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Son H, Kim N. Therapeutic Parent-Child Communication and Health Outcomes in the Childhood Cancer Context: A Scoping Review. Cancers (Basel) 2024; 16:2152. [PMID: 38893270 PMCID: PMC11172360 DOI: 10.3390/cancers16112152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Family communication has been thought to be an important area to support children's adjustment to a cancer diagnosis. However, the characteristics of therapeutic parent-child communication that contribute to better patient outcomes and the specific patient health outcomes have been less explored. This current review explored the characteristics of therapeutic parent-child communication and its physical and psychological health outcomes. A total of 5034 articles were initially identified, and only 10 articles remained for inclusion in this review after application of the exclusion criteria. Most studies used a cross-sectional design and measured verbal communication characteristics and its psychological outcomes, but no physical outcomes. The characteristics of therapeutic verbal communication (openness, maternal validation, quality of information shared, etc.) and nonverbal communication (eye contact, close physical distance, and acknowledging behaviors) were identified. The psychological health outcomes included less distress, a lower level of PTSS, less internalizing and externalizing of symptoms, increased levels of social emotional competencies, better peer relationships, and more cooperation during the procedure at the individual level. Increased family cohesion and family adaptation were family-level outcomes. Longitudinal studies are needed to identify what qualities of communication predict better psychological outcomes so that interventions can be developed and tested. In addition, physical outcomes should be evaluated.
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Affiliation(s)
- Heeyeon Son
- College of Nursing, University of Tennessee, 1412 Circle Drive, Knoxville, TN 37996, USA
| | - Nani Kim
- School of Nursing, The University of Texas at Austin, 1710 Red River St., Austin, TX 78712, USA;
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Ng NKY, Dudeney J, Jaaniste T. Parent-Child Communication Incongruence in Pediatric Healthcare. CHILDREN (BASEL, SWITZERLAND) 2023; 11:39. [PMID: 38255353 PMCID: PMC10814587 DOI: 10.3390/children11010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/12/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
Parents play a key role in providing children with health-related information and emotional support. This communication occurs both in their homes and in pediatric healthcare environments, such as hospitals, outpatient clinics, and primary care offices. Often, this occurs within situations entailing heightened stress for both the parent and the child. There is considerable research within the communication literature regarding the nature of both verbal and nonverbal communication, along with the way in which these communication modalities are either similar (i.e., congruent) or dissimilar (i.e., incongruent) to one another. However, less is known about communication congruency/incongruency, specifically in parent-child relationships, or within healthcare environments. In this narrative review, we explore the concept of verbal and nonverbal communication incongruence, specifically within the context of parent-child communication in a pediatric healthcare setting. We present an overview of verbal and nonverbal communication and propose the Communication Incongruence Model to encapsulate how verbal and nonverbal communication streams are used and synthesized by parents and children. We discuss the nature and possible reasons for parental communication incongruence within pediatric settings, along with the consequences of incongruent communication. Finally, we suggest a number of hypotheses derived from the model that can be tested empirically and used to guide future research directions and influence potential clinical applications.
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Affiliation(s)
- Nancy Kwun Yiu Ng
- Departments of Pain & Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (N.K.Y.N.); (J.D.)
- School of Clinical Medicine, University of New South Wales, Kensington, NSW 2033, Australia
| | - Joanne Dudeney
- Departments of Pain & Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (N.K.Y.N.); (J.D.)
- School of Clinical Medicine, University of New South Wales, Kensington, NSW 2033, Australia
- School of Psychological Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Tiina Jaaniste
- Departments of Pain & Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (N.K.Y.N.); (J.D.)
- School of Clinical Medicine, University of New South Wales, Kensington, NSW 2033, Australia
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Son H, Haase JE, Docherty SL. The Concept of Double Protection in the Childhood Cancer Context. Cancer Nurs 2023; 46:335-343. [PMID: 37607369 DOI: 10.1097/ncc.0000000000001112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The concept of double protection is used to describe communication avoidance used by parents and their child or adolescents with cancer in attempts to protect the other against disease-related stress and emotions, resulting from communication about the cancer, its treatment, and thoughts. This concept has received limited attention in the research literature. OBJECTIVES The aims of this concept analysis are to (1) explore its defining characteristics, applicability, and utility, (2) spotlight the concept and increase awareness and interest among healthcare providers and researchers, and (3) provide a direction for future interventions to improve parent-child communication in the childhood cancer context. METHODS Rodgers' Evolutionary Concept Analysis was used, and the findings from a study that explored the communication experience of Korean adolescents with cancer and their parents were integrated. RESULTS This study explored the attributes, antecedents, consequences, and related terms. The following attributes were extracted: intention to protect, bidirectional, and absence of parent-child communication at a deeper level. CONCLUSION Clarification of the concept of double protection provides insight into the concept as a barrier to engagement in parent-child communication and supports the significance of double protection in the childhood cancer context. IMPLICATIONS FOR PRACTICE There is a need for increased awareness of the challenges and dangers inherent in family communication avoidance, double protection. In order to address the issue, developing developmentally appropriate and valid clinical assessment tool and interventions are required. More research on the evidence-based benefits of effective parent-child communication is also required.
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Affiliation(s)
- Heeyeon Son
- Author Affiliations: School of Nursing, Duke University, Durham, North Carolina (Mrs Heeyeon Son and Dr Docherty); and School of Nursing, Indiana University, Indianapolis, Indiana (Dr Haase)
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Terrasson J, Rault A, Seigneur É, Brédart A, Dolbeault S. [The announcement of treatment resistance in pediatric oncology: Understanding parents' experiences and influencing factors with a mixed methodology]. Bull Cancer 2023:S0007-4551(23)00160-1. [PMID: 37100684 DOI: 10.1016/j.bulcan.2023.03.016] [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: 12/13/2022] [Revised: 02/24/2023] [Accepted: 03/17/2023] [Indexed: 04/28/2023]
Abstract
OBJECTIVE The announcement of a resistance to treatment in pediatric oncology occurs within the framework of an established parent-pediatrician relationship. The aim of this study was to understand the parents' experience of this announcement and the relational and communicational factors likely to impact it. METHOD A mixed-methods study was conducted in a pediatric oncology department with 15 parents of a child with treatment-resistant cancer, with an average age of 40.8years. The parents completed three questionnaires to assess their anxiety and depression (HADS) and their information needs (EORTC - QLQ Info 25 and PTPQ). Semi-structured interviews were conducted and a content analysis was performed. RESULTS The majority of parents have "suspected" or "proven" anxiety and/or depressive disorders. The experience of this announcement was influenced by the quality of the parent-pediatrician relationship, the perceived quality of the management, the anticipation of the announcement, the context of the announcement, and the experience of previous announcements. The parents interviewed were very satisfied with the informational exchanges. This satisfaction was underpinned by honest communication and by the responsiveness and availability of the pediatricians. DISCUSSION The establishment of a relationship of trust between the family and the pediatrician throughout the course of care plays a major role in the parents' experience of the announcement of resistance to treatment.
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Affiliation(s)
- Johanna Terrasson
- PSL université Paris, équipe SHARE Institut Curie, unité de psycho-oncologie, 75005 Paris, France.
| | - Aude Rault
- PSL université Paris, équipe SHARE Institut Curie, unité de psycho-oncologie, 75005 Paris, France
| | - Étienne Seigneur
- PSL université Paris, équipe SHARE Institut Curie, unité de psycho-oncologie, 75005 Paris, France; Institut Curie, centre SIREDO - Soins Innovation, Recherche en oncologie de l'Enfant, de l'aDOlescent et de l'adulte jeune, 75005 Paris, France
| | - Anne Brédart
- PSL université Paris, équipe SHARE Institut Curie, unité de psycho-oncologie, 75005 Paris, France; Université de Paris, laboratoire psychopathologie et processus de santé, 92100 Boulogne-Billancourt, France
| | - Sylvie Dolbeault
- PSL université Paris, équipe SHARE Institut Curie, unité de psycho-oncologie, 75005 Paris, France; University Paris Saclay, Inserm, Centre de recherche en épidémiologie et santé des populations (CESP), 94807 Villejuif, France
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Khazaeli K, Hosseini SA, Sortiji H, Saberi F. Spirituality and depression in mothers of children with leukemia. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2023. [DOI: 10.1080/19349637.2023.2184289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Affiliation(s)
- Khadije Khazaeli
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Ali Hosseini
- Department of Occupational Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hossein Sortiji
- Department of occupational therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzane Saberi
- Department of Occupational Therapy, School of Rehabilitation Science, Isfahan University of Medical Science, Isfahan, Iran
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Watson KH, Ciriegio AE, Pfalzer AC, Snow A, Hale L, Diehl S, McDonell KE, Claassen DO, Compas BE. Intrapersonal and Interpersonal Disengagement Coping: Associations with Emotions of Youth At-Risk for Huntington's Disease. J Huntingtons Dis 2023; 12:305-312. [PMID: 37334612 DOI: 10.3233/jhd-230566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND Families in which a parent has Huntington's disease (HD) are faced with significant stressors that can contribute to difficulties in communicating together about illness-related concerns. Family members who use more disengagement coping strategies, including denial and avoidance, to deal with illness-related stressors may have the greatest challenges to effective communication. OBJECTIVE The current study examined the associations of intrapersonal and interpersonal disengagement coping responses with observed and reported emotions of adolescents and young adults (AYA) at genetic risk for HD. METHODS Families included 42 AYA (n = 26 females) ages 10 to 34 (M = 19 years, 11 months; SD = 7 years, 6 months) and their parent with HD (n = 22 females, M age = 46 years, 10 months; SD = 9 years, 2 months). Dyads participated in observations of communication and completed questionnaires about disengagement coping and internalizing symptoms. RESULTS Disengagement coping of AYA was unrelated to their observed and reported emotional difficulties (intrapersonal coping). However, there was evidence for the importance of interpersonal disengagement coping, as AYA's negative affect was observed and reported to be highest when both AYA and their parents reported using high levels of avoidance, denial, and wishful thinking to cope with HD-related stress. CONCLUSION The findings underscore the importance of a family-oriented approach to coping and communication in families affected by HD.
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Affiliation(s)
- Kelly H Watson
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Abagail E Ciriegio
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Anna C Pfalzer
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Abigail Snow
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lisa Hale
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Spencer Diehl
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine E McDonell
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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Son H, Yang Y, Crego N, Docherty SL. Communication Challenges in Korean Families Coping With Adolescent Cancer. Oncol Nurs Forum 2020; 47:E190-E198. [PMID: 33063788 DOI: 10.1188/20.onf.e190-e198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the family communication experience of Korean adolescents with cancer and their parents, including how adolescents and their parents verbally share feelings and concerns related to the adolescent's cancer diagnosis with one another, and how emotional communication affects parent-adolescent relationships and the family's coping abilities. PARTICIPANTS & SETTING 20 participants (10 adolescents with cancer, aged 13-19 years, and their parents) at a university-affiliated hospital in Seoul, South Korea. METHODOLOGIC APPROACH Individual, semistructured interviews were conducted and analyzed based on a qualitative descriptive approach. Conventional content analysis was employed to analyze the data. FINDINGS The overarching core theme developed from the content analysis and theme generation was "I cannot share my feelings." This core theme is represented by three main themes. IMPLICATIONS FOR NURSING Increased need for nursing awareness and culturally relevant assessment of emotional family communication needs between Korean adolescents with cancer and their family caregivers are necessary.
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Murphy LK, Preacher KJ, Rights JD, Rodriguez EM, Bemis H, Desjardins L, Prussien K, Winning AM, Gerhardt CA, Vannatta K, Compas BE. Maternal Communication in Childhood Cancer: Factor Analysis and Relation to Maternal Distress. J Pediatr Psychol 2019; 43:1114-1127. [PMID: 30016505 DOI: 10.1093/jpepsy/jsy054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 06/17/2018] [Indexed: 11/13/2022] Open
Abstract
Objective This study aimed to characterize mothers' communication with their children in a sample of families with a new or newly relapsed pediatric cancer diagnosis, first using factor analysis and second using structural equation modeling to examine relations between self-reported maternal distress (anxiety, depression, and posttraumatic stress) and maternal communication in prospective analyses. A hierarchical model of communication was proposed, based on a theoretical framework of warmth and control. Methods The sample included 115 children (age 5-17 years) with new or newly relapsed cancer (41% leukemia, 18% lymphoma, 6% brain tumor, and 35% other) and their mothers. Mothers reported distress (Beck Anxiety Inventory, Beck Depression Inventory-II, and Impact of Events Scale-Revised) 2 months after diagnosis (Time 1). Three months later (Time 2), mother-child dyads were video-recorded discussing cancer. Maternal communication was coded with the Iowa Family Interaction Ratings Scales. Results Confirmatory factor analysis demonstrated poor fit. Exploratory factor analysis suggested a six-factor model (root mean square error of approximation = .04) with one factor reflecting Positive Communication, four factors reflecting Negative Communication (Hostile/Intrusive, Lecturing, Withdrawn, and Inconsistent), and one factor reflecting Expression of Negative Affect. Maternal distress symptoms at Time 1 were all significantly, negatively related to Positive Communication and differentially related to Negative Communication factors at Time 2. Maternal posttraumatic stress and depressive symptoms each predicted Expression of Negative Affect. Conclusions Findings provide a nuanced understanding of maternal communication in pediatric cancer and identify prospective pathways of risk between maternal distress and communication that can be targeted in intervention.
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Affiliation(s)
- Lexa K Murphy
- Department of Psychology & Human Development, Vanderbilt University
| | | | - Jason D Rights
- Department of Psychology & Human Development, Vanderbilt University
| | - Erin M Rodriguez
- Department of Psychology & Human Development, Vanderbilt University
| | - Heather Bemis
- Department of Psychology & Human Development, Vanderbilt University
| | | | - Kemar Prussien
- Department of Psychology & Human Development, Vanderbilt University
| | | | - Cynthia A Gerhardt
- The Research Institute at Nationwide Children's Hospital.,The Ohio State University
| | - Kathryn Vannatta
- The Research Institute at Nationwide Children's Hospital.,The Ohio State University
| | - Bruce E Compas
- Department of Psychology & Human Development, Vanderbilt University
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Yarboi J, Prussien KV, Bemis H, Williams E, Watson KH, McNally C, Henry L, King AA, DeBaun MR, Compas BE. Responsive Parenting Behaviors and Cognitive Function in Children With Sickle Cell Disease. J Pediatr Psychol 2019; 44:1234-1243. [PMID: 31579920 PMCID: PMC6823101 DOI: 10.1093/jpepsy/jsz065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Children with sickle cell disease (SCD) are at increased risk for cognitive impairment as a result in part from biological characteristics of the disease; however, limited research has explored possible social and contextual factors associated with risk for cognitive problems. The primary aim of the present study was to examine the relation between children's cognitive functioning and responsive parenting, a potentially important contextual factor in children with SCD, accounting for family socioeconomic disadvantage, child disease severity, and caregivers' perceived stress. METHODS Forty-eight children completed standardized cognitive assessments and caregivers provided self-reports of general and disease-related stress. Parent-child dyads completed a video recorded puzzle-solving task and observed parenting was quantified using two coding systems. Bivariate Pearson correlations were used to assess preliminary hypotheses, and linear multiple regression analyses were used to assess the primary hypothesis. RESULTS Results suggested that increased levels of parental stress were related to fewer observations of responsive parenting and provided evidence of an association between children's cognitive function and responsive parenting. Specifically, increased disease-related parent stress and reduced parental use of expansive language were associated with significantly lower cognitive functioning in children with SCD. CONCLUSIONS Findings suggest that social environmental factors along with disease characteristics are sources of risk for cognitive problems with children with SCD. Further, these findings highlight the need to develop targeted interventions for parents of children with SCD to decrease levels of stress and enhance parenting skills, with the aim improving cognitive functioning in youth.
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Affiliation(s)
- Janet Yarboi
- Department of Psychology of Human Development, Vanderbilt University
| | - Kemar V Prussien
- Department of Psychology of Human Development, Vanderbilt University
| | - Heather Bemis
- Department of Psychology of Human Development, Vanderbilt University
| | - Ellen Williams
- Department of Psychology of Human Development, Vanderbilt University
| | - Kelly H Watson
- Department of Psychology of Human Development, Vanderbilt University
| | - Collen McNally
- Department of Psychology of Human Development, Vanderbilt University
| | - Lauren Henry
- Department of Psychology of Human Development, Vanderbilt University
| | - Allison A King
- Department of Pediatrics, Washington University School of Medicine
| | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt University School of Medicine
| | - Bruce E Compas
- Department of Psychology of Human Development, Vanderbilt University
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Prussien KV, Murphy LK, Gerhardt CA, Vannatta K, Bemis H, Desjardins L, Ferrante AC, Shultz EL, Keim MC, Cole DA, Compas BE. Longitudinal associations among maternal depressive symptoms, child emotional caretaking, and anxious/depressed symptoms in pediatric cancer. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2018; 32:1087-1096. [PMID: 30211572 PMCID: PMC6289594 DOI: 10.1037/fam0000463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Research has shown that children experience increased emotional distress when engaging in emotional caretaking of a parent. The current study is the first to examine this process in families in which the source of the stress is the child's illness. Prospective associations were tested among mothers' depressive symptoms near the time of their child's cancer diagnosis, mothers' expressed distress and their child's emotional caretaking during an interaction task, and child anxious/depressed symptoms at 1 year postdiagnosis. Families (N = 78) were recruited from two pediatric hospitals soon after their child's (Ages 5-18) new diagnosis or relapse of cancer. Mothers reported on their own depressive symptoms and their child's anxious/depressed symptoms near the time of diagnosis or recurrence (Time 1) and 1 year later (Time 3). At Time 2 (4 months after Time 1), mother-child dyads completed a video-recorded discussion of their experience with cancer that was coded for observed maternal expressed distress (anxiety, sadness) and observed child emotional caretaking. Maternal expressed distress during the interaction was significantly related to more emotional caretaking behaviors by both boys and girls. Results of a moderated mediation model showed that child emotional caretaking at Time 2 significantly mediated the relation between maternal depressive symptoms at Time 1 and child anxious/depressed symptoms at Time 3 for girls but not for boys. The findings suggest that children's emotional caretaking behaviors contribute to subsequent anxious/depressed symptoms for girls, but not for boys, with cancer. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Richmond S, Schwartz O, Johnson KA, Seal ML, Bray K, Deane C, Sheeber LB, Allen NB, Whittle S. Exploratory Factor Analysis of Observational Parent-Child Interaction Data. Assessment 2018; 27:1758-1776. [PMID: 30221976 DOI: 10.1177/1073191118796557] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The majority of studies using observational coding systems for family interaction data derive scales describing family members' behaviors based on rational/theoretical approaches. This study explored an empirical approach to identifying the component structure of parent-child observational data that incorporated the affective context of the interaction. Dyads of 155 typically developing 8-year-olds and their mothers completed questionnaires and two interaction tasks, one each designed to illicit positive and negative interactions. Behaviors were coded based on a modified version of the Family Interaction Macro-coding System. Multiple factor analysis identified four-component solutions for the maternal and child data. For both, two of the components included negative behaviors, one positive behavior, and one communicative behavior. Evidence for the validity of the maternal and child components was demonstrated by associations with child depression and anxiety symptoms and behavioral problems. Preliminary evidence supports an empirical approach to identify context-specific components in parent-child observational data.
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Affiliation(s)
| | - Orli Schwartz
- University of Melbourne, Parkville, Victoria, Australia
| | | | - Marc L Seal
- University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | | | - Camille Deane
- University of Melbourne, Parkville, Victoria, Australia
| | | | - Nicholas B Allen
- University of Melbourne, Parkville, Victoria, Australia.,University of Oregon, Eugene, OR, USA
| | - Sarah Whittle
- University of Melbourne, Parkville, Victoria, Australia.,Melbourne Health, Melbourne, Victoria, Australia
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Abstract
OBJECTIVE To examine the prospective association between adolescents' coping with cancer-related stress and observed positive and negative affect during a mother-adolescent interaction task involving discussion of cancer-related stressors. METHODS Adolescents (age 10-15 years) self-reported about their coping and affect approximately 2 months after cancer diagnosis. Approximately 3 months later, adolescents and mothers were video recorded having a discussion about cancer, and adolescents were coded for expression of positive affect (positive mood) and negative affect (sadness and anxiety). RESULTS Adolescents' use of secondary control coping (i.e., acceptance, cognitive reappraisal, and distraction) in response to cancer-related stress predicted higher levels of observed positive affect, but not negative affect, over time. CONCLUSION Findings provide support for the importance of coping in the regulation of positive emotions. The potential role of coping in preventive interventions to enhance resilience in adolescents facing cancer-related stress is highlighted.
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Memarpour M, Bazrafkan L, Zarei Z. Assessment of dental students' communication skills with patients. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2016; 4:33-38. [PMID: 26793724 PMCID: PMC4711814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 11/19/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Establishment of effective communication between the clinician and patient is essential in order to increase the effectiveness of treatment. These skills have been less investigated among dental students. This study aimed to evaluate communication skills of dental students in Shiraz with patients through direct observation, patients' perspectives and students' self-assessments. METHODS This cross-sectional study enrolled the fifth and sixth year dental students and one of each student's patients who was chosen using simple random sampling method. We used a checklist for data collection. Students' communication skills were assessed at three steps of the student-patient interview - at the beginning of the interview, during the interview, and at the end of the interview. The checklist was completed by three groups: 1) an observer, 2) the patient and 3) the student, as self-assessment. The validity of the checklist was confirmed by clinical professors and the reliability was determined by Cronbach's alpha test. Data were analyzed using descriptive statistics and Student's t test. A repeated measure MANOVA was used to compare the mean communication skills in the researcher, patients, and students at each step of the patient interviews. RESULTS There were 110 students (mean age: 22.3±8.4 years) and 110 patients (mean age: 32±8.8 years) who completed the checklists. Overall, the communication skills of dental students were rated as good according to the patients. However, the observer and student participants rated the skills at the moderate level. We observed significant differences between communication skills in all three groups and in the three steps of the patient interviews (p<0.001). According to patients' beliefs and students' self assessments, there were no differences between male and female students in communication skills in the three steps of the patient interviews (all p>0.05). However from the observer's viewpoint, female students showed better communication skills during the interviews (p=0.001). CONCLUSION There was a degree of failure in communication skills of dental students with patients in the interview process. It will be necessary that communication skills be taught, particularly for students involved in clinical practice.
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Affiliation(s)
- Mahtab Memarpour
- Prevention of Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Bazrafkan
- Quality Improvement in Clinical Education Research Center, Education Development Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zarei
- Student Research Committee, School of Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Rodriguez EM, Murphy L, Vannatta K, Gerhardt CA, Young-Saleme T, Saylor M, Bemis H, Desjardins L, Dunn MJ, Compas BE. Maternal Coping and Depressive Symptoms as Predictors of Mother-Child Communication About a Child's Cancer. J Pediatr Psychol 2015; 41:329-39. [PMID: 26609183 DOI: 10.1093/jpepsy/jsv106] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 10/12/2015] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE This study sought to identify possible associations between maternal coping and depression and subsequent mother-child communication about cancer following the child's diagnosis. METHOD Mothers (N = 100) reported on coping and depressive symptoms shortly after the child's diagnosis (M = 1.9 months). Subsequently, we observed children (age 5-17 years; M = 10.2 years; 48% female; 81% White) and mothers discussing cancer and coded maternal communication. RESULTS Higher primary and secondary control coping, and lower depressive symptoms, were generally correlated with more positive, and less harsh and withdrawn communication. In regression models, higher primary control coping (i.e., coping efforts to change the stressor or one's emotional reaction to the stressor) independently predicted less withdrawn communication, and depressive symptoms mediated relations between coping and harsh communication. CONCLUSIONS Maternal primary control coping and depressive symptoms predict mothers' subsequent harsh and withdrawn communication about cancer.
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Affiliation(s)
| | | | - Kathryn Vannatta
- The Research Institute at Nationwide Children's Hospital, and The Ohio State University
| | - Cynthia A Gerhardt
- The Research Institute at Nationwide Children's Hospital, and The Ohio State University
| | - Tammi Young-Saleme
- The Research Institute at Nationwide Children's Hospital, and The Ohio State University
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15
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Hobart-Porter L, Wade S, Minich N, Kirkwood M, Stancin T, Taylor HG. Determinants of Effective Caregiver Communication After Adolescent Traumatic Brain Injury. PM R 2015; 7:836-844. [PMID: 25687111 PMCID: PMC5437845 DOI: 10.1016/j.pmrj.2015.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 01/31/2015] [Accepted: 02/10/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To characterize the effects of caregiver mental health and coping strategies on interactions with an injured adolescent acutely after traumatic brain injury (TBI). DESIGN Multi-site, cross-sectional study. SETTING Outpatient setting of 3 tertiary pediatric hospitals and 2 tertiary general medical centers. PARTICIPANTS Adolescents (N = 125) aged 12-17 years, 1-6 months after being hospitalized with complicated mild to severe TBI. METHODS Data were collected as part of a multi-site clinical trial of family problem-solving therapy after TBI. Multiple regression analyses were used to examine the relationship of caregiver and environmental characteristics to the dimensions of effective communication, warmth, and negativity during caregiver-adolescent problem-solving discussions. MAIN OUTCOMES MEASURES Adolescent and caregiver interactions, as measured by the Iowa Family Interaction Rating Scales. RESULTS Caregivers who utilized problem-focused coping strategies were rated as having higher levels of effective communication (P < .01), as were those with higher socioeconomic status (P < .01). Problem-focused coping style and higher socioeconomic status were also associated lower levels of negative interactions (P < .01 and P < .05, respectively). Female gender of the adolescent and fewer children in the home were associated with increased parental warmth during the interaction (P < .01 and P < .05, respectively). Neither adolescent TBI severity nor caregiver depression significantly influenced caregiver-teen interactions. CONCLUSIONS Problem-focused coping strategies are associated with higher levels of effective communication and lower levels of caregiver negativity during the initial months after adolescent TBI, suggesting that effective caregiver coping may facilitate better caregiver-adolescent interactions after TBI.
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Affiliation(s)
| | - Shari Wade
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Nori Minich
- Case Western Reserve University, Cleveland, OH
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Murphy LK, Rodriguez EM, Schwartz L, Bemis H, Desjardins L, Gerhardt CA, Vannatta K, Saylor M, Compas BE. Longitudinal associations among maternal communication and adolescent posttraumatic stress symptoms after cancer diagnosis. Psychooncology 2015. [PMID: 26216475 DOI: 10.1002/pon.3918] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The purpose of this study was to prospectively examine adolescent and maternal posttraumatic stress symptoms (PTSS) and maternal communication from time near cancer diagnosis to 12-month follow-up to identify potential risk factors for adolescent PTSS. METHODS Forty-one adolescents with cancer (10-17 years, 54% female) and their mothers self-reported PTSS at T1 (two months after cancer diagnosis) and T3 (1-year follow-up). At T2 (3 months after T1), mother-adolescent dyads were videotaped discussing cancer, and maternal communication was coded with macro (harsh and withdrawn) and micro (solicits and validations) systems. RESULTS Adolescent PTSS at T1 was associated with adolescent PTSS at T3. Greater maternal PTSS at T1 predicted greater harsh maternal communication at T2. There was an indirect effect of maternal PTSS at T1 on adolescent PTSS at T3 through maternal validations at T2. CONCLUSIONS Findings underscore the importance of maternal PTSS, maternal communication, and subsequent adolescent PTSS over the course of treatment of childhood cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Lexa K Murphy
- Vanderbilt University, Department of Psychology and Human Development, Peabody 512, 230, Appleton Place, Nashville, TN, 37212, United States
| | - Erin M Rodriguez
- Vanderbilt University, Department of Psychology and Human Development, Peabody 512, 230, Appleton Place, Nashville, TN, 37212, United States
| | - Laura Schwartz
- Vanderbilt University, Department of Psychology and Human Development, Peabody 512, 230, Appleton Place, Nashville, TN, 37212, United States
| | - Heather Bemis
- Vanderbilt University, Department of Psychology and Human Development, Peabody 512, 230, Appleton Place, Nashville, TN, 37212, United States
| | - Leandra Desjardins
- Vanderbilt University, Department of Psychology and Human Development, Peabody 512, 230, Appleton Place, Nashville, TN, 37212, United States
| | - Cynthia A Gerhardt
- Vanderbilt University, Department of Psychology and Human Development, Peabody 512, 230, Appleton Place, Nashville, TN, 37212, United States
| | - Kathryn Vannatta
- Vanderbilt University, Department of Psychology and Human Development, Peabody 512, 230, Appleton Place, Nashville, TN, 37212, United States
| | - Megan Saylor
- Vanderbilt University, Department of Psychology and Human Development, Peabody 512, 230, Appleton Place, Nashville, TN, 37212, United States
| | - Bruce E Compas
- Vanderbilt University, Department of Psychology and Human Development, Peabody 512, 230, Appleton Place, Nashville, TN, 37212, United States
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Lord JH, Rumburg TM, Jaser SS. Staying Positive: Positive Affect as a Predictor of Resilience in Adolescents With Type 1 Diabetes. J Pediatr Psychol 2015; 40:968-77. [PMID: 25979081 DOI: 10.1093/jpepsy/jsv042] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 04/16/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescents with Type 1 Diabetes (T1D) are at increased risk for diminished quality of life, deteriorating glycemic control, and psychological symptoms, yet some adolescents are able to adapt to the challenges associated with having diabetes exceptionally well. We sought to examine positive affect as a protective process predicting resilience over time in youth with T1D. METHOD Adolescents and their mothers completed questionnaire data, and HbA1c was obtained from adolescents' medical records at baseline and after 6 months. Adolescents were coded for observed positive mood during a videotaped interaction with their mothers. RESULTS Positive mood, including both self-report and observed mood, was associated with glycemic control, psychological symptoms, and quality of life. In addition, positive mood predicted improvements in glycemic control and externalizing problems over 6 months. CONCLUSIONS Positive affect emerged as a protective process for resilient outcomes in adolescents with T1D, suggesting novel targets for intervention in this high-risk population.
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Chorney JM, McMurtry CM, Chambers CT, Bakeman R. Developing and modifying behavioral coding schemes in pediatric psychology: a practical guide. J Pediatr Psychol 2014; 40:154-64. [PMID: 25416837 DOI: 10.1093/jpepsy/jsu099] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To provide a concise and practical guide to the development, modification, and use of behavioral coding schemes for observational data in pediatric psychology. METHODS This article provides a review of relevant literature and experience in developing and refining behavioral coding schemes. RESULTS A step-by-step guide to developing and/or modifying behavioral coding schemes is provided. Major steps include refining a research question, developing or refining the coding manual, piloting and refining the coding manual, and implementing the coding scheme. Major tasks within each step are discussed, and pediatric psychology examples are provided throughout. CONCLUSIONS Behavioral coding can be a complex and time-intensive process, but the approach is invaluable in allowing researchers to address clinically relevant research questions in ways that would not otherwise be possible.
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Affiliation(s)
- Jill MacLaren Chorney
- Department of Pediatric Anesthesia, Centre for Pediatric Pain Research, IWK Health Centre, Departments of Anesthesia, Pain Management and Perioperative Medicine, Psychology and Neuroscience, and Surgery, Dalhousie University, Department of Psychology, Guelph University, Children's Health Research Institute, Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, and Department of Psychology, Georgia State University Department of Pediatric Anesthesia, Centre for Pediatric Pain Research, IWK Health Centre, Departments of Anesthesia, Pain Management and Perioperative Medicine, Psychology and Neuroscience, and Surgery, Dalhousie University, Department of Psychology, Guelph University, Children's Health Research Institute, Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, and Department of Psychology, Georgia State University Department of Pediatric Anesthesia, Centre for Pediatric Pain Research, IWK Health Centre, Departments of Anesthesia, Pain Management and Perioperative Medicine, Psychology and Neuroscience, and Surgery, Dalhousie University, Department of Psychology, Guelph University, Children's Health Research Institute, Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, and Department of Psychology, Georgia State University
| | - C Meghan McMurtry
- Department of Pediatric Anesthesia, Centre for Pediatric Pain Research, IWK Health Centre, Departments of Anesthesia, Pain Management and Perioperative Medicine, Psychology and Neuroscience, and Surgery, Dalhousie University, Department of Psychology, Guelph University, Children's Health Research Institute, Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, and Department of Psychology, Georgia State University
| | - Christine T Chambers
- Department of Pediatric Anesthesia, Centre for Pediatric Pain Research, IWK Health Centre, Departments of Anesthesia, Pain Management and Perioperative Medicine, Psychology and Neuroscience, and Surgery, Dalhousie University, Department of Psychology, Guelph University, Children's Health Research Institute, Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, and Department of Psychology, Georgia State University Department of Pediatric Anesthesia, Centre for Pediatric Pain Research, IWK Health Centre, Departments of Anesthesia, Pain Management and Perioperative Medicine, Psychology and Neuroscience, and Surgery, Dalhousie University, Department of Psychology, Guelph University, Children's Health Research Institute, Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, and Department of Psychology, Georgia State University
| | - Roger Bakeman
- Department of Pediatric Anesthesia, Centre for Pediatric Pain Research, IWK Health Centre, Departments of Anesthesia, Pain Management and Perioperative Medicine, Psychology and Neuroscience, and Surgery, Dalhousie University, Department of Psychology, Guelph University, Children's Health Research Institute, Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, and Department of Psychology, Georgia State University
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Qualitative observation instrument to measure the quality of parent-child interactions in young children with type 1 diabetes mellitus. BMC Pediatr 2014; 14:145. [PMID: 24915962 PMCID: PMC4086281 DOI: 10.1186/1471-2431-14-145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 05/01/2014] [Indexed: 01/08/2023] Open
Abstract
Background In young children with type 1 diabetes mellitus (T1DM), parents have complete responsibility for the diabetes-management. In toddlers and (pre)schoolers, the tasks needed to achieve optimal blood glucose control may interfere with normal developmental processes and could negatively affect the quality of parent–child interaction. Several observational instruments are available to measure the quality of the parent–child interaction. However, no observational instrument for diabetes-specific situations is available. Therefore, the aim of the present study was to develop a qualitative observation instrument, to be able to assess parent–child interaction during diabetes-specific situations. Methods First, in a pilot study (n = 15), the observation instrument was developed in four steps: (a) defining relevant diabetes-specific situations; (b) videotaping these situations; (c) describing all behaviors in a qualitative observation instrument; (d) evaluating usability and reliability. Next, we examined preliminary validity (total n = 77) by testing hypotheses about correlations between the observation instrument for diabetes-specific situations, a generic observation instrument and a behavioral questionnaire. Results The observation instrument to assess parent–child interaction during diabetes-specific situations, which consists of ten domains: “emotional involvement”, “limit setting”, “respect for autonomy”, “quality of instruction”, “negative behavior”, “avoidance”, “cooperative behavior”, “child’s response to injection”, “emphasis on diabetes”, and “mealtime structure”, was developed for use during a mealtime situation (including glucose monitoring and insulin administration). Conclusions The present study showed encouraging indications for the usability and inter-rater reliability (weighted kappa was 0.73) of the qualitative observation instrument. Furthermore, promising indications for the preliminary validity of the observation instrument for diabetes-specific situations were found (r ranged between |.24| and |.45| for significant correlations and between |.10| and |.23| for non-significant trends). This observation instrument could be used in future research to (a) test whether parent–child interactions are associated with outcomes (like HbA1c levels and psychosocial functioning), and (b) evaluate interventions, aimed at optimizing the quality of parent–child interactions in families with a young child with T1DM.
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Murray CB, Amaro CM, Devine KA, Psihogios AM, Murphy LK, Holmbeck GN. Observed macro- and micro-level parenting behaviors during preadolescent family interactions as predictors of adjustment in emerging adults with and without spina bifida. J Pediatr Psychol 2014; 40:18-32. [PMID: 24864277 DOI: 10.1093/jpepsy/jsu030] [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: 01/15/2023] Open
Abstract
OBJECTIVE To examine observed autonomy-promoting and -inhibiting parenting behaviors during preadolescence as predictors of adjustment outcomes in emerging adults with and without spina bifida (SB). METHODS Demographic and videotaped interaction data were collected from families with 8/9-year-old children with SB (n = 68) and a matched group of typically developing youth (n = 68). Observed interaction data were coded with macro- and micro-coding schemes. Measures of emerging adulthood adjustment were collected 10 years later (ages 18/19 years; n = 50 and n = 60 for SB and comparison groups, respectively). RESULTS Autonomy-promoting (behavioral control, autonomy-relatedness) and -inhibiting (psychological control) observed preadolescent parenting behaviors prospectively predicted emerging adulthood adjustment, particularly within educational, social, and emotional domains. Interestingly, high parent undermining of relatedness predicted better educational and social adjustment in the SB sample CONCLUSIONS Parenting behaviors related to autonomy have long-term consequences for adjustment in emerging adults with and without SB.
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Affiliation(s)
- Caitlin B Murray
- Psychology Department, Loyola University Chicago, Clinical Child Psychology Program, University of Kansas, Department of Medicine, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, and Department of Psychology and Human Development, Vanderbilt University
| | - Christina M Amaro
- Psychology Department, Loyola University Chicago, Clinical Child Psychology Program, University of Kansas, Department of Medicine, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, and Department of Psychology and Human Development, Vanderbilt University
| | - Katie A Devine
- Psychology Department, Loyola University Chicago, Clinical Child Psychology Program, University of Kansas, Department of Medicine, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, and Department of Psychology and Human Development, Vanderbilt University
| | - Alexandra M Psihogios
- Psychology Department, Loyola University Chicago, Clinical Child Psychology Program, University of Kansas, Department of Medicine, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, and Department of Psychology and Human Development, Vanderbilt University
| | - Lexa K Murphy
- Psychology Department, Loyola University Chicago, Clinical Child Psychology Program, University of Kansas, Department of Medicine, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, and Department of Psychology and Human Development, Vanderbilt University
| | - Grayson N Holmbeck
- Psychology Department, Loyola University Chicago, Clinical Child Psychology Program, University of Kansas, Department of Medicine, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, and Department of Psychology and Human Development, Vanderbilt University
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Raj SP, Wade SL, Cassedy A, Taylor HG, Stancin T, Brown TM, Kirkwood MW. Parent psychological functioning and communication predict externalizing behavior problems after pediatric traumatic brain injury. J Pediatr Psychol 2013; 39:84-95. [PMID: 24065551 DOI: 10.1093/jpepsy/jst075] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Adolescents sustaining traumatic brain injury (TBI) show increased prevalence of behavior problems. This study investigated the associations of parent mental health, family functioning, and parent-adolescent interaction with adolescent externalizing behavior problems in the initial months after TBI, and examined whether injury severity moderated these associations. METHODS 117 parent-adolescent dyads completed measures of family functioning, adolescent behavior, and parent mental health an average of 108 days post-TBI. Dyads also engaged in a 10-min video-recorded problem-solving activity coded for parent behavior and tone of interaction. RESULTS Overall, higher ratings of effective parent communication were associated with fewer externalizing behavior problems, whereas poorer caregiver psychological functioning was associated with greater adolescent externalizing behaviors. Results failed to reveal moderating effects of TBI severity on the relationship between socio-environmental factors and behavior problems. CONCLUSIONS Interventions targeting parent communication and/or improving caregiver psychological health may ameliorate potential externalizing behavior problems after adolescent TBI.
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Affiliation(s)
- Stacey P Raj
- PhD, Division of Pediatric Rehabilitation, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 4009, Cincinnati, OH 45229, USA.
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Rodriguez EM, Dunn MJ, Zuckerman T, Hughart L, Vannatta K, Gerhardt CA, Saylor M, Schuele CM, Compas BE. Mother-child communication and maternal depressive symptoms in families of children with cancer: integrating macro and micro levels of analysis. J Pediatr Psychol 2013; 38:732-43. [PMID: 23616622 PMCID: PMC3721187 DOI: 10.1093/jpepsy/jst018] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 02/25/2013] [Accepted: 03/04/2013] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study examines associations between maternal depressive symptoms and macro- and micro-level aspects of mothers' communication about their children's cancer. METHODS Mothers reported depressive symptoms after diagnosis or relapse (child mean age = 10.4 years; 53% male). Mother-child dyads (N = 94) were subsequently observed discussing the child's cancer and maternal communication was coded. RESULTS Macro-level indicators (positive and negative communication) were associated with certain micro-level indicators of communication (topic maintenance, reflections, reframes, and imperatives). Higher depressive symptoms predicted lower positive communication and higher negative communication. Maternal reflections and imperatives predicted positive communication, and topic maintenance and reframes predicted negative communication, beyond child age, family income, and depressive symptoms. CONCLUSIONS Findings suggest concrete targets for improving communication in families after diagnosis or relapse.
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Affiliation(s)
- Erin M Rodriguez
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN 37203, USA.
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Ach E, Gerhardt CA, Barrera M, Kupst MJ, Meyer EA, Patenaude AF, Vannatta K. Family factors associated with academic achievement deficits in pediatric brain tumor survivors. Psychooncology 2013; 22:1731-7. [PMID: 23059621 PMCID: PMC3574177 DOI: 10.1002/pon.3202] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 08/31/2012] [Accepted: 09/08/2012] [Indexed: 11/08/2022]
Abstract
PURPOSE The purpose of this study is to examine whether parental education, socioeconomic status, or family environment moderate the extent of academic achievement deficits in pediatric brain tumor survivors (PBTS) relative to classmate case-controls. PBTS are known to be at risk for cognitive and academic impairment; however, the degree of impairment varies. Prior research has focused on treatment risk, and efforts to examine the protective role of family resources and relationships have been lacking. METHODS Pediatric brain tumor survivors (N = 164), ages 8-15 and 1-5 years posttreatment, were recruited at five treatment centers in the United States and Canada. A case-control classmate, matched for age, gender, and race, was recruited for each survivor. The Wide Range Achievement Test, a demographic form, and the Family Environment Scale were administered in families' homes. Treatment data were abstracted from medical charts. RESULTS Pediatric brain tumor survivors demonstrated lower achievement than classmate-controls in reading, spelling, and arithmetic. Parental education and socioeconomic status were associated with levels of achievement demonstrated by PBTS but did not account for discrepancies between PBTS and classmate-controls. Deficits in achievement relative to classmate-controls, across all academic domains, were greater for survivors in families lower in support and higher in conflict. These associations remained after controlling for age at diagnosis, time since treatment, and whether treatment had involved chemotherapy, focal, or whole brain radiation. CONCLUSIONS These results support the development of interventions to enhance family functioning as well as educational resources as part of intervention and rehabilitation services to optimize academic progress in children who have been treated for brain tumors.
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Affiliation(s)
- Emily Ach
- The Research Institute at Nationwide Children’s Hospital and The Ohio State University
| | - Cynthia A. Gerhardt
- The Research Institute at Nationwide Children’s Hospital and The Ohio State University
| | | | - Mary Jo Kupst
- Children’s Hospital Milwaukee and the Medical College of Wisconsin
| | | | | | - Kathryn Vannatta
- The Research Institute at Nationwide Children’s Hospital and The Ohio State University
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Park YO, Son Hong GR, Tak YR. Predictors of Resilience in Adolescents with Cancer. CHILD HEALTH NURSING RESEARCH 2013. [DOI: 10.4094/chnr.2013.19.3.177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Dunn MJ, Rodriguez EM, Barnwell AS, Grossenbacher JC, Vannatta K, Gerhardt CA, Compas BE. Posttraumatic stress symptoms in parents of children with cancer within six months of diagnosis. Health Psychol 2011; 31:176-85. [PMID: 21942750 DOI: 10.1037/a0025545] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To investigate levels and correlates of posttraumatic stress symptoms (PTSS) in mothers and fathers of children and youth with cancer. METHODS Mothers (n = 191) and fathers (n = 95), representing 195 families of children and youth with cancer, completed measures of PTSS (Impact of Event Scale-Revised), depression (Beck Depression Inventory-II), and anxiety (Beck Anxiety Inventory) between 2 and 22 weeks after their child's cancer diagnosis or recurrence of initial diagnosis. RESULTS Substantial subgroups of mothers (41%) and fathers (30%) reported levels of PTSS that exceeded cut-offs for elevated symptoms, and these subgroups of parents were characterized by heightened symptoms of depression and anxiety. Fathers of children and youth treated for relapse reported higher rates of elevated PTSS than fathers of children and youth treated for first-time diagnosis, but mothers' rates were similar. Mothers and fathers reported comparable mean levels of PTSS that were strongly positively correlated with symptoms of anxiety and depression. PTSS and other symptoms of distress were negatively related to education level for fathers. CONCLUSION These findings provide additional evidence that mothers and fathers experience substantial PTSS near the time of their child or adolescent's cancer diagnosis during the first 6 months of treatment. Results suggest that PTSS may be part of a broader pattern of emotional distress and that a substantial portion of both mothers and fathers of children and youth with cancer may be in need of supportive mental health services within the first 6 months of their child's diagnosis.
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Affiliation(s)
- Madeleine J Dunn
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN 37203, USA
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Holmbeck GN, Devine KA. Commentary: Family assessment in pediatric psychology. J Pediatr Psychol 2011; 36:642-6. [PMID: 21325268 DOI: 10.1093/jpepsy/jsr004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Grayson N Holmbeck
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Chicago, IL 60660, USA.
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