depression and anxiety. Caregiver symptoms also declined over time, though considerable variability was observed. CONCLUSION Although most children remain well-adjusted during the first year of treatment, many caregivers experience clinically relevant symptoms of psychological distress. Implications for development of interventions targeting at-risk patients and caregivers are discussed. Identifying processes that predict between-family variability in trajectories of psychopathology is an important next step. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Iris Lavi
- Department of Social Work, University of Haifa
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16
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Huang IC, Brinkman TM, Mullins L, Pui CH, Robison LL, Hudson MM, Krull KR. Child symptoms, parent behaviors, and family strain in long-term survivors of childhood acute lymphoblastic leukemia. Psychooncology 2018; 27:2031-2038. [PMID: 29772082 DOI: 10.1002/pon.4769] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE How family environment and parental factors affect health status and symptoms in childhood cancer survivors is understudied. We examined the influence of family cohesion, parent distress, and overprotection on child symptom burden and health-related quality of life (HRQOL) and family strain in survivors of childhood acute lymphoblastic leukemia. METHODS Parents of 213 children treated with chemotherapy only completed a survey when survivors were at least 5-year postdiagnosis. Family Environment Scale, Brief Symptom Inventory-18, Parent Protection Scale, Pediatric Quality of Life Inventory, and Impact on Family were used to assess family cohesion, parental distress, overprotection, child symptom burden and HRQOL, and family strain, respectively. Path analysis was conducted to quantify effects of family cohesion on family strain through parental distress, overprotection, child symptoms, and HRQOL. RESULTS Lower family cohesion (β = 0.06, 95% CI, 0.01-0.13), higher parental distress (β = 0.35, 95% CI, 0.20-0.45), and overprotection (β = 0.17, 95% CI, 0.01-0.32) were associated with more child symptom burden. More symptom burden were associated with poorer child HRQOL (β = 0.66, 95% CI, 0.57-0.75), which in turn was associated with more family strain (β = 0.11, 95% CI, 0.01-0.22). Lower maternal education was associated with overprotection (β = -0.23, 95% CI, -0.33 to -0.12), more child symptoms (β = -0.30, 95% CI, -0.41 to -0.16), poorer child HRQOL (β = -0.36, 95% CI, -0.46 to -0.21), and more family strain (β = -0.15, 95% CI, -0.23 to -0.08). CONCLUSIONS Family and parental factors contributed to health outcomes of childhood acute lymphoblastic leukemia survivors. Interventions to enhance family cohesion, decrease parental distress and overprotection, and ameliorate child symptoms may improve family functioning.
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Affiliation(s)
- I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Larry Mullins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - Ching-Hon Pui
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
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17
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Quast LF, Phillips PC, Li Y, Kazak AE, Barakat LP, Hocking MC. A prospective study of family predictors of health-related quality of life in pediatric brain tumor survivors. Pediatr Blood Cancer 2018; 65:e26976. [PMID: 29350456 PMCID: PMC5911210 DOI: 10.1002/pbc.26976] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/11/2017] [Accepted: 12/22/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND The objective of this study was to examine prospectively the associations between family functioning at the end of tumor-directed treatment and the health-related quality of life (HRQL) of pediatric brain tumor survivors (PBTSs) approximately 9 months later. PROCEDURE Thirty-five PBTS (age 6-16 years) and their mothers completed measures of family functioning and survivor HRQL within 5 months of completing tumor-directed therapy (baseline) and again approximately 9 months later (follow-up). RESULTS Survivor-rated general family functioning at baseline significantly predicted mother proxy- and self-reported survivor HRQL at follow-up when controlling for survivor HRQL at baseline and relevant demographic and treatment-related variables. CONCLUSIONS Family functioning is a key factor contributing to survivor HRQL and should be screened throughout the course of tumor-directed treatment. Psychosocial interventions directed toward improving general family functioning may improve survivor well-being following the completion of treatment.
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Affiliation(s)
| | - Peter C. Phillips
- The Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania
| | - Yimei Li
- The Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania
| | - Anne E. Kazak
- Nemours Children’s Health System and Sidney Kimmel School of Medicine at Thomas Jefferson University
| | - Lamia P. Barakat
- The Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania
| | - Matthew C. Hocking
- The Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania
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18
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Janin MMH, Ellis SJ, Wakefield CE, Fardell JE. Talking About Cancer Among Adolescent and Young Adult Cancer Patients and Survivors: A Systematic Review. J Adolesc Young Adult Oncol 2018; 7:515-524. [PMID: 29851370 DOI: 10.1089/jayao.2017.0131] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Communication plays an essential role in social relationships. Yet it is unclear how young cancer patients and survivors communicate with peers, and whether this contributes to increased rates of social difficulties. We aimed to analyze how childhood cancer patients and survivors communicate about their cancer with family and peers. We systematically searched Medline, Embase and PsycINFO for peer-reviewed studies on cancer-related communication among patients and survivors (any cancer, <25 years at diagnosis). We screened 309 articles, and included 6 qualitative studies. Studies were assessed using a standardized quality assessment tool. Participants were adolescents and young adults, 16-34 years of age at the time of study. Included studies related to different forms of cancer-related communication, benefits, and challenges. We found that cancer-related communication was an individual, complex process, addressing medical, existential, and emotional aspects of cancer. Communication occurred on a spectrum with variation in who information was shared with, as well as differences in the frequency at which information was shared, and the amount and type of information shared. Communication often occurred at uncertain or significant times for participants, or was initiated by others. Communicating about cancer yielded benefits as a coping strategy, prompted social support, and appeared central to significant relationships. Barriers to communication, including fear of stigma and poor peer reactions, hindered willingness to disclose. The number of studies analyzing this topic was limited. Communicating about cancer is a significant yet complex process for young patients and survivors. Further research is needed to complement the existing literature and to establish the evidence base for the development of future effective interventions promoting social and communication skills.
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Affiliation(s)
- Madeleine Marie Hortense Janin
- 1 Kids Cancer Center, Sydney Children's Hospital , Randwick, Australia .,2 School of Women's and Children's Health, Discipline of Pediatrics, UNSW Medicine, University of New South Wales , Sydney, Australia
| | - Sarah Jane Ellis
- 1 Kids Cancer Center, Sydney Children's Hospital , Randwick, Australia .,2 School of Women's and Children's Health, Discipline of Pediatrics, UNSW Medicine, University of New South Wales , Sydney, Australia
| | - Claire Elizabeth Wakefield
- 1 Kids Cancer Center, Sydney Children's Hospital , Randwick, Australia .,2 School of Women's and Children's Health, Discipline of Pediatrics, UNSW Medicine, University of New South Wales , Sydney, Australia
| | - Joanna Elizabeth Fardell
- 1 Kids Cancer Center, Sydney Children's Hospital , Randwick, Australia .,2 School of Women's and Children's Health, Discipline of Pediatrics, UNSW Medicine, University of New South Wales , Sydney, Australia
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19
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Walubita M, Sikateyo B, Zulu JM. Challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia. BMC Health Serv Res 2018; 18:314. [PMID: 29720168 PMCID: PMC5932785 DOI: 10.1186/s12913-018-3127-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 04/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Zambia is experiencing high prevalence of childhood cancer. However, very few children access and complete treatment for cancer. This study aimed to document the challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia, and their coping strategies. METHODS This was an exploratory health facility-based qualitative study that was conducted at a Paediatric oncology ward at referral hospital in Zambia. In-depth individual interviews conducted with fifteen (15) caregivers and seven (7) key informants were analysed using thematic analysis. RESULTS Several challenges related to managing the childhood cancer diagnosis were recorded. Individual and family challenges were inadequate knowledge on childhood cancer, lack of finances to meet treatment and transport costs as well as long period of hospitalisation that affected women's ability to perform multiple responsibilities. Whereas challenges at community level were inadequate support to address emotional and physical distress and social stigmatisation experienced by caregivers. Health systems issues included inadequate specialised health workers, poor communication among health workers, limited space and beds as well as insufficient supplies such as blood. Cultural related factors were the belief that cancer is a product of witchcraft as well as religious beliefs regarding the role of faith healing in childhood cancer treatment. Coping strategies used by parents/ caregivers included praying to God, material support from organisations and church as well as delaying having another child. CONCLUSION Addressing the challenges for health care providers, parents and patients who face a childhood cancer diagnosis may require adopting a systems or an ecological approach that allows developing strategies that simultaneously address challenges related to the individual, family, community, health system and cultural aspects.
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Affiliation(s)
- Mulima Walubita
- School of Public Health, Department of Health Promotion and Education, University of Zambia, P.O. Box 50110, Lusaka, Zambia.
| | - Bornwell Sikateyo
- School of Public Health, Department of Health Promotion and Education, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Joseph M Zulu
- School of Public Health, Department of Health Promotion and Education, University of Zambia, P.O. Box 50110, Lusaka, Zambia
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20
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Peikert ML, Inhestern L, Bergelt C. Psychosocial interventions for rehabilitation and reintegration into daily life of pediatric cancer survivors and their families: A systematic review. PLoS One 2018; 13:e0196151. [PMID: 29672608 PMCID: PMC5908186 DOI: 10.1371/journal.pone.0196151] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/07/2018] [Indexed: 11/18/2022] Open
Abstract
Background The survival rate of childhood cancer patients increased over the past decades. However, even after successful treatment the transition back to normalcy is often a major challenge for the whole family. Therefore, this study aims to provide an overview of psychosocial interventions for childhood cancer survivors and their families in the first years after the end of cancer treatment. Methods We conducted a systematic review following the PRISMA Checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PROSPERO registration number: CRD42017059782). In November 2016 and September 2017, we searched the databases CINAHL, MEDLINE, PSYNDEX, and Web of Science. We included studies investigating psychosocial interventions for childhood cancer survivors diagnosed under the age of 21, their family members or the family as a whole. Further, we summarized the study characteristics and conducted a narrative synthesis of the results. Finally, we assessed the study quality with the Effective Public Health Practice Project Quality Assessment Tool. Results We identified a total of 8215 records based on our database searches and 17 additional records through hand searches. We included 33 articles in the qualitative synthesis. Most of the studies described interventions for the cancer survivor (n = 15). Nine studies investigated interventions for the whole family, and two studies interventions for siblings. The interventions mainly take place in an outpatient group setting (n = 15). Overall, most of the studies reported a significant psychosocial benefit of the interventions. However, the quality of the included studies was limited. Conclusion In summary, we identified a broad range of different interventions and thus could give a comprehensive overview of existing interventions for childhood cancer survivors and their families. However, there is a necessity for high quality studies. The results may help to optimize health care services that support families with the re-entry into daily life.
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Affiliation(s)
- Mona Leandra Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Coughtrey A, Millington A, Bennett S, Christie D, Hough R, Su MT, Constantinou MP, Shafran R. The Effectiveness of Psychosocial Interventions for Psychological Outcomes in Pediatric Oncology: A Systematic Review. J Pain Symptom Manage 2018; 55:1004-1017. [PMID: 28962919 DOI: 10.1016/j.jpainsymman.2017.09.022] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 11/18/2022]
Abstract
CONTEXT This review summarizes the current randomized controlled trials literature on psychological and physical outcomes of psychosocial interventions in pediatric oncology. OBJECTIVES The objective of this study was to evaluate the effectiveness and impact of psychosocial interventions in children with cancer. METHODS A search of the literature resulted in a total of 12 randomized clinical trials and these have evaluated psychosocial interventions in children younger than 18 years with current and previous diagnoses of cancer. Outcome measures were both psychological (e.g., symptoms of anxiety, depression, quality of life, and self-esteem) and physical (e.g., cancer symptoms, treatment adherence, and pain). Interventions identified included cognitive behavioral therapy (CBT; n = 4), joint CBT and physical exercise therapy (n = 1), family therapy (n = 2), therapeutic music video (n = 2), self-coping strategies (n = 1), a wish fulfillment intervention (n = 1), and joint family therapy and CBT (n = 1). RESULTS Nine studies reported statistically significant improvements on psychological outcomes. These findings suggest that psychosocial interventions are effective at reducing anxiety and depressive symptoms as well as improving quality of life. Additionally, six studies found psychosocial interventions to have a positive impact on physical symptoms and well-being, including a reduction in procedural pain and symptom distress. CONCLUSION These findings suggest that mental health needs in pediatric oncology patients can and should be addressed, potentially which will lead to better mental and physical health outcomes.
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Affiliation(s)
- Anna Coughtrey
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Amy Millington
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sophie Bennett
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Deborah Christie
- Child and Adolescent Psychological Services, University College London Hospital, NHS Foundation Trust, London, UK
| | - Rachael Hough
- Department of Adolescent Haematology, University College London Hospital, NHS Foundation Trust, London, UK
| | - Merina T Su
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, London, UK.
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22
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Walsh CP, Ewing LJ, Cleary JL, Vaisleib AD, Farrell CH, Wright AGC, Gray K, Marsland AL. Development of glucocorticoid resistance over one year among mothers of children newly diagnosed with cancer. Brain Behav Immun 2018; 69:364-373. [PMID: 29269321 PMCID: PMC5857426 DOI: 10.1016/j.bbi.2017.12.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 12/04/2017] [Accepted: 12/17/2017] [Indexed: 12/13/2022] Open
Abstract
Chronic distress associates with peripheral release of cortisol and a parallel upregulation of innate inflammation. Typically, cortisol functions to down-regulate inflammatory processes. However, in the context of chronic stress, it is hypothesized that glucocorticoid receptors within immune cells become less sensitive to the anti-inflammatory effects of cortisol, resulting in increased systemic inflammation. Caring for a child newly diagnosed with cancer is a particularly provocative chronic stressor. Here, we examine evidence for the development of cellular resistance to glucocorticoids among 120 mothers (Aged 18-56 years; 86% Caucasian) across the 12 months following their child's new diagnosis with cancer. Measures of psychological distress, interleukin (IL)-6, and glucocorticoid resistance (GCR) were assessed 1, 6, and 12 months after the diagnosis. A latent factor for distress was derived from the covariation among symptoms of anxiety, depression, and post-traumatic stress. Latent change score models revealed a significant positive association between change in distress and change in GCR from 0 to 6 months, and 6 months-1 year. This finding provides initial evidence for a longitudinal association between change in maternal distress and change in GCR from the onset of a chronic stressor through one year. Although levels of IL-6 increased during the first six months after the child's diagnosis, the magnitude of this change was not related to change in distress or change in GCR. Given the possible health consequences of reduced immune sensitivity to glucocorticoids, future work should further explore this stress response and its clinical significance.
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Affiliation(s)
| | - Linda J Ewing
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States
| | | | - Alina D Vaisleib
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States
| | - Chelsea H Farrell
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, United States
| | - Katarina Gray
- Department of Psychology, University of Pittsburgh, United States
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, United States
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23
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Cupit-Link M, Syrjala KL, Hashmi SK. Damocles' syndrome revisited: Update on the fear of cancer recurrence in the complex world of today's treatments and survivorship. Hematol Oncol Stem Cell Ther 2018; 11:129-134. [PMID: 29476707 DOI: 10.1016/j.hemonc.2018.01.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 01/20/2018] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE/BACKGROUND Improvements in curative treatments for many types of cancer have emerged over the past several decades, resulting in a growing population of long-term cancer survivors - of both adult and childhood cancers. Despite this incredible medical achievement, long-term survivors of cancer face a unique fear: the fear of relapse. METHODS We conducted a review of the literature for data on fear of relapse among cancer survivors. RESULTS The fear of cancer recurrence is present in survivors of childhood and adult cancers as well as family members and often leads to psychological sequelae. CONCLUSION Literature on the fear of cancer recurrence has begun to emerge. However, herein we provide a unique approach through the use of a metaphor: Cicero's story of Damocles' sword. We aim to outline the many fear-related and emotional challenges faced by cancer survivors with an extensive review of studies demonstrating such challenges.
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Affiliation(s)
| | - Karen L Syrjala
- Biobehavioral Sciences Department, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
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24
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Young TL. An Empathetic Model of Group Counseling for Parents of Children with Cancer. JOURNAL FOR SPECIALISTS IN GROUP WORK 2018. [DOI: 10.1080/01933922.2018.1431348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Zheng DJ, Lu X, Schore RJ, Balsamo L, Devidas M, Winick NJ, Raetz EA, Loh ML, Carroll WL, Sung L, Hunger SP, Angiolillo A, Kadan-Lottick NS. Longitudinal analysis of quality-of-life outcomes in children during treatment for acute lymphoblastic leukemia: A report from the Children's Oncology Group AALL0932 trial. Cancer 2018; 124:571-579. [PMID: 29112230 PMCID: PMC5808870 DOI: 10.1002/cncr.31085] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 09/24/2017] [Accepted: 09/27/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Children with average-risk acute lymphoblastic leukemia (AR-ALL) face many challenges that can adversely affect their quality of life (QOL). However, to the authors' knowledge, patterns and predictors of QOL impairment during therapy have not been well characterized to date. METHODS Patients with AR-ALL who were enrolled on the Children's Oncology Group AALL0932 trial were offered participation in this prospective cohort study if they were aged ≥4 years at the time of diagnosis and had an English-speaking parent. At approximately 2 months, 8 months, 17 months, 26 months, and 38 months (boys only) after diagnosis, parents completed the Pediatric Quality of Life Inventory Generic Core Scales Version 4.0 (PedsQL4.0) and McMaster Family Assessment Device instruments for QOL (physical, emotional, and social functioning) and family functioning, respectively. The proportions of individuals scoring in the impaired range (2 standard deviations below the population mean) were calculated at each time point. Longitudinal impairment patterns and predictors were examined. RESULTS A total of 594 participants with AR-ALL were diagnosed at a mean age of 6.0 years (standard deviation, 1.6 years). At 2 months, a substantial proportion of participants had impaired scores for physical (36.5%; 95% confidence interval [95% CI], 32.3%-40.8%) and emotional (26.2%; 95% CI, 22.5%-30.2%) functioning compared with population norms of 2.3%. These elevations persisted at 26 months. Emotional impairment at 2 months (odds ratio, 3.4; 95% CI, 1.5-7.7) was found to significantly predict emotional impairment at 26 months. In repeated measures analysis with multivariate modeling, unhealthy family functioning (odds ratio, 1.5; 95% CI, 1.1-2.1) significantly predicted emotional impairment controlling for age and sex. QOL outcomes were similar between sexes at the end of therapy (26 months for girls and 38 months for boys). CONCLUSIONS Many children with AR-ALL experience physical and emotional functioning impairment that begins early in treatment and persists. Early screening may identify high-risk patients who might benefit from family-based interventions. Cancer 2018;124:571-9. © 2017 American Cancer Society.
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Affiliation(s)
- Daniel J. Zheng
- Yale University School of Medicine, New Haven, CT
- Boston Children’s Hospital, Boston, MA
- Boston Medical Center, Boston, MA
| | | | | | - Lyn Balsamo
- Yale University School of Medicine, New Haven, CT
- Yale Cancer Center, New Haven, CT
| | | | | | - Elizabeth A Raetz
- Primary Children’s Hospital, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
- University of Utah, Salt Lake City, UT
| | - Mignon L. Loh
- Benioff Children’s Hospital, San Francisco, CA
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
- University of California, San Francisco, San Francisco, CA
| | | | - Lillian Sung
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen P. Hunger
- Division of Oncology and Center for Childhood Cancer Research, Children’s Hospital of Philadelphia, Philadelphia, PA
- The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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26
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Évolution de l’auto-efficacité, des émotions et du concept de soi chez des adolescents hospitalisés en hémato-oncologie pendant une intervention de musicothérapie interactive : une étude pilote. PSYCHO-ONCOLOGIE 2017. [DOI: 10.1007/s11839-017-0622-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ander M, Wikman A, Ljótsson B, Grönqvist H, Ljungman G, Woodford J, Lindahl Norberg A, von Essen L. Guided internet-administered self-help to reduce symptoms of anxiety and depression among adolescents and young adults diagnosed with cancer during adolescence (U-CARE: YoungCan): a study protocol for a feasibility trial. BMJ Open 2017; 7:e013906. [PMID: 28132011 PMCID: PMC5278290 DOI: 10.1136/bmjopen-2016-013906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION A subgroup of adolescents and young adults diagnosed with cancer during adolescence reports elevated levels of anxiety and depressive symptoms and unmet needs for psychological support. Evidence-based psychological treatments tailored for this population are lacking. This protocol describes a feasibility study of a guided-internet-administered self-help programme (YoungCan) primarily targeting symptoms of anxiety and depression among young persons diagnosed with cancer during adolescence and of the planned study procedures for a future controlled trial. METHODS/ANALYSIS The study is an uncontrolled feasibility trial with a pre-post and 3-month follow-up design. Potential participants aged 15-25 years, diagnosed with cancer during adolescence, will be identified via the Swedish Childhood Cancer Registry. 30 participants will be included. Participants will receive YoungCan, a 12-week therapist-guided, internet-administered self-help programme consisting primarily of cognitive-behavioural therapy organised into individually assigned modules targeting depressive symptoms, worry and anxiety, body dissatisfaction and post-traumatic stress. Interactive peer support and psychoeducative functions are also available. Feasibility outcomes include: recruitment and eligibility criteria; data collection; attrition; resources needed to complete the study and programme; safety procedures; participants' and therapists' adherence to the programme; and participants' acceptability of the programme and study methodology. Additionally, mechanisms of impact will be explored and data regarding symptoms of anxiety, depression, post-traumatic stress, body dissatisfaction, reactions to social interactions, quality of life, axis I diagnoses according to the Mini International Neuropsychiatric Interview and healthcare service use will be collected. Exploratory analyses of changes in targeted outcomes will be conducted. ETHICS/DISSEMINATION This feasibility protocol was approved by the Regional Ethical Review Board in Uppsala, Sweden (ref: 2016/210). Findings will be disseminated to relevant research, clinical, health service and patient communities through publications in peer-reviewed and popular science journals and presentations at scientific and clinical conferences. TRIAL REGISTRATION NUMBER ISRCTN97835363.
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Affiliation(s)
- Malin Ander
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anna Wikman
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Brjánn Ljótsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Helena Grönqvist
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Gustaf Ljungman
- Pediatric Oncology, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Clinical Education Development and Research (CEDAR), Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Annika Lindahl Norberg
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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28
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Psychosocial Issues in Children with Cancer: The Role of Patient Advocacy and Its Impact on Care. Sarcoma 2017. [DOI: 10.1007/978-3-319-43121-5_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Brand S, Wolfe J, Samsel C. The Impact of Cancer and its Treatment on the Growth and Development of the Pediatric Patient. Curr Pediatr Rev 2017; 13:24-33. [PMID: 27848890 PMCID: PMC5503788 DOI: 10.2174/1573396313666161116094916] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 11/08/2016] [Accepted: 12/12/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cancer treatment can have profound effects on the growth and development of pediatric patients. Different models of psychosocial development and behavioral treatment approaches aid children receiving medical treatment. Providing education, anticipatory guidance, and individualized support to child and their families is a psychosocial standard. OBJECTIVE Clarify the different models of psychosocial development and applicable psychosocial interventions to better prepare and tailor cancer treatment to pediatric patients. METHODS Authors reviewed existing evidenced-based literature in oncology, psychology, developmental, and psychiatric while drawing on case examples and expert knowledge to illustrate the impact of cancer treatment on pediatric patients, analyze developmentally individualized needs, and describe facilitative interventions. RESULT Pediatric patients of all ages cope and adjust better to all phases of treatment when their care is delivered in a developmentally-informed and psychosocially thoughtful way. CONCLUSION Providers can comprehensively prepare their patients and families for treatment better by utilizing a psychosocially- and developmentally-informed framework while meeting individualized unique needs of patients. An integrated multidisciplinary psychosocial support team is facilitative in anticipating and meeting the needs of pediatric cancer patients and has recently become a psychosocial standard of care.
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Affiliation(s)
- Sarah Brand
- Dana-Farber Cancer Institute, 450 Brookline Avenue, SW360E, Boston, MA 02115. United States
| | - Joanne Wolfe
- Department of Medicine, Boston Children`s Hospital, MA. United States
| | - Chase Samsel
- Harvard Medical School, Boston, MA. United States
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30
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Loiselle KA, Rausch JR, Bidwell S, Drake S, Davies SM, Pai ALH. Predictors of health-related quality of life over time among pediatric hematopoietic stem cell transplant recipients. Pediatr Blood Cancer 2016; 63:1834-9. [PMID: 27332623 DOI: 10.1002/pbc.26112] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 05/26/2016] [Accepted: 05/31/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Advances in hematopoietic stem cell transplantation (HSCT) have contributed to increased survival for pediatric patients. However, there are inconsistent findings regarding the impact of HSCT on health-related quality of life (HRQOL) outcomes for children. This study aimed to establish trajectories of HRQOL following HSCT and identify predictors of the HRQOL course. PROCEDURE Ninety caregivers of a child who received HSCT (mean age = 6.42 years) for various oncologic, immunologic, and metabolic conditions completed questionnaires regarding family psychosocial functioning and child HRQOL at the time of discharge from HSCT and follow-up HRQOL at four additional time points. RESULTS There was a significant change in overall HRQOL in 3 months postdischarge, with the greatest improvement in physical functioning. Caregiver stress and social support, and child psychosocial problems predicted changes in HRQOL over time. CONCLUSIONS These results point to potentially modifiable factors that are related to the course of HRQOL following HSCT, and interventions aimed at these factors should be implemented.
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Affiliation(s)
- Kristin A Loiselle
- Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Joseph R Rausch
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio
| | - Sarah Bidwell
- Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Sarah Drake
- Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Stella M Davies
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Ahna L H Pai
- Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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31
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Simonova G, Kozubikova P, Liscak R, Novotny J. Leksell Gamma Knife treatment for pilocytic astrocytomas: long-term results. J Neurosurg Pediatr 2016; 18:58-64. [PMID: 26991883 DOI: 10.3171/2015.10.peds14443] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate long-term treatment results, radiation-related toxicity, and prognostic factors for the progression-free survival (PFS) of patients with pilocytic astrocytomas treated by means of stereotactic radiosurgery with a Leksell Gamma Knife. METHODS A total of 25 patients with pilocytic astrocytomas underwent Gamma Knife surgery during the period 1992-2002. The median target volume was 2700 mm(3) (range 205-25,000 mm(3)). The 18 patients treated with 5 daily fractions received a median minimum target dose of 25 Gy. Doses for the 2 patients treated with 10 fractions over 5 days (2 fractions delivered on the same day at least 6 hours apart) were 23 and 28 Gy. For the 5 patients treated with a single fraction, the minimum target dose ranged from 13 to 20 Gy (median 16 Gy). RESULTS Complete regression occurred in 10 patients (40%) and partial regression in 10 patients (40%). The 10-year overall survival rate was 96% and the 10-year PFS rate was 80%. Target volume appeared to be a significant prognostic factor for PFS (p = 0.037). Temporary Grade 3 toxicity appeared in 2 patients (8%), and these patients were treated with corticosteroids for 2 months. Permanent Grade 4 toxicity appeared in 2 patients (8%) and was associated with neurocognitive dysfunction. In these 2 individuals, the neurocognitive dysfunction was also felt to be in part the result of the additional therapeutic interventions (4 in one case and 6 in the other) required to achieve durable control of their tumors. CONCLUSIONS Radiosurgery represents an alternative treatment modality for small residual or recurrent volumes of pilocytic astrocytomas and provides long-term local control. Target volume appears to be the most important factor affecting PFS.
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Affiliation(s)
| | - Petra Kozubikova
- Departments of 1 Stereotactic and Radiation Neurosurgery and.,Medical Physics, Na Homolce Hospital, Prague; and.,Department of Dosimetry and Application of Ionizing Radiation, Faculty of Nuclear Science and Physical Engineering, Czech Technical University in Prague, Czech Republic
| | - Roman Liscak
- Departments of 1 Stereotactic and Radiation Neurosurgery and
| | - Josef Novotny
- Departments of 1 Stereotactic and Radiation Neurosurgery and.,Medical Physics, Na Homolce Hospital, Prague; and.,Department of Dosimetry and Application of Ionizing Radiation, Faculty of Nuclear Science and Physical Engineering, Czech Technical University in Prague, Czech Republic
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Safarabadi-Farahani A, Maarefvand M, Biglarian A, Khubchandani J. Effectiveness of a Brief Psychosocial Intervention on Quality of Life of Primary Caregivers of Iranian Children With Cancer: A Randomized Controlled Trial. J Pediatr Nurs 2016; 31:e262-70. [PMID: 26860879 DOI: 10.1016/j.pedn.2016.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 12/17/2022]
Abstract
UNLABELLED Cancer in children has a great impact on primary caregiver quality of life (QOL). OBJECTIVE This study examined the effectiveness of a brief psychosocial intervention (BPI) on QOL of Primary Caregivers of Children with Cancer (PCCCs). METHODS Sixty-five PCCCs participated in a randomized controlled trial in Mahak Hospital and Rehabilitation Complex in Tehran, Iran. A 5-week long BPI (which comprised of counseling sessions and telephone follow-up) was delivered to the intervention group in addition to usual service, while the control group was provided with usual service. Data were collected using the Caregiver Quality of Life Index-Cancer-Persian version (CQOLC-P) prior to intervention, post-intervention, and at follow-up (i.e. 30days after the intervention). Repeated measures analysis of variance analysis (ANOVA) was used to evaluate outcomes. RESULTS Majority of the participants were mothers (95%), between ages of 24-47 years (95%) with children between ages of 2-12 years. Most child cancer diagnoses were for brain tumors (n=31) and blood cancers (n=17). Significant improvement was found within the intervention group on QOL (p<0.001) including improvements on subscale measures of mental/emotional burden (p<0.001), disruption (p<0.001), and positive adaptation (p<0.001), compared with the control group over time. There was no difference between the intervention and control groups on the financial subscale measure after intervention (p>0.05). CONCLUSION BPI was an effective strategy to improve the quality of life of PCCCs. Similar interventions can be planned by practitioners to reduce the burden of childhood cancer on PCCCs.
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Affiliation(s)
| | - Masoomeh Maarefvand
- Substance Abuse and Dependence Research Center, Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Akbar Biglarian
- Biostatistics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Jagdish Khubchandani
- Department of Physiology and Health Science, Ball State University, Muncie, IN, USA
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Seeing the good in the bad: which factors are associated with posttraumatic growth in long-term survivors of adolescent cancer? Support Care Cancer 2016; 24:4607-15. [DOI: 10.1007/s00520-016-3303-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022]
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Phelps C, Minou M, Baker A, Hughes C, French H, Hawkins W, Leeuwenberg A, Crabtree R, Hutchings PB. Necessary but not sufficient? Engaging young people in the development of an avatar-based online intervention designed to provide psychosocial support to young people affected by their own or a family member's cancer diagnosis. Health Expect 2016; 20:459-470. [PMID: 27292018 PMCID: PMC5433534 DOI: 10.1111/hex.12473] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 11/26/2022] Open
Abstract
Objective This study discusses the challenges and successes of engaging young people in a project aimed at developing an online counselling intervention for young people affected by cancer. Context For younger people with a diagnosis of cancer or who are caring for someone with cancer, the psychosocial consequences can create significant challenges for their social and educational development. Whilst young people have been shown to be reluctant to make use of traditional face‐to‐face counselling, research is beginning to suggest that effective therapeutic relationships can be formed with young people online. Design The first phase of the study involved working with a ‘Young Persons’ Panel’ of healthy school pupils and university students to develop and pilot an online counselling intervention and study materials in preparation for a pilot evaluation of the intervention. Intervention An avatar‐based virtual reality counselling world was created where young people can create their own avatar and receive counselling over the Internet from a qualified counsellor via an avatar in a virtual reality world. Findings The process of engaging young people in the C:EVOLVE project enabled a unique intervention to be developed and demonstrated positive developmental opportunities. However, despite the rigorous approach to the development of the intervention, initial attempts within the pilot evaluation phase of the study showed difficulties recruiting to the study, and this phase of the study has currently ceased whilst further exploratory work takes place. Conclusion This study has demonstrated the complexities of intervention development and evaluation research targeted at young people and the challenges created when attempting to bring clinical practice and research evaluation together.
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Affiliation(s)
- Ceri Phelps
- School of Psychology, University of Wales Trinity Saint David, Swansea, UK
| | - Masoumeh Minou
- School of Psychology, University of Wales Trinity Saint David, Swansea, UK
| | - Andrew Baker
- School of Psychology, University of Wales Trinity Saint David, Swansea, UK
| | - Carol Hughes
- School of Psychology, University of Wales Trinity Saint David, Swansea, UK
| | | | - Wayne Hawkins
- School of Psychology, University of Wales Trinity Saint David, Swansea, UK
| | - Andrew Leeuwenberg
- School of Psychology, University of Wales Trinity Saint David, Swansea, UK
| | - Rebecca Crabtree
- School of Psychology, University of Wales Trinity Saint David, Swansea, UK
| | - Paul B Hutchings
- School of Psychology, University of Wales Trinity Saint David, Swansea, UK
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35
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Polat S, Güdücü Tüfekci F, Küçükoğlu S, Kobya Bulut H. Acceptance–rejection levels of the Turkish mothers toward their children with cancer. Collegian 2016. [DOI: 10.1016/j.colegn.2015.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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36
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Kunin-Batson AS, Lu X, Balsamo L, Graber K, Devidas M, Hunger SP, Carroll WL, Winick NJ, Mattano LA, Maloney KW, Kadan-Lottick NS. Prevalence and predictors of anxiety and depression after completion of chemotherapy for childhood acute lymphoblastic leukemia: A prospective longitudinal study. Cancer 2016; 122:1608-17. [PMID: 27028090 DOI: 10.1002/cncr.29946] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 12/08/2015] [Accepted: 01/11/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND The months immediately after the completion of treatment for childhood acute lymphoblastic leukemia (ALL) are often regarded as a stressful time for children and families. In this prospective, longitudinal study, the prevalence and predictors of anxiety and depressive symptoms after the completion of treatment were examined. METHODS Participants included 160 children aged 2 to 9 years with standard-risk ALL who were enrolled on Children's Oncology Group protocol AALL0331. Parents completed standardized rating scales of their children's emotional-behavioral functioning and measures of coping and family functioning at approximately 1 month, 6 months, and 12 months after diagnosis and again 3 months after the completion of chemotherapy. RESULTS At 3 months off therapy, approximately 24% of survivors had at-risk/clinically elevated anxiety scores and 28% had elevated depression scores, which are significantly higher than the expected 15% in the general population (P = .028 and .001, respectively). Patients with elevated anxiety 1 month after diagnosis were at greater risk of off-therapy anxiety (odds ratio, 4.1; 95% confidence interval, 1.31-12.73 [P = .022]) and those with elevated depressive symptoms 6 months after diagnosis were at greater risk of off-therapy depression (odds ratio, 7.88; 95% confidence interval, 2.61-23.81 [P = .0002]). In adjusted longitudinal analyses, unhealthy family functioning (P = .008) and less reliance on social support coping (P = .009) were found to be associated with risk of emotional distress. Children from Spanish-speaking families (P = .05) also were found to be at a greater risk of distress. CONCLUSIONS A significant percentage of children experience emotional distress during and after therapy for ALL. These data provide a compelling rationale for targeted early screening and psychosocial interventions to support family functioning and coping skills. Cancer 2016;122:1608-17. © 2015 American Cancer Society.
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Affiliation(s)
- Alicia S Kunin-Batson
- HealthPartners Institute, Minneapolis, Minnesota.,Division of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
| | - Xiaomin Lu
- Division of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.,Department of Biostatistics, Colleges of Medicine, Public Health, and Health Professions, University of Florida, Gainesville, Florida
| | - Lyn Balsamo
- Department of Pediatric Hematology/Oncology, Yale University School of Medicine, Yale Comprehensive Cancer Center, New Haven, Connecticut
| | - Kelsey Graber
- Yale University Child Study Center, New Haven, Connecticut
| | - Meenakshi Devidas
- Department of Biostatistics, Colleges of Medicine, Public Health, and Health Professions, University of Florida, Gainesville, Florida
| | - Stephen P Hunger
- Center for Childhood Cancer Research, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - William L Carroll
- Department of Pediatrics, New York University Langone Medical Center, Stephen D. Hassenfeld Children's Center for Cancer and Blood Disorders, New York, New York
| | - Naomi J Winick
- Department of Pediatric Hematology/Oncology, University of Texas Southwestern School of Medicine, Dallas, Texas
| | | | - Kelly W Maloney
- Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado
| | - Nina S Kadan-Lottick
- Department of Pediatric Hematology/Oncology, Yale University School of Medicine, Yale Comprehensive Cancer Center, New Haven, Connecticut
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Wakefield CE, Sansom-Daly UM, McGill BC, Ellis SJ, Doolan EL, Robertson EG, Mathur S, Cohn RJ. Acceptability and feasibility of an e-mental health intervention for parents of childhood cancer survivors: "Cascade". Support Care Cancer 2016; 24:2685-94. [PMID: 26781620 DOI: 10.1007/s00520-016-3077-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/03/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to evaluate the feasibility and acceptability of "Cascade": an online, group-based, cognitive behavioral therapy intervention, delivered "live" by a psychologist, to assist parents of children who have completed cancer treatment. METHODS Forty-seven parents were randomized to Cascade (n = 25) or a 6-month waitlist (n = 22). Parents completed questionnaires at baseline, 1-2 weeks and 6 months post-intervention. Thirty parents completed full evaluations of the Cascade program (n = 21 randomized to Cascade, n = 9 completed Cascade post-waitlist). RESULTS Ninety-six percent of Cascade participants completed the intervention (n = 24/25). Eighty percent of parents completed every questionnaire (mean completion time 25 min (SD = 12)). Cascade was described as at least "somewhat" helpful by all parents. None rated Cascade as "very/quite" burdensome. Parents reported that the "online format was easy to use" (n = 28, 93.3 %), "I learnt new skills" (n = 28, 93.3 %), and "I enjoyed talking to others" (n = 29, 96.7 %). Peer-to-peer benefits were highlighted by good group cohesion scores. CONCLUSIONS Cascade is highly acceptable and feasible. Its online delivery mechanism may address inequities in post-treatment support for parents, a particularly acute concern for rural/remote families. Future research needs to establish the efficacy of the intervention. TRIAL REGISTRATION ACTRN12613000270718, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12613000270718.
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Affiliation(s)
- Claire E Wakefield
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Ursula M Sansom-Daly
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
- Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, Randwick, NSW, Australia
| | - Brittany C McGill
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Sarah J Ellis
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Emma L Doolan
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Eden G Robertson
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Sanaa Mathur
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Richard J Cohn
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
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Raz H, Tabak N, Kreitler S. Psychosocial Outcomes of Sharing a Diagnosis of Cancer with a Pediatric Patient. Front Pediatr 2016; 4:70. [PMID: 27489853 PMCID: PMC4951526 DOI: 10.3389/fped.2016.00070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/24/2016] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This innovative pilot study was designed to provide research-based evidence on the variables to consider informing a child of his/her cancer diagnosis, so as to minimize the negative psychosocial effects of the cancer experience on survivors. The hypotheses of the study were that "good information" about cancer, will allow the child a better understanding way to cope with treatment and improve sociopsychological outcomes at adulthood. METHODS Ninety-one adult childhood cancer (CC) survivors got the questionnaires while waiting to their routine checkup at a grate CC medical center in center Israel. RESULTS To our surprise and not according to the hypothesis, there was a difference between children diagnosed up to 12 years of age and those diagnosed during adolescence. (Participants were divided into two groups according to their age at diagnosis: from birth to 12 years old and from age 12-18). In the group diagnosed at a younger age, those who had received "good information" were found to have better quality of life, lower mental pain, and higher mental pain tolerance than did those in the same group (diagnosed at a younger age) who received "not good information." By contrast, in the group diagnosed during adolescence, those who had received "not good information" scored higher on these measures than did their counterparts who had received "good information." CONCLUSION Given that information conveyed to children diagnosed with cancer can have a significant impact on survivors' quality of life, further research is needed to determine the precise information to be divulged to children at the time of diagnosis. In the meantime, extreme caution, sensitivity, and careful judgment are required. CLINICAL RELEVANCE Findings of the current study and of future studies can be used to formulate clear guidelines for assessing a child's readiness and the information to be divulged, so as to improve the quality of life of CC survivors.
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Affiliation(s)
- Haya Raz
- Nursing Department, Machon Tal, Jerusalem College of Technology , Jerusalem , Israel
| | - Nili Tabak
- Faculty of Nursing, School of Health Professions, Tel-Aviv University Medical School , Tel-Aviv , Israel
| | - Shulamith Kreitler
- Psychooncology Research Center, Sheba Medical Center, School of Psychological Sciences, Tel-Aviv University , Tel-Aviv , Israel
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39
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A review of supportive care interventions to manage distress in young children with cancer and parents. Cancer Nurs 2015; 37:E1-26. [PMID: 24936752 DOI: 10.1097/ncc.0000000000000095] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a positive relationship between parent and young child distress during cancer treatment. Dimensions of parent/child distress are multifaceted and associated with family function and quality of life outcomes. A critical examination of intervention research is needed to identify how dimensions of parent/child distress and related outcomes are being addressed. OBJECTIVE The aims of this study were to summarize and describe supportive care intervention research for young children with cancer and parents and to discuss implications for family-based intervention research. METHODS This systematic review examined supportive care intervention studies with randomized and nonrandomized designs for young children with cancer (aged 3-8 years) and/or their parents published between 1991 and 2011. Twenty-two studies that met specific inclusion criteria were reviewed to determine intervention type, intervention components, targeted outcomes and findings, and whether interventions addressed child, parent, or parent/child needs. RESULTS Most interventions focused primarily on procedural support, followed by parent education/counseling. Most studies targeted the child or the parent alone; very few targeted parent/child dyads. Outcomes focused primarily on child distress, anxiety, and pain. Quality of life and coping were rarely measured, and no studies examined family function. This body of research is emerging, with most interventions in the developmental pilot phase and few efficacy trials. CONCLUSIONS Findings confirm underrepresentation of young children in supportive care intervention research and the need for more complex, family-based interventions to advance young child intervention research beyond acute, procedural distress. IMPLICATIONS FOR PRACTICE The authors discuss the implications of review findings for clinical practice.
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Tackett AP, Cushing CC, Suorsa KI, Mullins AJ, Gamwell KL, Mayes S, McNall-Knapp R, Chaney JM, Mullins LL. Illness Uncertainty, Global Psychological Distress, and Posttraumatic Stress in Pediatric Cancer: A Preliminary Examination Using a Path Analysis Approach. J Pediatr Psychol 2015; 41:309-18. [PMID: 26423322 DOI: 10.1093/jpepsy/jsv093] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 09/01/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate the relationship of illness uncertainty (IU) to global psychological distress (GPD) and posttraumatic stress symptomatology (PTSS) using a path analysis approach. METHODS Participants were 105 caregivers (MAge = 36.9 years, standard deviation [SD] = 8.7) of children (MAge = 8.6 years, SD = 5.0) with newly diagnosed cancer. A path analysis model examined the indirect and direct effects of each IU subscale on PTSS through GPD. RESULTS The final model accounted for 47.30% of the variance in PTSS, and the ambiguity facet of IU had a significant indirect effect on PTSS through GPD. Lack of clarity and unpredictability were not significant predictors. CONCLUSIONS Ambiguity experienced by parents may be salient in the development of PTSS. Future research should examine these relationships longitudinally in larger samples to better understand adjustment in parents of children with cancer.
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Affiliation(s)
| | - Christopher C Cushing
- Department of Psychology, Oklahoma State University, Department of Psychology, University of Kansas, and
| | | | | | | | - Sunnye Mayes
- Department of Pediatrics, University of Oklahoma Health Sciences Center
| | - Rene McNall-Knapp
- Department of Pediatrics, University of Oklahoma Health Sciences Center
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Kim SH, Yoo EK. Ethnographic Research on Adjustment of Mothers Caring for their Cancer Children in Korea. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2015; 21:216-231. [PMID: 37684826 DOI: 10.4069/kjwhn.2015.21.3.216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/09/2015] [Accepted: 08/21/2015] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study is to provide the basic data to develop the effective nursing intervention for the parent who have children with cancer by acquiring the deeper understanding of the mothers' adjustment of caring for their children with cancer. METHODS The ethnographic research method was used to find out the pattern of caring adjustment in Korean cultural context. Informants consisted of 12 mothers who were caring for their children with cancer. The data were collected using in-depth interviews, participant observation, and telephone interviews by maximum variation purposive sampling. The data were analyzed following Spradley's methodology. RESULTS The mothers' caring adjustment were organized into one cultural theme, four categories, and twelve properties. The cultural theme was 'standing alone as a mother with sin'. The four categories were 'blaming for falling illness', 'overcoming with motherhood', 'desperate struggling with side effects', and 'establishing new network as a dependent'. CONCLUSION For the mothers who are caring children with cancer, the supportive nursing intervention based on the deeper understanding of mothers' pattern of caring adjustment for their children and centered on facilitating effective adjustment in each cultural context especially from the very early stage of caring in the hospital ward is extremely required.
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Affiliation(s)
- Seong Heui Kim
- Department of Nursing, Daejin University, Pocheon, Korea
| | - Eun Kwang Yoo
- Department of Nursing, Daejin University, Pocheon, Korea
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Doherty WJ, McDaniel SH, Hepworth J. Contributions of medical family therapy to the changing health care system. FAMILY PROCESS 2014; 53:529-543. [PMID: 25039655 DOI: 10.1111/famp.12092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Medical family therapy is a form of professional practice that uses a biopsychosocial approach and systemic family therapy principles in the collaborative treatment of individuals and families dealing with medical problems. It emerged out of the experience of family therapists working in primary medical care settings in the 1980s and 1990s. This article describes how contemporary medical family therapy can contribute to a transformed health care system in four areas: the patient experience of health care, the health of the population, the containment of health care costs, and enhanced practice environments.
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Seitz DCM, Knaevelsrud C, Duran G, Waadt S, Goldbeck L. Internet-based psychotherapy in young adult survivors of pediatric cancer: feasibility and participants' satisfaction. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2014; 17:624-9. [PMID: 25167082 DOI: 10.1089/cyber.2014.0066] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract The Internet-based psychotherapeutic intervention Onco-STEP for adolescent and young adult (AYA)-aged survivors of pediatric cancer was developed, implemented, and participants' satisfaction was evaluated by use of questionnaires. The intervention consisted of two modules: "Looking Back," aimed to reduce posttraumatic stress symptoms, and "Looking Ahead," supported coping with cancer-related fears of relapse and progression. The writing program was fully completed by 20 participants (Mage=27.3±4.8 years at study; 70% female). The majority was satisfied and perceived the treatment components as helpful. Results demonstrate that an Internet-based psychotherapeutic intervention for AYA-aged survivors of pediatric cancer is feasible and accepted by the target population.
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Affiliation(s)
- Diana C M Seitz
- 1 Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm , Ulm, Germany
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Stinson J, Gupta A, Dupuis F, Dick B, Laverdière C, LeMay S, Sung L, Dettmer E, Gomer S, Lober J, Chan CY. Usability testing of an online self-management program for adolescents with cancer. J Pediatr Oncol Nurs 2014; 32:70-82. [PMID: 25037173 DOI: 10.1177/1043454214543021] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to explore the usability of a bilingual (English and French) Internet-based self-management program for adolescents with cancer and their parents and refine the Internet program. A qualitative study design with semistructured, audio-taped interviews and observation was undertaken with 4 iterative cycles. A purposive sample of English-speaking and French-speaking adolescents with cancer and one of their parents/caregivers was recruited. Adolescents and parents provided similar feedback on how to improve the usability of the Internet program. Most changes to the website were completed after the initial cycles of English and French testing. Both groups also found information presented on the website to be appropriate, credible, and relevant to their experiences of going through cancer. Participants reported the program would have been extremely helpful when they were first diagnosed with cancer. Usability testing uncovered some issues that affected the usability of the website that led to refinements in the online program.
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Affiliation(s)
| | - Abha Gupta
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Bruce Dick
- University of Alberta, Edmonton, Alberta, Canada
| | | | - Sylvie LeMay
- University of Montreal, Montreal, Quebec, Canada
| | - Lillian Sung
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | - Janie Lober
- CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Carol Y Chan
- The Hospital for Sick Children, Toronto, Ontario, Canada
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Caes L, Goubert L, Devos P, Verlooy J, Benoit Y, Vervoort T. The relationship between parental catastrophizing about child pain and distress in response to medical procedures in the context of childhood cancer treatment: a longitudinal analysis. J Pediatr Psychol 2014; 39:677-86. [PMID: 24906963 DOI: 10.1093/jpepsy/jsu034] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Children with leukemia frequently undergo invasive medical procedures, such as lumbar punctures (LPs) and bone marrow aspirations (BMAs). To date, cross-sectional evidence indicates that LP/BMA procedures continue to elicit distress over the course of treatment in children and parents. METHOD The current study used prospective analyses investigating in 28 children diagnosed with leukemia, the course of parental and child distress when confronted with consecutive LP/BMA procedures and potential moderation by catastrophic thinking. Parents' level of catastrophic thoughts was assessed before the first treatment-related LP/BMA, while child and parent distress was reported on after each LP/BMA procedure. RESULTS Whereas parental distress decreased over time among low catastrophizing parents, LP/BMA procedures remained highly distressing for high catastrophizing parents. Child distress during LP/BMA procedures increased over time and was positively related with parental distress. CONCLUSION These findings stress the importance of targeting child and parent distress as early as possible in treatment.
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Affiliation(s)
- Line Caes
- Centre for Pediatric Pain Research, IWK Health Centre, Department of Experimental-Clinical and Health Psychology, Ghent University, Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Ghent University Hospital, and Faculty of Medicine and Health Science, Ghent University
| | - Liesbet Goubert
- Centre for Pediatric Pain Research, IWK Health Centre, Department of Experimental-Clinical and Health Psychology, Ghent University, Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Ghent University Hospital, and Faculty of Medicine and Health Science, Ghent University
| | - Patricia Devos
- Centre for Pediatric Pain Research, IWK Health Centre, Department of Experimental-Clinical and Health Psychology, Ghent University, Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Ghent University Hospital, and Faculty of Medicine and Health Science, Ghent University
| | - Joris Verlooy
- Centre for Pediatric Pain Research, IWK Health Centre, Department of Experimental-Clinical and Health Psychology, Ghent University, Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Ghent University Hospital, and Faculty of Medicine and Health Science, Ghent University
| | - Yves Benoit
- Centre for Pediatric Pain Research, IWK Health Centre, Department of Experimental-Clinical and Health Psychology, Ghent University, Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Ghent University Hospital, and Faculty of Medicine and Health Science, Ghent UniversityCentre for Pediatric Pain Research, IWK Health Centre, Department of Experimental-Clinical and Health Psychology, Ghent University, Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Ghent University Hospital, and Faculty of Medicine and Health Science, Ghent University
| | - Tine Vervoort
- Centre for Pediatric Pain Research, IWK Health Centre, Department of Experimental-Clinical and Health Psychology, Ghent University, Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Ghent University Hospital, and Faculty of Medicine and Health Science, Ghent University
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Margherita G, Martino ML, Recano F, Camera F. Invented fairy tales in groups with onco-haematological children. Child Care Health Dev 2014; 40:426-34. [PMID: 23672257 DOI: 10.1111/cch.12076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The impact of an onco-haematological illness for children is a traumatic event that opens to pain, hospitalizations and interrupts the continuity of daily life. It is difficult for the child to make meaning, to share the pain or ask a question related to the illness because, often, the parents or doctors cannot find a way to communicate in a suitable way for the child who remains in a situation of 'unspoken', where, fear, anxiety and pain cannot find a space to express. METHODS The present research-intervention uses the methodology of invented fairy tales in groups with onco-haematological children, in the hospital, in order to explore the organization of the meanings at the base of the tales co-constructed by the participants underlying weaknesses and strengths of the invented fairy tales in groups intervention. The invented fairy tales in groups is used as a tool, such as a play, to express, share and support the experience of the illness of children. Forty-nine children participated to the invented fairy tales in groups in an onco-haematological hospital. Within a quali-quantitative framework we performed a thematic analysis of elementary context, cluster analysis, on the fairy tales considered as a unique narrative corpus of the thought of the group. RESULTS The analysis shows four thematic clusters: fantasy as search for a meaning, 29.71%, the group as a space for illusions, 27.90%, the illness as a family problem, 25.72%, anchoring reality, 16.67%. The results highlighted three main carriers of sense: the representation of illness/the relational world/the representation of the institution. CONCLUSIONS The use of invented-fairy-tales groups allowed the onco-haematological children to tell and share the experience of illness through a different way, which let them express symbolically their pain. The invented fairy tale in groups becomes a mediator of psychic processes which offer new solutions while improving interpersonal relationships/communication between the participants in group.
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Affiliation(s)
- G Margherita
- Department of Humanistic Studies, Federico II University, Naples, Italy
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Anxiety among adolescent survivors of pediatric cancer: A missing link in the survivorship literature. Palliat Support Care 2014; 13:345-9. [PMID: 24773913 DOI: 10.1017/s1478951514000297] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE With growing numbers of pediatric cancer survivors, it is becoming increasingly important to investigate the psychosocial sequelae of surviving cancer diagnosed during childhood or adolescence. It is particularly important to study the psychosocial needs of adolescent survivors of pediatric cancer because adolescence is a critical time during psychosocial development. Although there is existent literature about the general psychosocial adjustment of this population, the literature regarding anxiety is scant. This brief review aimed to assesses currently available literature that addresses anxiety in adolescent cancer survivors. METHOD Articles assessing psychosocial adjustment in adolescent survivors of pediatric cancer were reviewed for information regarding anxiety symptoms. RESULTS To the authors' knowledge, there is no literature that focuses specifically on anxiety in this population. However, many articles reported results that indicated the possibility of increased anxiety in this group. SIGNIFICANCE OF RESULTS It is critical to further investigate anxiety in this group and develop appropriate interventions if necessary. Doing so will aid the process of enhancing psychosocial care for adolescent cancer survivors.
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Altay N, Kilicarslan E, Sarı Ç, Kisecik Z. Determination of social support needs and expectations of mothers of children with cancer. J Pediatr Oncol Nurs 2014; 31:147-53. [PMID: 24647009 DOI: 10.1177/1043454213520471] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to determine the social support needs of mothers of children with cancer and their expectations regarding nurses. The sample consisted of 88 mothers of children aged 0 to 18 years. The data were collected by a questionnaire and the Multidimensional Scale of Perceived Social Support (MSPSS) was used. The variables were investigated using visual methods (histograms and probability plots) and the Mann-Whitney U, Kolmogorov-Smirnov, Kruskal-Wallis, and Spearman tests. All the mothers stated that they needed social support but only 73.9% received it. Support was obtained mostly from families (83.0%), physicians (44.6%), nurses (38.4%), friends (30.7%), and neighbors (24.6%). Most of the social support was emotional (76.9%) and informational (49.2%). A total of 54.5% of the mothers expected social support from nurses. The mean total MSPSS score was 51.18 ± 25.30. In conclusion, all mothers felt that they needed social support, but their rate of receiving social support was lower than their needs.
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Howard AF, Tan de Bibiana J, Smillie K, Goddard K, Pritchard S, Olson R, Kazanjian A. Trajectories of social isolation in adult survivors of childhood cancer. J Cancer Surviv 2014; 8:80-93. [PMID: 24202698 PMCID: PMC3923114 DOI: 10.1007/s11764-013-0321-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 10/15/2013] [Indexed: 01/14/2023]
Abstract
PURPOSE Long-term childhood cancer survivors may be at increased risk for poor social outcomes as a result of their cancer treatment, as well as physical and psychological health problems. Yet, important challenges, namely social isolation, are not well understood. Moreover, survivors' perspectives of social isolation as well as the ways in which this might evolve through young adulthood have yet to be investigated. The purpose of this research was to describe the trajectories of social isolation experienced by adult survivors of a childhood cancer. METHODS Data from 30 in-depth interviews with survivors (9 to 38 years after diagnosis, currently 22 to 43 years of age, 60 % women) were analyzed using qualitative, constant comparative methods. RESULTS Experiences of social isolation evolved over time as survivors grew through childhood, adolescence and young adulthood. Eleven survivors never experienced social isolation after their cancer treatment, nor to the present day. Social isolation among 19 survivors followed one of three trajectories; (1) diminishing social isolation: it got somewhat better, (2) persistent social isolation: it never got better or (3) delayed social isolation: it hit me later on. CONCLUSIONS Knowledge of when social isolation begins and how it evolves over time for different survivors is an important consideration for the development of interventions that prevent or mitigate this challenge. IMPLICATIONS FOR CANCER SURVIVORS Assessing and addressing social outcomes, including isolation, might promote comprehensive long-term follow-up care for childhood cancer survivors.
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Affiliation(s)
- A Fuchsia Howard
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada,
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Parents’ perspectives of life challenges experienced by long-term paediatric brain tumour survivors: work and finances, daily and social functioning, and legal difficulties. J Cancer Surviv 2014; 8:372-83. [DOI: 10.1007/s11764-013-0331-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 11/23/2013] [Indexed: 11/27/2022]
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