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Skrabal Ross X, Konings S, Schiena E, Phipps-Nelson J, Wang Y, Hodgson F, Patterson P, McDonald FEJ. Piloting a new cross-sector model of care to support parents with cancer: feasibility and acceptability of the Parent Support Worker role. Support Care Cancer 2024; 32:435. [PMID: 38878200 PMCID: PMC11180003 DOI: 10.1007/s00520-024-08629-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/03/2024] [Indexed: 06/19/2024]
Abstract
PURPOSE A new Parent Support Worker (PSW) service was piloted in three Australian hospitals. This study assesses the feasibility and acceptability (including preliminary effectiveness) of the service in supporting cancer patients with children. METHODS A multi-site, mixed-methods study collected quantitative and qualitative data on the effectiveness of the service (pre post-test, n = 36), qualitative and quantitative data on acceptability of the service (survey, n = 43), and qualitative data on acceptability (semi-structured interviews, n = 13). Feasibility was assessed through rates of service uptake amongst referred parents. RESULTS Of 1133 parents referred, 810 (71%) accepted to receive the service, suggesting high interest in PSW support. Interviewees likewise reported that the service was accessible and facilitated further referrals, indicating good feasibility. Surveys completed three months after accessing PSW support showed high acceptability and satisfaction. Additionally, there was preliminary evidence of service impacts: parents' distress, parenting concerns, parenting efficacy, and stress about situations of concern improved significantly from pre- to post-service (all p < 0.005). Interviewees further described how their emotional coping and confidence to support and communicate with their children had improved through contact with the service. CONCLUSION The PSW service, integrated into a novel cross-sector model of care, showed to be feasible and acceptable to parent patients and their partners and improved psychological and parenting outcomes. The study suggests refinements to the service and the need for future larger studies to explore the effectiveness of the service in improving parents' outcomes. This study complements previous evidence on the implementation of the PSW service in hospitals.
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Affiliation(s)
- X Skrabal Ross
- Policy and Patient Department, Canteen Australia, Sydney, Australia
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Australia
| | - S Konings
- Psycho-Oncology Department, Clinique Saint-Jean, Brussels, Belgium
| | - E Schiena
- Department of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Phipps-Nelson
- Department of Oncology, Sir Peter MacCallum, University of Melbourne, Melbourne, Australia
- Office of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Y Wang
- Policy and Patient Department, Canteen Australia, Sydney, Australia
- Guangxi Minzu University, Nanning, China
| | - F Hodgson
- John Hunter Hospital, Newcastle, Australia
| | - P Patterson
- Policy and Patient Department, Canteen Australia, Sydney, Australia
| | - F E J McDonald
- Policy and Patient Department, Canteen Australia, Sydney, Australia.
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
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Skrabal Ross X, McDonald FEJ, Konings S, Schiena E, Phipps-Nelson J, Hodgson F, Patterson P. Cancer patients as parents: implementation of a cross sector service for families with adolescent and young adult children. BMC Health Serv Res 2023; 23:472. [PMID: 37165404 PMCID: PMC10173515 DOI: 10.1186/s12913-023-09413-8] [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: 01/30/2023] [Accepted: 04/18/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Cancer patients who are parents show concerns about their ability to parent following diagnosis, and their adolescent and young adult (AYA) children have a need for improved cancer communication within the family. However, psychosocial support for families affected by parental cancer is not routinely available. This study explores the implementation of the Parent Support Worker (PSW) role, as part of a new cross sector model of care to support parent patients, their partners, and AYA children. METHODS Two PSWs, social workers and healthcare staff (n = 26) from three hospitals participated in audio-recorded, semi-structured interviews about implementation of the PSW role. Template Analysis and Normalization Process Theory were used to analyze the interviews. Data on PSW service activity and referrals of AYA to support from a community organization were analyzed using descriptive statistics. RESULTS Eleven themes categorized into enablers and barriers of implementation were identified. Regarding acceptability of the role, three enablers (social workers' understanding of the PSW role increasing, easy and prompt access of staff and parent patients to PSWs, satisfaction with the PSW role) and one barrier (communication related confusion and frustration about the PSW role) were identified. Additionally, three enablers (the PSW role fills gaps in parenting-focused support and continuity of care, the PSW role alleviates social workers' workload, negotiation helped to define responsibilities) and one barrier (fear of social work roles to be overtaken by PSWs) for appropriateness of the role were found. Finally, two enablers of feasibility of the role (PSWs and social workers co-managing the work, higher confidence from hospital staff to talk about children in the family) and one barrier (lack of systematic identification and referral processes) were identified. Across hospitals, the number of referrals of AYA children to the community organization increased between 2.7 and 12 times nine months post-introduction of the service. CONCLUSIONS Established in response to identified gaps in oncology care for parents with cancer, their partners and AYA children, a novel cross-sector model of care was acceptable, appropriate, and feasible. Barriers and enablers to implementation identified in this study need to be considered when designing and implementing similar services.
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Affiliation(s)
- X Skrabal Ross
- Policy and Patient Department, Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia.
| | - F E J McDonald
- Policy and Patient Department, Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - S Konings
- Psycho-Oncology Department, Clinique Saint-Jean, Brussels, Belgium
| | - E Schiena
- Department of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Phipps-Nelson
- Department of Oncology, University of Melbourne, Melbourne, Australia
- Office of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - F Hodgson
- John Hunter Hospital, New Lambton Heights, Australia
| | - P Patterson
- Policy and Patient Department, Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Knutsson S, Golsäter M, Enskär K. The meaning of being a visiting child of a seriously ill parent receiving care at the ICU. Int J Qual Stud Health Well-being 2021; 16:1999884. [PMID: 34775932 PMCID: PMC8604516 DOI: 10.1080/17482631.2021.1999884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/25/2020] [Accepted: 10/26/2021] [Indexed: 10/30/2022] Open
Abstract
PURPOSE Children's visits to the ICU are still restricted, and more focus on the child's own needs and experiences are needed. The aim of this study is to illustrate the meaning of being a visiting child of a seriously ill parent receiving care at the ICU. METHOD A qualitative descriptive design was used, with open-ended interviews with seven children (6-18 years) performed and analysed using a phenomenological research approach. FINDINGS Being a visiting child of a seriously ill parent receiving care at the ICU is described as a life situation taking place in an unfamiliar environment, characterized by a heartfelt, genuine desire to be there, in an interdependence entailing offering a loved one the help they need while at the same time being seen in a compassionate way and being able to share, revealing a sudden awakening of an inner truth of reality and a sense of a healing wisdom of understanding. CONCLUSIONS The children felt good when they visited their ill parent, but at the same time not fully involved, and desired a more compassionate, caring approach by the nurses. Improvements are needed in how to approach visiting children in a more individual and caring way.
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Affiliation(s)
- Susanne Knutsson
- Child, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Marie Golsäter
- Child Health Services, Region Jönköping County, Jönköping, Sweden; and Department of Health, Medicine and Caring, Linköping University, Linköping, Sweden
| | - Karin Enskär
- Department of Women´s and Children´s health, Malmö University, Malmö, Sweden
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Golsäter M, Knutsson S, Enskär K. Children's experiences of information, advice and support from healthcare professionals when their parent has a cancer disease - experiences from an oncological outpatient department. Eur J Oncol Nurs 2021; 50:101893. [PMID: 33465701 DOI: 10.1016/j.ejon.2020.101893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/01/2020] [Accepted: 12/24/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE This study was carried out in order to evaluate children's experiences after taking part in the pilot clinical intervention "See Me" aimed at supporting children as relatives. METHOD A qualitative explorative design with interviews was chosen, with analyses using an inductive approach. Interviews were conducted with 19 children (9 aged 7-12 years and 10 aged 13-18 years). The younger children were asked to draw a picture of a person in hospital, using the Child Drawing: hospital (CD:H) instrument to measure the child's level of anxiety. The older children completed the Caring Professional Scale (CPS) as a measure of the caring approach in their encounter with the nurse. RESULTS The interviews with the children show that: they felt expected and welcomed at the hospital; they needed knowledge about their parent's situation; they needed information and participation based on their individual situation; and they needed the nurse to offer them information and support. The results from the pictures showed that one child had above-average levels of anxiety. The older children reported that the nurses were Competent Practitioners, but to a lesser degree that they were Compassionate Healers. CONCLUSIONS The results of this pilot study indicate that the structure of "See Me" could be used as a starting point to ensure that children as relatives receive information, advice, and support. Further the results indicate that both CD:H and CPS could be used to evaluated children's experiences of support when a parent has a long-term illness.
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Affiliation(s)
- Marie Golsäter
- CHILD, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden and Linköping University, Linköping, Sweden.
| | - Susanne Knutsson
- CHILD, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Karin Enskär
- CHILD, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Nukpezah RN, Khoshnavay Fomani F, Hasanpour M, Nasrabadi AN. A qualitative study of Ghanaian pediatric oncology nurses' care practice challenges. BMC Nurs 2021; 20:17. [PMID: 33435975 PMCID: PMC7802173 DOI: 10.1186/s12912-021-00538-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 01/04/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Pediatric cancer is a global problem, and some studies have emphasized that nurses caring for these children experience work-related challenges. This has caused many children diagnosed with cancer to have a prolonged hospital stay and suffer unnecessary pain. However, there is insufficient documentary evidence on this issue. This study aims to explore and understand the challenges faced by pediatric oncology nurses in caring for children in Ghana. METHODS An exploratory qualitative research design study was conducted from August 2019 to April 2020. The study was conducted at the pediatric oncology unit which is located at the Tamale Teaching Hospital (TTH), Ghana. The study was conducted among 14 Ghanaian pediatric oncology nurses who were purposively sampled. A semi-structured interview guide was used to collect data. The interviews were recorded, transcribed verbatim, and analyzed inductively using Elo and Kyngas content analysis approach. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study. RESULTS From the analysis of participants transcripts, eight subcategories emerged from two major categories. The subcategories were; time-consuming care, low job motivations, inadequate logistics, work stress, reduced labour force, low knowledge level, lack of teamwork and the perception of contracting cancer. CONCLUSIONS The results point to several organizational and personal constraints experienced by the nurses who work at the pediatric oncology ward. It is hoped that by addressing these challenges, it would lead to further improvement in the care that is provided to children with cancer. There is the need for the administrative managers of hospitals, government and other stakeholders to invest in human, material and financial resources for delivering childhood cancer care services.
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Affiliation(s)
- Ruth Nimota Nukpezah
- Department of Pediatric Nursing, School of Nursing and Midwifery, International Campus-Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Khoshnavay Fomani
- Department of Pediatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Hasanpour
- Department of Pediatric Nursing, NIDCAP Professional, Spiritual Health Branch of Research Center of the Quran; Hadith and Medicine, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Nikbakht Nasrabadi
- Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Nukpezah RN, Khoshnavay FF, Hasanpour M, Nasrabadi AN. Striving to reduce suffering: A Phenomenological Study of nurses experience in caring for children with cancer in Ghana. Nurs Open 2021; 8:473-481. [PMID: 33318855 PMCID: PMC7729530 DOI: 10.1002/nop2.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/26/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022] Open
Abstract
Aim To provide insights into nurses lived experiences in caring for children with cancer. Background Little is known about the paediatric oncology nurses shared practices of caring for children with cancer in Ghana. Design A hermeneutic phenomenological qualitative study. Methods A semi-structured interview with 14 purposely sampled Ghanaian paediatric oncology nurses. Findings were analysed using Diekelman, Allen and Tanner's approach. Results The theme "Striving to reduce suffering" and three relational subthemes: "knowing children's needs," "Rendering a hopeful fight" and "Ensuring continuity and coordination of care" emerged. Increased awareness of this phenomenon for the nurses who care for these children is vital to ensure quality and holistic care that is meaningful and satisfying by nurses for children with cancer. Paediatric oncology nurses can use the result of the study to evaluate their caring practice and as an avenue to develop better caring practice.
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Affiliation(s)
- Ruth Nimota Nukpezah
- Department of Pediatric NursingSchool of Nursing and MidwiferyInternational campus‐Tehran University of Medical SciencesTehranIran
| | - Fatemeh Fomani Khoshnavay
- Department of Pediatric NursingSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Marzieh Hasanpour
- Department of Pediatric NursingNIDCAP ProfessionalSpiritual Health Branch of Rresearch Center of the Quran; Hadith and MedicineSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Alireza Nikbakht Nasrabadi
- Department of Medical and Surgical NursingSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
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