Parenting a child with cancer: a couple-based approach

Parenting a child with cancer and maintaining a healthy couple relationship: Findings from the Family Talk Intervention

BACKGROUND

Despite the challenges that caring for a child with cancer brings for parents, little knowledge is available concerning the effects on the parents' couple relationship. Furthermore, few interventions have been designed to support parents in their couple relationship. The aim of this paper was, therefore, to explore parents' experiences of their couple relationship while having a dependent child with cancer and the support they received from a family-based intervention, the Family Talk Intervention (FTI).

METHODS

Data for this paper were taken from semi-structured interviews performed in a pilot study of the FTI in the context of pediatric oncology. In total, 22 couples were interviewed after participating in the FTI. The interviews were transcribed and analyzed using qualitative content analysis.

RESULTS

Parents described how maintaining a couple relationship while living with childhood cancer could be very challenging and was not given the highest priority. The FTI was considered a way of providing important support to the couple and a chance for them to sit down together and listen to each other's perspectives on the situation. Parents described that the FTI had helped them gain an increased mutual understanding, sometimes also helping them to realize that they needed more extensive professional support in their relationship.

CONCLUSIONS

Living with childhood cancer and upholding a healthy couple relationship is challenging for parents. The FTI has the potential to support couples, mainly by providing opportunities for parents to communicate with each other. However, some couples may be in need of a tailored clinical intervention.

'Like ships in the night': A qualitative investigation of the impact of childhood cancer on parents' emotional and sexual intimacy

BACKGROUND

Childhood cancer is highly distressing for families and can place strain on parents' relationships. Parental functioning and cohesiveness are important predictors of family functioning and adaptation to stress. This qualitative study investigated the perceived impact of childhood cancer on parents' relationship with their partner, with a focus on emotional and sexual intimacy.

METHODS

We conducted semi-structured interviews with 48 parents (42 mothers, six fathers) of children under the age of 18 who had completed curative cancer treatment. We analysed the interviews using thematic analysis.

RESULTS

At interview, parents were on average 40.7 years old (SD = 5.5, range: 29-55 years), and had a child who had completed cancer treatment between 3 months and 10.8 years previously (M = 22.1 months). All participants were living with their partner in a married/de facto relationship. Most parents reported that their child's cancer treatment had a negative impact on emotional and sexual intimacy with their partner, with some impacts extending to the post-treatment period. Reasons for compromised intimacy included exhaustion and physical constraints, having a shifted focus, and discord arising from different coping styles. Some parents reported that their relationship strengthened. Parents also discussed the impact of additional stressors unrelated to the child's cancer experience.

CONCLUSIONS

Parents reported that childhood cancer had a negative impact on aspects of emotional and sexual intimacy, although relationship strengthening was also evident. It is important to identify and offer support to couples who experience ongoing relationship stress, which may have adverse effects on family functioning and psychological wellbeing into survivorship.

Hilfreiche psychosoziale Unterstützung für Eltern in der pädiatrischen Onkologie

Hintergrund

Krebserkrankungen im Kindes- und Jugendalter haben Auswirkungen auf die gesamte Familie – auch für die betroffenen Eltern hinsichtlich psychischer Aspekte. Gegenwärtig existieren nur wenige Untersuchungen zu den Anforderungen an hilfreiche psychosoziale Unterstützungsangebote für Eltern.

Ziel der Arbeit

Zur Gewinnung weiterer Erkenntnisse für die psychosoziale Versorgung wurden Eigenschaften und inhaltliche Komponenten von hilfreichen psychosozialen Unterstützungsangeboten für Eltern mit an Krebs erkrankten Kindern untersucht.

Methodik

Im Rahmen einer qualitativen Studie wurden N = 15 Expert_innen verschiedener Disziplinen und Standorte aus Akut- und Rehakliniken sowie ambulant tätige Kolleg_innen eingeschlossen. Die Durchführung basierte auf einem teilstrukturierten Interviewleitfaden. Die Auswertung erfolgte anhand der qualitativen Inhaltsanalyse.

Ergebnisse

Grundsätzlich erachteten die eingeschlossenen Expert_innen niedrigschwellige und flexible Angebote als ideale psychosoziale Unterstützungsform. Hinsichtlich des optimalen Zeitpunkts zeigte sich hingegen ein heterogenes Bild. Inhaltlich wurden häufig die Förderung der Familienkohäsion, der Kommunikationsfähigkeiten sowie der Selbstfürsorge, aber auch Erziehungsthemen und angenehme gemeinsame Aktivitäten in der Gemeinschaft als essenziell angesehen.

Diskussion

Die psychosoziale Versorgung von Eltern mit an Krebs erkrankten Kindern ist herausfordernd, da die Langzeitverläufe individuell und dynamisch fluktuierend beschrieben werden. Eine Kombination aus verschiedenen Interventionsformaten (Präsenztermine vs. E‑Health-Module, Gruppen‑, Einzel- oder partnerschaftliche Sitzungen, strukturiert vs. themenoffen) scheint am praktikabelsten zu sein.

Researching the Experiences of Children with Cancer: Considerations for Practice

Children and adolescents with cancer often participate in medical and psychosocial research throughout their diagnosis and treatment. Furthermore, this involvement frequently extends into the survivorship period. Sometimes referred to as "doubly vulnerable" research participants, children and adolescents with cancer are not only minors, but also minors facing significant medical, developmental, and psychosocial stressors associated with chronic illness. Thus, it is important to exercise care in designing and conducting research with this population; however, these considerations have not been adequately addressed in pediatric healthcare literature. Therefore, the purpose of this review is to describe the research preferences and experiences of children and adolescents with cancer to identify techniques for supporting this population as research participants. By incorporating developmentally appropriate, context-specific, and child-centered adjustments, researchers can help children and adolescents with cancer effectively and meaningfully describe their illness experiences while also developing a positive outlook on future research participation.

Introduction to the special issue on child and family health: the role of behavioral medicine in understanding and optimizing child health

Health promotion during early life and childhood can reduce the prevalence and impact of acute and chronic health conditions later in life. Research regarding factors that influence child and family health, prevention, and intervention programs that address them, and policies that promote implementation of best practices are needed to efficiently and effectively address the multi-faceted, biopsychosocial influences on child health, especially among youth from underserved backgrounds. The current special issue dedicated to child and family health offers a series of articles that illustrate how explanatory studies and targeted intervention programs for children, families, health care providers, and communities can be used to improve child health. Articles in this special issue are organized into three areas related to child and family health: (i) diet and nutrition, (ii) cancer prevention and control, and (iii) social determinants of health and health care. The articles included in this special issue underscore that behavioral medicine practitioners, researchers, and policy makers are well poised to lead innovative efforts to promote child health across clinical, community, health care, and population settings.