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Peng L, Xiong SS, Li J, Wang M, Wong FKY. Promoting psychological support services for parents of children with sarcoma through health-social partnership: A quality improvement project. J Pediatr Nurs 2024; 77:e583-e592. [PMID: 38796359 DOI: 10.1016/j.pedn.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 05/19/2024] [Accepted: 05/19/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE A significant portion of parents of children diagnosed with sarcoma experience excessive stress and anxiety disorder. This quality improvement project aimed to implement a psychological support service program tailored for parents of children with sarcoma and evaluate its effects. DESIGN AND METHODS An interprofessional team was formed through a health-social partnership to deliver comprehensive psychological support service program involving multiple cognitive-behavioral components to parents of children with sarcoma. Parents who were identified as having excessive stress and/or anxiety disorder and voluntarily agreed to participate were enrolled. Pre- and post-intervention assessments were conducted, and previously recorded data from parents of children hospitalized in the year prior to this quality improvement project were included as historical controls. RESULTS A total of 48 parents, including 35 mothers and 13 fathers, participated in the quality improvement project. Results showed that participants achieved greater reduction in emotional, somatic, and behavioral stress when compared with historical controls (all p < .001). Significantly lower prevalence of moderate to severe anxiety disorder was also found (4.2% vs. 85.4%, p < .001). CONCLUSIONS The implementation of a psychological support service program, informed by cognitive-behavioral theory and delivered through a health-social partnership, effectively alleviated multiple facets of stress and anxiety disorder in parents of children newly diagnosed with sarcoma. PRACTICE IMPLICATIONS Nurses can facilitate and coordinate the collaboration among interprofessional team to deliver specialized psychological support services and ensure that parents of children with sarcoma have access to these services, ultimately enhancing their psychological well-being.
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Affiliation(s)
- Li Peng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Sha-Sha Xiong
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Juan Li
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Mian Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; Joint Research Centre for Primary Health Care, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Frances Kam Yuet Wong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; Joint Research Centre for Primary Health Care, The Hong Kong Polytechnic University, Hong Kong, China
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Sim JA, Horan MR, Choi J, Srivastava DK, Armstrong GT, Ness KK, Hudson MM, Huang IC. Multilevel Social Determinants of Patient-Reported Outcomes in Young Survivors of Childhood Cancer. Cancers (Basel) 2024; 16:1661. [PMID: 38730616 PMCID: PMC11083567 DOI: 10.3390/cancers16091661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving treatment at St. Jude Children's Research Hospital who were <18 years of age during follow-up from 2017 to 2018 and their primary caregivers. Social determinants included family factors (caregiver-reported PROs, family dynamics) and county-level deprivation (socioeconomic status, physical environment via the County Health Rankings & Roadmaps). PROMIS measures assessed survivors' and caregivers' PROs. General linear regression tested associations of social determinants with survivors' PROs. We found that caregivers' higher anxiety was significantly associated with survivors' poorer depression, stress, fatigue, sleep issues, and reduced positive affect (p < 0.05); caregivers' sleep disturbances were significantly associated with lower mobility in survivors (p < 0.05). Family conflicts were associated with survivors' sleep problems (p < 0.05). Residing in socioeconomically deprived areas was significantly associated with survivors' poorer sleep quality (p < 0.05), while higher physical environment deprivation was associated with survivors' higher psychological stress and fatigue and lower positive affect and mobility (p < 0.05). Parental, family, and neighborhood factors are critical influences on young survivors' quality of life and well-being and represent new intervention targets.
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Affiliation(s)
- Jin-ah Sim
- Department of Epidemiology & Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.-a.S.); (M.R.H.); (J.C.); (G.T.A.); (K.K.N.); (M.M.H.)
- Department of AI Convergence, Hallym University, Chuncheon 24252, Republic of Korea
| | - Madeline R. Horan
- Department of Epidemiology & Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.-a.S.); (M.R.H.); (J.C.); (G.T.A.); (K.K.N.); (M.M.H.)
| | - Jaesung Choi
- Department of Epidemiology & Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.-a.S.); (M.R.H.); (J.C.); (G.T.A.); (K.K.N.); (M.M.H.)
| | - Deo Kumar Srivastava
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA;
| | - Gregory T. Armstrong
- Department of Epidemiology & Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.-a.S.); (M.R.H.); (J.C.); (G.T.A.); (K.K.N.); (M.M.H.)
| | - Kirsten K. Ness
- Department of Epidemiology & Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.-a.S.); (M.R.H.); (J.C.); (G.T.A.); (K.K.N.); (M.M.H.)
| | - Melissa M. Hudson
- Department of Epidemiology & Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.-a.S.); (M.R.H.); (J.C.); (G.T.A.); (K.K.N.); (M.M.H.)
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - I-Chan Huang
- Department of Epidemiology & Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (J.-a.S.); (M.R.H.); (J.C.); (G.T.A.); (K.K.N.); (M.M.H.)
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van Hulst AM, Grootenhuis MA, Verwaaijen EJ, van Litsenburg RR, Li L, van Zelst BD, Broer L, Pluijm SM, Pieters R, Fiocco M, van den Akker EL, van den Heuvel-Eibrink MM. Unraveling Dexamethasone-Induced Neurobehavioral and Sleep Problems in Children With ALL: Which Determinants Are Important? JCO Precis Oncol 2023; 7:e2200678. [PMID: 37343203 PMCID: PMC10309531 DOI: 10.1200/po.22.00678] [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: 12/09/2022] [Revised: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 06/23/2023] Open
Abstract
PURPOSE Dexamethasone, the preferred corticosteroid in most treatment protocols for pediatric acute lymphoblastic leukemia (ALL), can induce undesirable side effects. Neurobehavioral and sleep problems are frequently reported, but the interpatient variability is high. We therefore aimed to identify determinants for parent-reported dexamethasone-induced neurobehavioral and sleep problems in pediatric ALL. METHODS Our prospective study included patients with medium-risk ALL and their parents during maintenance treatment. Patients were assessed before and after one 5-day dexamethasone course. Primary end points were parent-reported dexamethasone-induced neurobehavioral and sleep problems, measured with the Strengths and Difficulties Questionnaire and Sleep Disturbance Scale for Children, respectively. Analyzed determinants included patient and parent demographics, disease and treatment characteristics, parenting stress (Parenting Stress Index and Distress Thermometer for Parents), dexamethasone pharmacokinetics, and genetic variation (candidate single-nucleotide polymorphisms rs41423247 and rs4918). Statistically significant determinants identified in univariable logistic regression analyses were incorporated in a multivariable model. RESULTS We included 105 patients: median age was 5.4 years (range, 3.0-18.8) and 61% were boys. Clinically relevant dexamethasone-induced neurobehavioral and sleep problems were reported by parents in 70 (67%) and 61 (59%) patients, respectively. In our multivariable regression models, we identified parenting stress as a significant determinant for parent-reported neurobehavioral (odds ratio [OR], 1.16; 95% CI, 1.07 to 1.26) and sleep problems (OR, 1.06; 95% CI, 1.02 to 1.10). Furthermore, parents who experienced more stress before start of a dexamethasone course reported more sleep problems in their child (OR, 1.16; 95% CI, 1.02 to 1.32). CONCLUSION We identified parenting stress, and not dexamethasone pharmacokinetics, genetic variation, patient/parent demographics, or disease/treatment characteristics, as a significant determinant for parent-reported dexamethasone-induced neurobehavioral and sleep problems. Parenting stress may be a modifiable target to reduce these problems.
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Affiliation(s)
| | | | | | | | - Letao Li
- Department of Hospital Pharmacy, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bertrand D. van Zelst
- Division of Endocrinology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Linda Broer
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Rob Pieters
- Pediatric Oncology, Princess Máxima Center, Utrecht, the Netherlands
| | - Marta Fiocco
- Pediatric Oncology, Princess Máxima Center, Utrecht, the Netherlands
- Mathematical Institute, Leiden University, Leiden, the Netherlands
- Department of Biomedical Data Science, Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Erica L.T. van den Akker
- Department of Pediatric Endocrinology, Erasmus MC- Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Marry M. van den Heuvel-Eibrink
- Pediatric Oncology, Princess Máxima Center, Utrecht, the Netherlands
- Child Health, UMCU-Wilhelmina Children's Hospital, Utrecht, the Netherlands
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Cai J, Cheung YT, Au-Doung PLW, Hu W, Gao Y, Zhang H, Ji M, Shen S, Chen J, Tang J. Psychosocial outcomes in Chinese survivors of pediatric cancers or bone marrow failure disorders: A single-center study. PLoS One 2022; 17:e0279112. [PMID: 36512620 PMCID: PMC9746993 DOI: 10.1371/journal.pone.0279112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/OBJECTIVES Most of the studies on functional outcomes in pediatric survivors of cancers and bone marrow failure disorders have been conducted in North American, European, and Oceanian populations, with few studies having been performed in China. The objective of this study was to evaluate psychosocial outcomes in a cohort of Chinese pediatric survivors diagnosed with cancer or conditions requiring hematopoietic stem cell transplantation (HSCT), and to identify clinical and behavioral factors associated with adverse psychosocial outcomes. METHODS This was a cross-sectional survey study. We recruited pediatric survivors of cancer or inherited disorder requiring HSCT at ≤18 years old and were ≥6 months post-treatment. Parents completed the St. Jude Children's Research Hospital After Completion of Therapy questionnaire to report their child's emotional functioning, social functioning, attention/concentration and behavior. Multivariable general linear modeling was used to identify clinical, treatment and behavioral factors associated with psychosocial outcomes, adjusting for sex, age and cancer diagnoses. RESULTS Ninety-five pediatric survivors were recruited (62.1% male; mean [standard deviation] age 9.7 [3.4] years; 4.1 [2.6] years post-diagnosis). They were diagnosed with bone marrow failure disorders (23.2%), hematological malignancies (45.3%) or solid tumors (23.2%). Compared with survivors with no current health problems, those with more than one current health problem performed worse in emotional functioning (Estimate = 2.42, SE = 0.88, P = 0.008) and social functioning (Estimate = 2.90, SE = 1.64, P = 0.03). Higher pain interference was significantly associated with worse emotional functioning (Estimate = 0.19, SE = 0.08, P = 0.03) and attention functioning (Estimate = 0.26, SE = 0.11, P = 0.03). Compared with survivors who reported less sleep problems, those who had more sleep problems demonstrated poorer emotional functioning (Estimate = 0.30, SE = 0.08, P = 0.001). Survivors who had a longer duration of screen usage per day reported more impairment on attention and behavior functioning than those who had a shorter duration of screen usage per day (both P<0.5). CONCLUSION Survivors who were diagnosed at a younger age or had unaddressed/untreated health problems may require additional psychological evaluation. The implementation of psychosocial assessments during routine long-term follow-up care may help to identify high-risk patients during the early phase of survivorship. Rehabilitation interventions should address modifiable behavioral factors (e.g. sleep habits, screen time and chronic pain).
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Affiliation(s)
- Jiaoyang Cai
- Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, Shanghai, China
- * E-mail: (JC); (YTC)
| | - Yin Ting Cheung
- Faculty of Medicine, School of Pharmacy, The Chinese University of Hong Kong, Hong Kong SAR, China
- * E-mail: (JC); (YTC)
| | | | - Wenting Hu
- Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, Shanghai, China
| | - Yijin Gao
- Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, Shanghai, China
| | - Hua Zhang
- Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, Shanghai, China
| | - Mingjing Ji
- Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, Shanghai, China
| | - Shuhong Shen
- Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, Shanghai, China
| | - Jing Chen
- Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, Shanghai, China
| | - Jingyan Tang
- Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, Shanghai, China
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Lemétayer F, Florquin M, Chastagner P, Lanfranchi JB. Life engagement and anxiety-depressive symptoms in adolescents and young adults with or without a cancer history and their mothers: A dyadic analytic approach. Eur J Cancer Care (Engl) 2022; 31:e13745. [PMID: 36245427 DOI: 10.1111/ecc.13745] [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: 05/02/2022] [Revised: 07/29/2022] [Accepted: 09/27/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of the present study was to examine the dyadic relationships between symptoms of anxiety and depression and life engagement in mother-adolescent and young adult (AYA) dyads with and without a history of cancer. METHODS One hundred mother-AYA dyads and 50 mother-AYA cancer survivor dyads self-reported anxiety and depressive symptoms and life engagement. Multilevel modelling analyses were used to test actor-partner interdependence models. RESULTS Significant actor effects of depressive symptoms on life engagement were found for AYAs and their mothers in both groups. But this effect was significantly attenuated downward in AYAs with a history of cancer. In addition, only AYAs' depressive symptoms exerted a significant effect on mothers' life engagement, indicating the presence of significant partner effects for mothers. CONCLUSION AYAs' and mothers' depressive symptoms are related to life engagement. Mothers' perception of depressive symptoms relates not only to their own perception of life engagement but also to that of their AYAs. These findings show the complex relationships that exist between AYAs and their mothers and point to the mechanisms through which AYAs-related variables affect mother outcomes, in the two groups of AYAs.
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Affiliation(s)
| | | | - Pascal Chastagner
- Service d'Hématologie pédiatrique, Hôpital d'Enfants, Vandoeuvre-les-Nancy, France
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Lavan O, Peled O, Avishai-Neumann M, Weizman A, Yahel A, Apter A, Valevski A, Fennig S, Stein J, Benaroya-Milshtein N. Psychopharmacology in the Pediatric Oncology and Bone Marrow Transplant Units: Antidepressant Treatment. J Child Adolesc Psychopharmacol 2022; 32:153-161. [PMID: 35255222 DOI: 10.1089/cap.2021.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: The aim of this study was to characterize the clinical profiles, tolerability, and efficacy of two groups of antidepressants, selective serotonin reuptake inhibitors (SSRIs), and the atypical antidepressant, mirtazapine, in children and adolescents treated in a large pediatric Hematology-Oncology center. Methods: A review of computerized medical charts of 32 pediatric patients with cancer, from December 2011 to April 2020, was conducted. Efficacy and tolerability of antidepressant medications were retrospectively analyzed. The Clinical Global Impressions-Severity (CGI-S) and Clinical Global Impressions-Improvement (CGI-I) Scales were used to evaluate psychiatric symptoms severity before and following treatment, while the data on adverse events and drug-drug interactions were retrieved from the computerized medical records. Results: Thirty-two children and adolescents with cancer, 2-21 years of age (mean 14.1 ± 4.6 years), were treated with antidepressants. Fourteen patients (44%) received mirtazapine, whereas 18 patients (56%) received SSRIs: sertraline (25%), escitalopram (25%), or fluoxetine (6%). Treatment choice was dictated either by physician preference or informed by potential drug-drug interactions. The most common psychiatric diagnoses were major depressive disorders (47%), anxiety disorders (19%), and medication-induced psychiatric disorders (19%). The most common psychiatric-medical symptoms were depressed mood (94%) and anxiety (62%). CGI-S improved significantly (p < 0.05) between pretreatment and on-treatment assessments, with no statistically significant difference between SSRI and mirtazapine-treated patients. CGI-I scores at reassessment indicated improvement in most patients (84%). Adverse events of treatment were mild in all patients. Conclusions: The antidepressants used in this study, SSRIs and mirtazapine, were effective and well tolerated in children and adolescents with cancer and psychiatric comorbidities. Given the high rates of depression and anxiety in children with cancer, large-scale, multisite, prospective clinical trials of antidepressants are warranted.
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Affiliation(s)
- Orly Lavan
- Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orit Peled
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pharmacy, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Meital Avishai-Neumann
- Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Geha Mental Health Center, Petah Tikva, Israel
| | - Anat Yahel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Alan Apter
- Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avi Valevski
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Geha Mental Health Center, Petah Tikva, Israel
| | - Silvana Fennig
- Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jerry Stein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Noa Benaroya-Milshtein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pharmacy, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
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Sharma A, Loades ME, Baker L, Jordan A, James V. Parental experiences of adolescent cancer-related distress: A qualitative study. Eur J Cancer Care (Engl) 2021; 30:e13417. [PMID: 33512062 DOI: 10.1111/ecc.13417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 12/21/2020] [Accepted: 01/11/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Adolescents' cancer-related distress is more complex, severe, and long-lasting than that of children and adults. Parents adopt an active role in supporting their adolescent, reporting that adolescent cancer-related distress is the most problematic symptom parents experience. Research has predominantly focused on exploring adolescents' experiences of cancer-related distress, with little attention to how their parents experience their adolescent's cancer-related distress. Therefore, we aimed to explore parents' experiences of distress within the context of parenting an adolescent with cancer-related distress during or immediately subsequent to active treatment. METHODS A total of 21 semi-structured interviews were conducted face-to-face or via telephone, with parents of adolescents aged 12-18 years from south-west England. Inductive reflexive thematic analysis was used to analyse the data. RESULTS Three themes were generated: "The contagion of distress", "Navigating breaking point" and "Developmental disruption". Parental distress transcended from adolescent cancer-related distress, eliciting uncertainty and challenging parenting limits. Parental distress was perpetuated by feelings that their adolescent had missed out on "normal" adolescence during and just after active treatment. CONCLUSION Parental distress reflected the multi-faceted nature of their adolescent's cancer-related distress. Findings advocate the importance of providing a parental voice within adolescent oncology populations. Developing tailored interventions to address parental distress are suggested.
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Affiliation(s)
- Aditi Sharma
- Department of Psychology, University of Bath, Bath, UK
| | - Maria E Loades
- Department of Psychology, University of Bath, Bath, UK.,Bristol Medical School, University of Bristol, Bristol, UK
| | - Laura Baker
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Abbie Jordan
- Department of Psychology, University of Bath, Bath, UK.,Centre for Pain Research, University of Bath, Bath, UK
| | - Venessa James
- Department of Psychology, University of Bath, Bath, UK
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Barone R, Gulisano M, Cannata E, Padalino S, Saia F, Maugeri N, Pettinato F, Lo Nigro L, Casabona A, Russo G, Di Cataldo A, Rizzo R. Self- and Parent-Reported Psychological Symptoms in Young Cancer Survivors and Control Peers: Results from a Clinical Center. J Clin Med 2020; 9:jcm9113444. [PMID: 33120900 PMCID: PMC7693519 DOI: 10.3390/jcm9113444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 11/16/2022] Open
Abstract
Pediatric cancer survivors are at increased risk for psychological distress. We sought to understand the severity and symptoms' co-occurrence among pediatric survivors compared to controls by rating both self- and parent-reported symptomatology. Forty survivors (22 males; mean age at study time: 12.9 years) participated in the study. Most survivors (85%) had a diagnosis of acute lymphoblastic leukemia. Seventy-nine healthy controls with the same age and gender distribution as the patients were included. A standardized assessment of psychological functioning was conducted by self- and parent-reported symptoms evaluations. The self-reported anxious symptom severity was significantly higher in survivors. A significantly higher proportion of survivors compared to controls had clinically significant anxiety, depression, and combined anxiety symptoms (i.e., social anxiety, separation anxiety, or physical symptoms). In both study groups, the self-reported emotional and somatic symptoms were significantly associated. The multi-informant assessments of the psychological symptoms revealed distinct associations between the child- and parent-reported symptoms in the survivors' group: the survivors' self-reports of depressive symptoms, somatic symptoms, and functional impairment were significantly correlated with the parent reports of child behavioral concerns, somatic complaints, and functional impairment, respectively. Conclusion: Self-reported symptoms showed similar comorbidity profiles in survivors and control peers. The multi-informant assessments detected differences in the association of self- and parent-reported symptoms between the survivor and control groups. The present study showed that multi-informant assessment is critical to understanding symptom profiles and to informing intervention with particular regard to parental participation and support.
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Affiliation(s)
- Rita Barone
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
- Correspondence: ; Tel.: +39-095-378-2898
| | - Mariangela Gulisano
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Emanuela Cannata
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Sara Padalino
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Federica Saia
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Nicoletta Maugeri
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Fabio Pettinato
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Luca Lo Nigro
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Antonino Casabona
- Department of Biomedical and Biotechnological Sciences, Section of Physiology, School of Medicine, University of Catania, 95123 Catania, Italy;
| | - Giovanna Russo
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Andrea Di Cataldo
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Renata Rizzo
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
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Koutná V, Blatný M. Socialization of Coping in Pediatric Oncology Settings: Theoretical Consideration on Parent-Child Connections in Posttraumatic Growth. Front Psychol 2020; 11:554325. [PMID: 33071875 PMCID: PMC7530937 DOI: 10.3389/fpsyg.2020.554325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022] Open
Abstract
This theoretical article aims to summarize the results of studies relevant to parental influence on coping with childhood cancer and provide implications for future research focused on parent–child connections in posttraumatic growth (PTG) following childhood cancer. Parental influence on child coping described by the socialization of coping and socialization of emotions theories has already been studied in connection with posttraumatic stress, but the role of parents in the process of PTG in the child has not been clearly described yet. Several studies focused on PTG in childhood cancer survivors and their parents simultaneously, but only two studies explicitly included a parent–child connection in PTG in statistical analysis. Studies suggest that child PTG may be facilitated through parental coping advice supporting emotion expression and that parent–child connection in PTG may be mediated by the child’s subjective perception of the parents’ PTG. More research is needed to describe specific strategies proposed by parents and leading to child PTG and design tailored interventions for the use in the clinical care of childhood cancer survivors and their family.
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Affiliation(s)
- Veronika Koutná
- Institute of Psychology, Czech Academy of Sciences, Brno, Czechia
| | - Marek Blatný
- Institute of Psychology, Czech Academy of Sciences, Brno, Czechia
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10
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Junkins CC, Kent E, Litzelman K, Bevans M, Cannady RS, Rosenberg AR. Cancer across the ages: a narrative review of caregiver burden for patients of all ages. J Psychosoc Oncol 2020; 38:782-798. [DOI: 10.1080/07347332.2020.1796887] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Courtney C. Junkins
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Erin Kent
- Gillings School of Global Public Health, Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kristin Litzelman
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Margaret Bevans
- Office of Research on Women’s Heath, National Institutes of Health, Bethesda, Maryland, USA
| | - Rachel S. Cannady
- Cancer Control Department, American Cancer Society, Atlanta, Georgia, USA
| | - Abby R. Rosenberg
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington, USA
- Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, Washington, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
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11
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Schepers SA, Okado Y, Russell K, Long AM, Phipps S. Adjustment in Childhood Cancer Survivors, Healthy Peers, and Their Parents: The Mediating Role of the Parent-Child Relationship. J Pediatr Psychol 2020; 44:186-196. [PMID: 30247631 DOI: 10.1093/jpepsy/jsy069] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/12/2018] [Indexed: 11/12/2022] Open
Abstract
Objectives Aims were to (1) determine whether the associations between parent psychological functioning and adjustment outcomes of childhood cancer survivors (CCS) were mediated by the parent-child relationship and (2) examine possible differences in pathways for CCS and healthy peers. Method The study included CCS (n = 206), healthy peers (n = 132), and their primary caregivers. Youth (8-21 years) reported on the quality of the parent-child relationship and on their positive and negative adjustment outcomes. Parents reported on their own distress, posttraumatic growth, quality of the parent-child relationship, and their child's positive and negative adjustment outcomes. Two mediation models were tested, first examining youth-reported adjustment as the outcome and second examining parent-reported youth adjustment. Differences between model path coefficients of CCS and healthy peers were assessed by multigroup analyses. Results In the youth-reported model, the parent-child relationship mediated the relation between parental distress and adjustment, with more care leading to better youth-reported adjustment outcomes and more overprotection leading to poorer adjustment outcomes. In the parent-reported model, relational frustration and attachment mediated the link between parental distress/growth and parent-reported youth adjustment, with more relational frustration and less attachment relating to poorer youth adjustment outcomes. Multigroup analyses revealed no differences in model path coefficients between CCS and healthy peers. Conclusions Parental distress and the parent-child relationship likely play an important role in both youth- and parent-reported adjustment, and associations among these constructs do not differ between CCS and healthy peers. Families with less optimal parental functioning may benefit from interventions improving the quality of parent-child interactions.
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Affiliation(s)
| | - Yuko Okado
- Department of Psychology, California State University
| | - Kathryn Russell
- Department of Psychology, St. Jude Children's Research Hospital
| | - Alanna M Long
- Department of Psychology, St. Jude Children's Research Hospital
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital
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12
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Brotkin SM, Maslow GR, Bonner MJ. JPP Student Journal Club Commentary: The Relationship between Parent and Child Distress in Pediatric Cancer. J Pediatr Psychol 2019; 44:1137-1139. [PMID: 31599946 DOI: 10.1093/jpepsy/jsz080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Gary R Maslow
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
| | - Melanie J Bonner
- Department of Psychology and Neuroscience, Duke University.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
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13
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Armstrong B. Commentary: Reflecting on Holmbeck (2002): Making Advanced Quantitative Methods Approachable in Pediatric Psychology. J Pediatr Psychol 2019; 44:813-815. [PMID: 31073606 PMCID: PMC6655387 DOI: 10.1093/jpepsy/jsz035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/15/2019] [Accepted: 04/17/2019] [Indexed: 11/13/2022] Open
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Bakula DM, Sharkey CM, Perez MN, Espeleta HC, Gamwell KL, Baudino M, Delozier AM, Chaney JM, Matt Alderson R, Mullins LL. Featured Article: The Relationship Between Parent and Child Distress in Pediatric Cancer: A Meta-Analysis. J Pediatr Psychol 2019; 44:1121-1136. [DOI: 10.1093/jpepsy/jsz051] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 05/18/2019] [Accepted: 06/02/2019] [Indexed: 12/20/2022] Open
Abstract
Abstract
Objective
Parents and children affected by pediatric cancer are at risk for psychological distress, including depression, anxiety, and post-traumatic stress. A link is believed to exist between parent and child distress; however, no systematic analysis of this relationship has occurred. A meta-analysis was conducted to assess the relationship between parent and child distress among families affected by pediatric cancer.
Methods
A systematic review and meta-analysis was conducted using EBSCO (searching PsycINFO, MEDLINE, Academic search Premiere, and Health Source: Nursing/Academic Edition) and PubMed. The initial search yielded a total of 29,118 articles. Inclusion criteria were that studies assessed the relation between parent and child distress in the context of pediatric cancer, were written in English, and were published in peer-reviewed journals. 28 articles met inclusion criteria.
Results
A statistically significant association was found between overall parent and child distress (r = .32, p < .001), such that increased parent-reported distress was associated with increased distress in their children. Significant relationships were also present among each type of parental distress (i.e., depression, anxiety, post-traumatic stress, and global distress; rs = .31–.51, ps < .001) and overall child distress. Moderation analyses via meta-regression indicated that parent proxy-report of child symptoms was associated with a stronger relationship between parent and child distress than child self-report of their own distress.
Conclusions
Aligned with the social–ecological framework, familial factors appear to be highly relevant in understanding distress following pediatric cancer diagnosis. Indeed, greater parent distress was associated with greater child distress.
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15
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Grégoire C, Chantrain C, Faymonville ME, Marini J, Bragard I. A HYPNOSIS-BASED GROUP INTERVENTION TO IMPROVE QUALITY OF LIFE IN CHILDREN WITH CANCER AND THEIR PARENTS. Int J Clin Exp Hypn 2019; 67:117-135. [PMID: 30939086 DOI: 10.1080/00207144.2019.1580965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Many children with cancer and their parents suffer from distress, fatigue, and relational difficulties. Hypnosis is often used to decrease children's procedure-related pain and distress in pediatric oncology and to improve the well-being of adults with cancer. This article describes a pilot study assessing the acceptability and feasibility of a group intervention combining self-care and hypnosis for children with cancer and their parents, and a quasi-experimental protocol aimed at assessing the efficacy of this intervention to improve quality of life, distress, fatigue, and coping. The pilot study showed that the intervention was feasible and perceived positively. Future research is needed to test the efficacy of group interventions combining self-care and hypnosis to improve quality of life for children with cancer and their families.
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Affiliation(s)
- Charlotte Grégoire
- a Public Health Department and Sensation and Perception Research Group, GIGA Consciousness , University of Liège , Liège , Belgium
| | - Christophe Chantrain
- b Paediatric Haematology/Oncology and Immunology Department , CHC Espérance , Liège , Belgium
| | - Marie-Elisabeth Faymonville
- c Algology-Palliative Care Department , University Hospital of Liège Sensation and Perception Research Group, GIGA Consciousness, University of Liège , Liège , Belgium
| | - Jennifer Marini
- b Paediatric Haematology/Oncology and Immunology Department , CHC Espérance , Liège , Belgium
| | - Isabelle Bragard
- a Public Health Department and Sensation and Perception Research Group, GIGA Consciousness , University of Liège , Liège , Belgium
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16
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Bisht S, Chawla B, Tolahunase M, Mishra R, Dada R. Impact of yoga based lifestyle intervention on psychological stress and quality of life in the parents of children with retinoblastoma. Ann Neurosci 2019; 26:66-74. [PMID: 31975776 PMCID: PMC6894619 DOI: 10.5214/ans.0972.7531.260206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/01/2019] [Accepted: 08/04/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Childhood cancers are associated with a psychological burden to the parents and hence, decline their mental and physical health and overall quality of life. PURPOSE The purpose of the present study is to investigate the impact of 12-weeks yoga based lifestyle intervention on psychological stress and quality of life in the parents of children affected with retinoblastoma. METHOD Single arm prospective clinical trial conducted from October 2015 to October 2017 at the Laboratory for Molecular Reproduction and Genetics, Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India. A pre-tested 12-weeks yoga based lifestyle intervention included asanas (physical postures), pranayama (breathing exercises), dhyana (meditation), relaxation techniques, lectures and films on yoga, interactive sessions and individualized advice was administered to the participants. RESULTS 12-weeks of yoga based lifestyle intervention programme leads to a significant improvement in psychological stress and overall quality of life in the parents of retinoblastoma patients. There was a significant improvement in all the domains (physical health, psychological health, social relationships, and environment) of WHOQOL-BREF from baseline (day 0) to 12-weeks of yoga based lifestyle intervention. Yoga based lifestyle intervention also led to a significant increase in the levels of brain derived neurotrophic factor, dehydroepiandrosterone sulphate, sirtuin 1 and decreased the cortisol and IL-6 levels. CONCLUSION Yoga based lifestyle intervention reduced the severity of psychological stress and resulted in improvement in overall quality of life and upregulation in levels of systemic biomarkers of neuroplasticity. YBLI may serve as a beneficial therapy and may also act as an effective medium for better stress management to develop better coping strategies in the parents of retinoblastoma patients.
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Affiliation(s)
- Shilpa Bisht
- Laboratory for Molecular Reproduction and Genetics,
Department of Anatomy, All India Institute of Medical Sciences, Ansari Nagar, New
Delhi, India
| | - Bhavna Chawla
- Ocular Oncology Service, Dr. Rajendra Prasad Centre for
Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New
Delhi, India
| | - Madhuri Tolahunase
- Laboratory for Molecular Reproduction and Genetics,
Department of Anatomy, All India Institute of Medical Sciences, Ansari Nagar, New
Delhi, India
| | - Richa Mishra
- Laboratory for Molecular Reproduction and Genetics,
Department of Anatomy, All India Institute of Medical Sciences, Ansari Nagar, New
Delhi, India
| | - Rima Dada
- Laboratory for Molecular Reproduction and Genetics,
Department of Anatomy, All India Institute of Medical Sciences, Ansari Nagar, New
Delhi, India
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17
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Salvador Á, Crespo C, Barros L. Parents' psychological well-being when a child has cancer: Contribution of individual and family factors. Psychooncology 2019; 28:1080-1087. [PMID: 30861257 DOI: 10.1002/pon.5057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of this study was to examine the contribution of individual (positive reappraisal) and family factors (parenting satisfaction, couple relationship quality, and family life difficulty) to the psychological well-being (PWB) of parents of children/adolescents diagnosed with cancer. METHODS This cross-sectional study was conducted at two pediatric oncology wards in Portugal. Two-hundred and five parents of pediatric patients with cancer completed self-report questionnaires assessing the use of positive reappraisal as a coping strategy, parenting satisfaction, relationship quality, family life difficulty, and PWB. Sociodemographic and clinical data were also assessed. RESULTS Standard multiple regression analysis showed a significant contribution of both individual- and family-level factors to parents' PWB. Specifically, the use of positive reappraisal as a coping strategy, parenting satisfaction, and relationship quality were associated with higher PWB; conversely, family life difficulty was linked to lower PWB. Sociodemographic (child's age and family's socioeconomic status) and clinical variables (time since diagnosis and treatment status) were not associated with PWB. CONCLUSIONS The present study identified potential resources for parents' adaptation to this stressful situation, contributing with insightful conclusions for both research and clinical practice. Screening and addressing both individual- and family-level aspects may be crucial to foster parents' well-being when a child is diagnosed with cancer.
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Affiliation(s)
- Ágata Salvador
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon
| | - Carla Crespo
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon
| | - Luísa Barros
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon
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18
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Cutillo A, Zimmerman K, Davies S, Madan-Swain A, Landier W, Arynchyna A, Rocque BG. Coping strategies used by caregivers of children with newly diagnosed brain tumors. J Neurosurg Pediatr 2019; 23:30-39. [PMID: 30485195 PMCID: PMC6944290 DOI: 10.3171/2018.7.peds18296] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/24/2018] [Indexed: 11/06/2022]
Abstract
In BriefThe authors interviewed families whose children had recently been hospitalized with a new brain tumor. From these interviews, they identified parents' coping strategies for handling the stress of having a child with a newly diagnosed tumor. Some strategies are considered "adaptive" and help parents deal with the stress better. Others are "maladaptive," leading to worse outcomes. Parents of children with brain tumors are at risk for maladaptive coping. Efforts to teach parents how to cope effectively with the stress of a sick child have the potential to improve outcomes.
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Affiliation(s)
- Alexandra Cutillo
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL
| | - Kathrin Zimmerman
- Department of Neurosurgery, Division of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
| | - Susan Davies
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Avi Madan-Swain
- Department of Pediatrics, Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL
| | - Wendy Landier
- Department of Pediatrics, Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL
| | - Anastasia Arynchyna
- Department of Neurosurgery, Division of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
| | - Brandon G. Rocque
- Department of Neurosurgery, Division of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
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19
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Labrell F, Câmara-Costa H, Dufour C, Grill J, Chevignard M. Maternal stress and pediatric brain cancer: A French study. J Psychosoc Oncol 2018; 37:96-109. [PMID: 30592250 DOI: 10.1080/07347332.2018.1529009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Despite evidence that pediatric cancer induces a trajectory of parental stress, studies including mothers of children with malignant brain tumors remain scarce. The present work aims to add to the scientific literature by evaluating maternal stress with a French translation of the Pediatric Inventory for Parents (PIP) in a population of mothers whose children have been diagnosed with a brain tumor. PROCEDURE The mothers of 35 children with malignant brain tumors completed the Pediatric Inventory for Parents (PIP), the State-Trait Anxiety Inventory (STAI) and the Family Assessment Device (FAD) at a mean time since diagnosis of 2.3 years. RESULTS The PIP showed good internal consistency and correlated significantly with the STAI and the FAD. Maternal stress scores were higher in younger mothers and in mothers of younger children. Emotional functioning was the most affected domain. CONCLUSIONS Emotional stress as assessed by the PIP in mothers of children with malignant brain tumors is considerable, and should be routinely assessed, in order to implement appropriate specific psychosocial interventions when needed.
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Affiliation(s)
- Florence Labrell
- a Université Paris-Saclay, Université Paris-Sud, UVSQ , Villejuif , France.,b INSHEA (National higher institute for training and research on special needs education) , Suresnes , France
| | - Hugo Câmara-Costa
- a Université Paris-Saclay, Université Paris-Sud, UVSQ , Villejuif , France
| | - Christelle Dufour
- c Department of Pediatric and Adolescent Oncology , Gustave Roussy , Villejuif , France
| | - Jacques Grill
- c Department of Pediatric and Adolescent Oncology , Gustave Roussy , Villejuif , France
| | - Mathilde Chevignard
- d Rehabilitation Department for children with acquired neurological injury , Saint Maurice Hospitals , Saint Maurice , France.,e Sorbonne Universités , Paris , France.,f GRC No18, Handicap Cognitif et Réadaptation (HanCRe) , Paris , France
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20
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Gutiérrez-Colina AM, Lee JL, VanDellen M, Mertens A, Marchak JG. Family Functioning and Depressive Symptoms in Adolescent and Young Adult Cancer Survivors and Their Families: A Dyadic Analytic Approach. J Pediatr Psychol 2018; 42:19-27. [PMID: 28173209 DOI: 10.1093/jpepsy/jsw041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/09/2016] [Accepted: 04/15/2016] [Indexed: 11/14/2022] Open
Abstract
Background To examine dyadic relationships between depressive symptoms and family functioning in families of pediatric cancer survivors. Methods Sixty-four adolescent and young adult (AYA) cancer survivors and their caregivers self-reported on depressive symptoms and family functioning. Multilevel modeling analyses were used to test actor–partner interdependence models. Results Significant actor effects of depressive symptoms on domains of family functioning were found for AYAs and their caregivers. Only caregivers’ depressive symptoms exerted a significant effect on AYAs’ report of family cohesion, indicating the presence of significant partner effects for AYAs. Conclusions AYAs’ and caregivers’ depressive symptoms are related to poorer family functioning. Caregivers’ perceptions of depressive symptoms relate not only to their own perceptions of family functioning but also to that of their children. These findings begin to map the complex relationships that exist between AYAs and their caregivers and elucidate some of the mechanisms through which caregiver-related variables affect AYA outcomes.
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Affiliation(s)
| | - Jennifer L Lee
- Children's Healthcare of Atlanta.,Emory University School of Medicine
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21
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Liu W, Cheung YT, Brinkman TM, Banerjee P, Srivastava D, Nolan VG, Zhang H, Gurney JG, Pui CH, Robison LL, Hudson MM, Krull KR. Behavioral symptoms and psychiatric disorders in child and adolescent long-term survivors of childhood acute lymphoblastic leukemia treated with chemotherapy only. Psychooncology 2018. [PMID: 29521470 DOI: 10.1002/pon.4699] [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: 11/09/2022]
Abstract
BACKGROUND Prevalence of emotional, behavioral, and psychiatric outcomes in child and adolescent survivors of childhood acute lymphoblastic leukemia treated on a chemotherapy-only protocol were not well defined. METHODS Self- and parent-reported emotional and behavioral symptoms were assessed for 161 survivors of childhood acute lymphoblastic leukemia (51.0% female; mean [SD] age 12.1[2.6] years; 7.5[1.6] years post-diagnosis). Age- and sex-adjusted scores were calculated for standardized measures and compared with 90th percentile of norms. Frequencies of survivor psychiatric disorders from structured diagnostic interviews with parents were compared with the general population. Parent emotional distress and post-traumatic stress symptoms were assessed. Associations between child symptoms/disorders and parent distress were examined with log-binomial models, adjusting for highest parent education. RESULTS Compared with population expectations (10%), more survivors self-reported symptoms of inattention (27.9; 95% CI, 21.0%-35.7%), hyperactivity/impulsivity (26.0%; CI, 19.2%-33.6%), and oppositional-defiant behavior (20.1%; CI, 14.1%-27.3%). Parents reported survivors with more symptoms of inattention (23.6%; CI, 17.2%-31.0%), higher frequencies of obsessive-compulsive disorder (10.3% vs 2%) and oppositional defiant disorder (16.0% vs 9.5%), but not attention-deficit/hyperactivity disorder (7.1% vs 7.8%) or generalized anxiety disorder (3.2% vs 4.1%), compared with national norms. Parent-report of child anxiety disorders was associated with parent self-reported emotional distress but not survivor self-report of anxiety. CONCLUSION A significant minority of survivors have long-term psychiatric morbidity, multi-informant assessment is important to understand these symptom profiles and to inform selection of appropriate interventions. Interventions targeting inattention and oppositional behavior in children and emotional distress in parents are warranted in families with survivors who display behavioral problems.
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Affiliation(s)
- Wei Liu
- Departments of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.,School of Public Health, University of Memphis, Memphis, TN, USA
| | - Yin Ting Cheung
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Tara M Brinkman
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Departments of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Pia Banerjee
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Deokumar Srivastava
- Departments of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Vikki G Nolan
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Hongmei Zhang
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - James G Gurney
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Ching-Hon Pui
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Leslie L Robison
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melissa M Hudson
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kevin R Krull
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Departments of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
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Racine NM, Khu M, Reynolds K, Guilcher GMT, Schulte FSM. Quality of life in pediatric cancer survivors: contributions of parental distress and psychosocial family risk. ACTA ACUST UNITED AC 2018; 25:41-48. [PMID: 29507482 DOI: 10.3747/co.25.3768] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Pediatric survivors of childhood cancer are at increased risk of poor quality of life and social-emotional outcomes following treatment. The relationship between parent psychological distress and child adjustment in pediatric cancer survivors has been well established. However, limited research has examined the factors that may buffer this association. The current study examined the associations between psychosocial family risk factors, parental psychological distress, and health-related quality of life (hrql) in pediatric cancer survivors. Methods Fifty-two pediatric cancer survivors (34 males, 18 females, mean age = 11.92) and their parents were recruited from a long-term cancer survivor clinic. Children and their parents who consented to participate completed the Pediatric Quality of Life Inventory 4.0. Parents completed a demographic information form, the Psychosocial Assessment Tool (pat 2.0) and the Brief Symptom Inventory (bsi). The Intensity of Treatment Rating (itr-3) was evaluated by the research team. Results Multiple regression analyses revealed that parental psychological distress negatively predicted parent-reported hrql, while treatment intensity, gender, and psychosocial risk negatively predicted parent and child-reported hrql. Psychosocial risk moderated the association between parent psychological distress and parent-reported child hrql (p = 0.03), whereby parents with high psychological distress but low levels of psychosocial risk reported their children to have higher hrql. Conclusion Low levels of family psychosocial risk buffer the impact of parent psychological distress on child hrql in pediatric cancer survivors. The findings highlight the importance of identifying parents and families with at-risk psychological distress and psychosocial risk in order to provide targeted support interventions to mitigate the impact on hrql.
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Affiliation(s)
- N M Racine
- Department of Psychology, University of Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, AB, Canada
| | - M Khu
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, AB, Canada
| | - K Reynolds
- Long Term Survivor Clinic, Alberta Children's Hospital, AB, Canada; and
| | - G M T Guilcher
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, AB, Canada.,Alberta Children's Hospital Research Institute, AB, Canada
| | - F S M Schulte
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, AB, Canada.,Alberta Children's Hospital Research Institute, AB, Canada.,Long Term Survivor Clinic, Alberta Children's Hospital, AB, Canada; and.,Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, AB, Canada
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23
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McCullough A, Ruehrdanz A, Jenkins MA, Gilmer MJ, Olson J, Pawar A, Holley L, Sierra-Rivera S, Linder DE, Pichette D, Grossman NJ, Hellman C, Guérin NA, O’Haire ME. Measuring the Effects of an Animal-Assisted Intervention for Pediatric Oncology Patients and Their Parents: A Multisite Randomized Controlled Trial. J Pediatr Oncol Nurs 2017; 35:159-177. [PMID: 29268667 DOI: 10.1177/1043454217748586] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: This multicenter, parallel-group, randomized trial examined the effects of an animal-assisted intervention on the stress, anxiety, and health-related quality of life for children diagnosed with cancer and their parents. Method: Newly diagnosed patients, aged 3 to 17 years (n = 106), were randomized to receive either standard care plus regular visits from a therapy dog (intervention group), or standard care only (control group). Data were collected at set points over 4 months of the child’s treatment. Measures included the State-Trait Anxiety Inventory™, Pediatric Quality of Life Inventory, Pediatric Inventory for Parents, and child blood pressure and heart rate. All instruments were completed by the child and/or his/her parent(s). Results: Children in both groups experienced a significant reduction in state anxiety ( P < .001). Parents in the intervention group showed significantly decreased parenting stress ( P = .008), with no changes in stress among parents in the control group. However, no significant differences between groups over time on any measures were observed. Conclusions: Animal-assisted interventions may provide certain benefits for parents and families during the initial stages of pediatric cancer treatment.
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Affiliation(s)
| | | | | | - Mary Jo Gilmer
- Vanderbilt University School of Nursing, Nashville, TN, USA
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN, USA
- Pediatric Palliative Care Research Team, Nashville, TN, USA
| | - Janice Olson
- Randall Children’s Hospital at Legacy Emanuel, Portland, OR, USA
| | - Anjali Pawar
- UC Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | | | | | - Deborah E. Linder
- Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
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Sohn IJ, Han JW, Hahn SM, Song DH, Lyu CJ, Cheon KA. Factors Associated with Emotional Distress in Children and Adolescents during Early Treatment for Cancer. Yonsei Med J 2017; 58:816-822. [PMID: 28540996 PMCID: PMC5447114 DOI: 10.3349/ymj.2017.58.4.816] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/22/2017] [Accepted: 03/24/2017] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Children and adolescents diagnosed with cancer experience emotional distress, such as sadness, worrying, and irritability. However, there is little information about the psychological well-being of parents at the time of their child's diagnosis. We sought to identify factors that were associated with emotional distress in cancer patients as a basis for developing innovative psychological interventions. MATERIALS AND METHODS A retrospective chart review was performed on patients newly diagnosed with cancer at a single center in Korea from 2014 to 2016. Eighty-five patients and their mothers completed psychological inventories. To determine factors associated with emotional distress in patients, we assessed the psychological inventory results using multiple linear regression after performing correlation analysis. RESULTS The maternal Beck Depression Inventory-II (BDI-II) score was positively correlated with total problem scores and externalizing scores in patients aged less than 7 years. In patients aged 7-12 years, there was no significant association between the patient's emotional distress and other variables. In contrast, the maternal BDI-II score was the strongest factor associated with patient depression in adolescents. CONCLUSION We suggest that the most important factor affecting emotional distress in children and adolescents with cancer is maternal depression, especially in patients aged 1-6 years and aged 13-17 years. Understanding the factors associated with emotional distress of cancer patients allows us to develop early psychiatric interventions for patients and their parents at the initial psychological crisis.
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Affiliation(s)
- In Jung Sohn
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Woo Han
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Min Hahn
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Ho Song
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Chuhl Joo Lyu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
| | - Keun Ah Cheon
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Monti JD, Winning A, Watson KH, Williams EK, Gerhardt CA, Compas BE, Vannatta K. Maternal and Paternal Influences on Children's Coping with Cancer-Related Stress. JOURNAL OF CHILD AND FAMILY STUDIES 2017; 26:2016-2025. [PMID: 29056838 PMCID: PMC5648020 DOI: 10.1007/s10826-017-0711-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Childhood cancer is a significant source of stress for children and families, and children's coping with cancer-related stress is a key predictor of emotional adjustment. To extend understanding of the determinants of children's coping with cancer-related stress, this study examined whether mothers' and fathers' functioning after their child's diagnosis-including coping and depressive symptoms-is predictive of children's coping over time. Participants included 166 children (Mage = 13.47, SD = 2.47, 51.2% female), 161 mothers, and 83 fathers. Approximately two months post-diagnosis (T1), parents reported on their coping and depressive symptoms. At T1 and approximately 12 months later (T2), children reported on their coping. Results indicated that mothers' coping and depressive symptoms were correlated with children's coping at T1; fathers' coping and depressive symptoms were generally not associated with children's coping at T1. Hierarchical regression analyses revealed that fathers' secondary control coping (i.e., coping aimed at adapting to cancer-related stress) predicted higher levels of secondary control coping in children over time. Mothers' depressive symptoms predicted lower levels of secondary control coping over time in girls, and fathers' depressive symptoms predicted lower levels of secondary control coping over time across sex. Parents' functioning after their child's cancer diagnosis may shape how children cope with cancer-related stress. Parents' coping and depressive symptoms may be important targets for interventions aiming to promote positive adjustment in children with cancer.
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Affiliation(s)
- Jennifer D Monti
- Nationwide Children's Hospital and The Ohio State University, Columbus, OH
| | - Adrien Winning
- Nationwide Children's Hospital and The Ohio State University, Columbus, OH
| | | | | | - Cynthia A Gerhardt
- Nationwide Children's Hospital and The Ohio State University, Columbus, OH
| | | | - Kathryn Vannatta
- Nationwide Children's Hospital and The Ohio State University, Columbus, OH
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26
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Healthcare Professionals' Knowledge of Family Psychosocial Problems in Pediatric Cancer: A Pilot Study. Cancer Nurs 2017; 39:263-71. [PMID: 26632881 DOI: 10.1097/ncc.0000000000000321] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Best practice guidelines for the treatment of cancer now advocate for a child- and family-centered model of care and a psychosocial model of risk prevention. However, healthcare professionals (HCPs) report a number of barriers preventing the implementation of psychosocial care, including an absence of tools to help identify psychosocial problems within the family. OBJECTIVES The aims of this study are to (1) explore the psychometric properties of the Psychosocial Care Checklist (PCCL) and (2) test if the PCCL can differentiate the degree to which HCPs are aware of psychosocial problems within the family (patient, siblings, parents) of a child with cancer. METHODS Thirty-seven HCPs caring for a child with cancer completed the PCCL at time 1 (2-4 weeks after diagnosis) and 29 HCPs completed the PCCL at time 2 (2-3 weeks after). RESULTS The PCCL had strong test-retest reliability for all domains (α > .60) and strong internal consistency for the total PCCL (α = .91). Interrater reliability was moderate for the oncologist-nurse dyad with regard to sibling knowledge (r = 0.56) and total psychosocial knowledge (r = 0.65). Social workers were significantly more knowledgeable than both nurses and oncologists about total family problems (P = .01) and sibling problems (P = .03). CONCLUSIONS Preliminary findings suggest that the PCCL has adequate test-retest reliability and validity and is useful in differentiating the degree to which HCPs are aware of psychosocial problems within the family, with social workers being the most knowledgeable. IMPLICATIONS FOR PRACTICE Using the PCCL may help HCPs to identify psychosocial problems within the family and appropriately allocate psychosocial resources.
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Sharp KMH, Lindwall JJ, Willard VW, Long AM, Martin-Elbahesh KM, Phipps S. Cancer as a stressful life event: Perceptions of children with cancer and their peers. Cancer 2017; 123:3385-3393. [PMID: 28472536 DOI: 10.1002/cncr.30741] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/09/2017] [Accepted: 03/20/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND The medical traumatic stress model is commonly applied to childhood cancer, assuming that the diagnosis of cancer is a traumatic event. However, to the authors' knowledge, little is known regarding what specifically children perceive as stressful about cancer or how it compares with other stressful events more often experienced by children. METHODS Children with cancer (254 children) and demographically similar peers without a history of serious illness (202 children) identified their most stressful life event as part of a diagnostic interview assessing for symptoms of posttraumatic stress disorder (PTSD). The events identified as most stressful were categorized thematically, with categories established separately for cancer-related and non-cancer-related events. Events also were examined to assess whether they met Diagnostic and Statistical Manual of Mental Disorders (DSM) A criteria for PTSD. RESULTS In the group of children with cancer, 54% described a cancer-related event as the most stressful event they had experienced. Six distinct categories of cancer-related events and 10 categories of non-cancer-related events were identified. The same noncancer events were identified by children in both groups, and occurred at similar frequencies. The percentage of cancer-related events that met DSM A criteria for PTSD differed dramatically depending on which version of the DSM was applied. CONCLUSIONS Children do not necessarily view their cancer experience as their most stressful life event. The findings of the current study suggest that the diagnosis of cancer might be better viewed as a manageable stressor rather than a major trauma, and are consistent with the change in the fifth edition of the DSM to eliminate the diagnosis of a life-threatening illness as a qualifying trauma for PTSD. Cancer 2017;123:3385-93. © 2017 American Cancer Society.
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Affiliation(s)
- Katianne M Howard Sharp
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Jennifer J Lindwall
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychiatry, School of Medicine, University of Colorado, Aurora, Colorado
| | - Victoria W Willard
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Alanna M Long
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
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Kirch R, Reaman G, Feudtner C, Wiener L, Schwartz LA, Sung L, Wolfe J. Advancing a comprehensive cancer care agenda for children and their families: Institute of Medicine Workshop highlights and next steps. CA Cancer J Clin 2016; 66:398-407. [PMID: 27145249 DOI: 10.3322/caac.21347] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 03/29/2016] [Accepted: 03/31/2016] [Indexed: 12/20/2022] Open
Abstract
This article highlights key findings from the "Comprehensive Cancer Care for Children and Their Families" March 2015 joint workshop by the Institute of Medicine (IOM) and the American Cancer Society. This initiative convened more than 100 family members, clinician investigators, advocates, and members of the public to discuss emerging evidence and care models and to determine the next steps for optimizing quality-of-life outcomes and well-being for children and families during pediatric cancer treatment, after treatment completion, and across the life spectrum. Participants affirmed the triple aim of pediatric oncology that strives for every child with cancer to be cured; provides high-quality palliative and psychosocial supportive, restorative, and rehabilitative care to children and families throughout the illness course and survivorship; and assures receipt of high-quality end-of-life care for patients with advancing disease. Workshop outcomes emphasized the need for new pediatric cancer drug development and identified critical opportunities to prioritize palliative care and psychosocial support as an integral part of pediatric cancer research and treatment, including the necessity for adequately resourcing these supportive services to minimize suffering and distress, effectively address quality-of-life needs for children and families at all stages of illness, and mitigate the long-term health risks associated with childhood cancer and its treatment. Next steps include dismantling existing silos and enhancing collaboration between clinical investigators, disease-directed specialists, and supportive care services; expanding the use of patient-reported and parent-reported outcomes; effectively integrating palliative and psychosocial care; and clinical communication skills development. CA Cancer J Clin 2016;66:398-407. © 2016 American Cancer Society.
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Affiliation(s)
- Rebecca Kirch
- Consultant, The Center to Advance Palliative Care, New York, NY
- Consultant, Cameron and Hayden Lord Foundation, New York, NY
| | - Gregory Reaman
- Associate Director, Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Chris Feudtner
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Lori Wiener
- Behavioral Health Core, and Head of the Psychosocial Support and Research Program, National Cancer Institute, Bethesda, MD
| | - Lisa A Schwartz
- Psychologist, Division of Oncology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
- Assistant Professor, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Lillian Sung
- Pediatric Oncologist, Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Joanne Wolfe
- Pediatric Palliative Care Service, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
- Director, Pediatric Palliative Care, Boston Children's Hospital, Boston, MA
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29
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Willard VW, Hostetter SA, Hutchinson KC, Bonner MJ, Hardy KK. Benefit Finding in Maternal Caregivers of Pediatric Cancer Survivors. J Pediatr Oncol Nurs 2016; 33:353-60. [DOI: 10.1177/1043454215620119] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: Benefit finding has been described as the identification of positive effects resulting from otherwise stressful experiences. In this mixed methods study, we examined the relations between qualitative themes related to benefit finding and quantitative measures of psychosocial adjustment and coping as reported by maternal caregivers of survivors of pediatric cancer. Methods: Female caregivers of survivors of pediatric cancer (n = 40) completed a qualitative questionnaire about their experiences caring for their child, along with several quantitative measures. Qualitative questionnaires were coded for salient themes, including social support and personal growth. Correlation matrices evaluated associations between qualitative themes and quantitative measures of stress and coping. Results: Identified benefits included social support and personal growth, as well as child-specific benefits. Total benefits reported were significantly positively correlated with availability of emotional resources. Coping methods were also associated, with accepting responsibility associated with fewer identified benefits. Conclusion: Despite the stress of their child’s illness, many female caregivers of survivors of pediatric cancer reported finding benefits associated with their experience. Benefit finding in this sample was associated with better adjustment.
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Affiliation(s)
| | | | | | - Melanie J. Bonner
- St. Jude Children’s Research Hospital, Memphis, TN, USA
- Duke University Medical Center, Durham, NC, USA
| | - Kristina K. Hardy
- Children’s National Health System, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
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30
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Évaluation du stress parental en cas de cancer de l’enfant. Bull Cancer 2016; 103:691-6. [DOI: 10.1016/j.bulcan.2016.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 04/20/2016] [Accepted: 04/24/2016] [Indexed: 01/13/2023]
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31
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Okado Y, Tillery R, Sharp KH, Long AM, Phipps S. Effects of Time since Diagnosis on the Association between Parent and Child Distress in Families with Pediatric Cancer. CHILDRENS HEALTH CARE 2015; 45:303-322. [PMID: 27630380 DOI: 10.1080/02739615.2014.996883] [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] [Indexed: 10/23/2022]
Abstract
Although parental distress and child distress have been linked in families of children with cancer, how these associations change over time is unknown. The present study examined how the amount of time elapsed since the child's diagnosis moderates the associations between self-reported parent and child symptoms of depression, anxiety, and post-traumatic stress in 255 parent-child dyads. Time since diagnosis moderated the associations between parental symptoms and child-reported anxiety and post-traumatic stress. Dyads farther out from diagnosis exhibited stronger associations between parental and child symptoms. Findings suggest the importance of monitoring the psychological adjustment of parents and children over time.
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