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Heier L, Weiß J, Heuser C, Nakata H, Brock-Midding E, Horbach-Bremen R, Brümmendorf TH, Brüne M, Dohmen M, Drueke B, Geiser F, Holsteg S, Icks A, Karger A, Panse J, Petermann-Meyer A, Viehmann A, Ernstmann N. Communication patterns in families affected by parental cancer from the healthy parents' perspective-process evaluation of the complex intervention Family-SCOUT. Support Care Cancer 2024; 32:500. [PMID: 38985388 DOI: 10.1007/s00520-024-08705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 07/01/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE Within families affected by parental cancer, open communication impacts the well-being of parents and their children; however, limited research exists on communication patterns in these families. This sub-study addresses this through the Family-SCOUT study, a multicenter, prospective, interventional, and non-randomized investigation with intervention (IG) and control group (CG). The purpose of this sub-study was to identify and compare the differences in communication patterns between the IG and CG as part of the process evaluation. The research question was addressed in both groups: What communication patterns do healthy parents perceive within their families? METHODS Using a qualitative approach, the study involved interviewing healthy parents as surrogates for their families. The interviews were audio-recorded, transcribed, and coded using a template analysis. The resulting data were analyzed at the group level. RESULTS Twenty-three interviews were conducted in the IG and 27 interviews in the CG. The analysis of themes centered on communication patterns as seen in the family structure. Both groups exhibited instances of open communication about fears and wishes as well as the use of child-friendly language when discussing cancer. Notable differences were observed: challenges in open communication with children were sorely reported in CG interviews, and "the illness is discussed when necessary" was sorely described in IG interviews. CONCLUSION This study underscores the need to address and encourage open communication within families with parental cancer.
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Affiliation(s)
- L Heier
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany.
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany.
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, The Netherlands.
- Department of Clinical Pharmacy, Cardiovascular Research Institute Maastricht, CARIM, Maastricht University, Maastricht, The Netherlands.
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair of Health Services Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - J Weiß
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
| | - C Heuser
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair of Health Services Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - H Nakata
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
| | - E Brock-Midding
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
| | - R Horbach-Bremen
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - T H Brümmendorf
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - M Brüne
- Center for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - M Dohmen
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - B Drueke
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Institute for Medical Psychology and Medical Sociology, Faculty of Medicine and University Hospital, RWTH Aachen University, Aachen, Germany
| | - F Geiser
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University Bonn, Bonn, Germany
| | - S Holsteg
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - A Icks
- Center for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Munich-Neuherberg, Germany
| | - A Karger
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - J Panse
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - A Petermann-Meyer
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - A Viehmann
- Center for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - N Ernstmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair of Health Services Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Yanai M, Aoyama M, Kosugi K, Tsumura A, Nakanishi E, Miyashita M. Reliability and validity of the Japanese version of the Parenting Concerns Questionnaire. Jpn J Clin Oncol 2024; 54:797-804. [PMID: 38600749 DOI: 10.1093/jjco/hyae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE Cancer patients with children are increasing; however, few studies have quantitatively assessed the parenting concerns of cancer patients with children. The Parenting Concerns Questionnaire was developed in the USA in 2012 and is the only instrument to measure the parenting concerns of cancer patients with children. This study aimed to develop a Japanese version of the Parenting Concerns Questionnaire and evaluate its reliability and validity. METHODS An Internet survey was conducted among cancer patients registered with 'Cancer Parents', an Internet community site for cancer patients, who have children aged <18 years, and 174 responses were recorded. Two weeks later, a retest was conducted, and responses were obtained from 87 patients. RESULTS Based on confirmatory factor analysis of the factor structure proposed by the authors of the original version, factors 'I. The impact of my illness on the child's daily life (five items)', 'II. The impact of my illness on the child's feelings (five items)' and 'III. Concerns about my parenting partner (five items)' were consistent with the original version. Cronbach's alpha coefficients for all items and by factors were 0.86, 0.79, 0.86 and 0.86. The Parenting Concerns Questionnaire total scores correlated with Hospital Anxiety and Depression Scale (r = 0.52), the Functional Assessment of Cancer Therapy General (r = -0.56), Family Assessment Device-General Functioning (r = 0.51) and Multidimensional Scale of Perceived Social Support (r = -0.47). The intraclass correlation coefficients for all items and by factors were 0.81, 0.71, 0.77 and 0.85. CONCLUSIONS The Japanese version of the Parenting Concerns Questionnaire has satisfactory reliability and validity.
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Affiliation(s)
- Misa Yanai
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Maho Aoyama
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akemi Tsumura
- Yokohama Children's Hospice Project, Yokohama, Japan
| | - Erika Nakanishi
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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Costa-Requena G, Richart-Aznar P, Segura-Huerta Á. Cancer worry at higher-risk sample of hereditary cancer in Spain. Eur J Cancer Prev 2024; 33:293-298. [PMID: 37997907 DOI: 10.1097/cej.0000000000000862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Few studies have examined the prevalence of cancer worry in the general and at-risk population. The objective of this study was to describe the prevalence of cancer worry in a sample of individuals at increased risk of developing hereditary cancer, determine differences in cancer worry by socio-demographic characteristics and assess the relationship between cancer worry and psychological distress. METHODS A cross-sectional study was designed with 895 patients. The Cancer Worry Scale (CWS), Hospital Anxiety and Depression Scale (HADS) for psychological distress and sociodemographic characteristics were examined. The multiple linear regression model was developed to explore what variables were predicted for cancer worry. To identify variables associated with higher cancer worry scores, a logistic model was fitted. RESULTS In the at-higher-risk sample of hereditary cancer, the mean of CWS was 10.20 (SD: 3.70). The significant predictors for cancer worry were gender, age, previous psychiatric treatment, patients affected by cancer and having children. In the sample, 38% of patients had higher scores on cancer worry, the variables associated were patients affected by cancer compared, women, widow/divorced participants, less than secondary school, patients with previous psychiatric treatment and patients less than 55 years old. Using the HADS cutoff score 29% of the sample showed significant psychological distress, more anxiety (35%) than depressive (22%) symptomatology. Psychological distress showed a higher variability (36%) on cancer worry. CONCLUSION Findings highlighted distinctive profiles in socio-demographic characteristics according to the degree of cancer worry; therefore, genetic counseling should continue to be provided to address cancer worry and relieve psychological distress.
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Affiliation(s)
- Gema Costa-Requena
- Department of Psychiatry and Clinical Psychology, Hospital Universitari i Politècnic La Fe
- Genetic Counselling Unit for Hereditary Cancer, Department of Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Paula Richart-Aznar
- Genetic Counselling Unit for Hereditary Cancer, Department of Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ángel Segura-Huerta
- Genetic Counselling Unit for Hereditary Cancer, Department of Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Romare Strandh M, Enebrink P, Stålberg K, Sörensdotter R, Ljungman L, Wikman A. Parenting under pressure: a cross-sectional questionnaire study of psychological distress, parenting concerns, self-efficacy, and emotion regulation in parents with cancer. Acta Oncol 2024; 63:468-476. [PMID: 38910314 DOI: 10.2340/1651-226x.2024.40404] [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: 03/22/2024] [Accepted: 05/31/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND AND PURPOSE As many as one in four adults with cancer have children under 18 years. Balancing parenting and cancer is challenging and can be a source of psychological distress. This study aimed to examine psychological distress in parents with cancer and its associations with parenting concerns, self-efficacy, and emotion regulation. MATERIALS AND METHODS This was a cross-sectional questionnaire study of 406 parents (aged 25-60 years) diagnosed with cancer within the last 5 years, with at least one dependent child (≤ 18 years). Parents completed questionnaires on psychological distress (DASS-21), parenting concerns (PCQ), self-efficacy (GSE), emotion regulation (ERQ), mental and physical health, and sociodemographics. Data were analysed using multiple logistic regressions on depression (yes/no), anxiety (yes/no), and stress (yes/no). RESULTS Higher parenting concerns were associated with greater odds of depression (OR = 2.33, 95% CI: 1.64-3.31), anxiety (OR = 2.30, 95% CI: 1.64-3.20), and stress (OR = 3.21, 95% CI: 2.20-4.69) when adjusting for health and sociodemographic factors. Poorer self-efficacy was associated with increased odds of anxiety (OR = 0.94, 95% CI: 0.89-0.99, p < 0.05), whereas lower use of cognitive reappraisal and higher use of expressive suppression increased the odds of depression (OR = 0.76, 95% CI: 0.59-0.98 | OR = 1.46, 95% CI: 1.18-1.80). INTERPRETATION The findings highlight the complexity of parental well-being in relation to parenthood and cancer, stressing the need for interventions that address relevant psychological factors to improve overall mental health in this population.
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Affiliation(s)
- Maria Romare Strandh
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER), Uppsala University, Uppsala, Sweden.
| | - Pia Enebrink
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Karin Stålberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Lisa Ljungman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anna Wikman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER), Uppsala University, Uppsala, Sweden
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5
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Lysecki DL, Bainbridge D, Akitt T, Georgiou G, McKean H, Meyer RM, Sussman J. Integration of child life into adult oncology: A mixed-methods feasibility study. Psychooncology 2024; 33:e6365. [PMID: 38898595 DOI: 10.1002/pon.6365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 05/13/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Cancer in a loved one can have negative effects on child health and development. Child Life Specialists (CLSs) specialize in assisting children understand and cope with difficult medical scenarios but are generally not available in adult care facilities to support the needs of patient-families with minor children. We conducted a mixed-methods study of the implementation of a pilot CLS program at a tertiary oncology centre. METHODS We collected administrative and clinical data on referred families; encounter data; and patient-reported questionnaire data before and 2 months after engagement with the program. RESULTS Over the initial 10 months, 98 families were referred, 91 of whom engaged through a total of 257 clinical encounters. The cancer patient in the family was most commonly a woman with a mean age of 45 years and in the role of mother. Breast cancer was the most common diagnosis (24%) and 78% of patients had stage IV disease. Most families had >1 child at home, and children were most commonly school-aged (5-14y). Phone and Hospital/Clinic visits accounted for the largest portion of CLS time. Interventions ranged from diagnosis education through to bereavement support. Most cancer patients indicated that the program was helpful to them and their families. There were trends of moderate improvements on patient reported outcomes. CONCLUSION Our study was able to provide an understanding of the initial CLS program operations to guide program development and future study. Such a program holds promise as an important aspect of adult oncology family-centered care.
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Affiliation(s)
- David L Lysecki
- McMaster University, Hamilton, Ontario, Canada
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Daryl Bainbridge
- McMaster University, Hamilton, Ontario, Canada
- Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Tracy Akitt
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Georgia Georgiou
- Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Heather McKean
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Ralph M Meyer
- McMaster University, Hamilton, Ontario, Canada
- Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Jonathan Sussman
- McMaster University, Hamilton, Ontario, Canada
- Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
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6
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Li JL, Ye Q, Liu N. Cancer parents' experiences of parenting concerns about minor children: A meta-synthesis of qualitative studies. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 6:100210. [PMID: 38872959 PMCID: PMC11169080 DOI: 10.1016/j.ijnsa.2024.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/08/2024] [Accepted: 05/21/2024] [Indexed: 06/15/2024] Open
Abstract
Background Some cancer patients not only endure physical and mental distress due to the disease and treatment but also shoulder the responsibility of raising their children. This situation significantly impacts the patients' quality of life. While there is a growing body of qualitative research focusing on parenting concerns among cancer patients, there remains a lack of comprehensive qualitative evidence. Objective This study aims to conduct a systematic review and synthesis of qualitative research evidence, investigating the experiences of cancer patients in raising minor children. Design Systematic review and synthesis of qualitative studies. Settings Through a screening process employing inclusion/exclusion criteria, qualitative studies specifically addressing cancer patients raising minor children were identified. Participants Participants: A total of 669 participants from 40 studies were included in the review. Methods Four English (Pubmed, Web of Science, Embase and Cochrane Library) and three Chinese (CNKI, Wanfang and Sinomed) databases were searched for qualitative studies of the real-life experiences of raising children in cancer patients from the establishment of the library to January 2024. The methodological quality of the included literature was assessed using the Critical Appraisal Skill Program (CSAP). Qualitative data were extracted, summarized, and meta-synthesized. Results A total of 26 studies were included in this meta-synthesis, encompassing 11 different countries. 160 themes were extracted from these included literatures, which were combined into ten categories, ultimately forming four themes: the impact of parents' disease on their children, the challenges of parenting, coping strategies, and multifaceted parenting needs. Based on the Confidence in the Output of Qualitative research synthesis (ConQual) approach, the confidence level of the synthesized findings ranged from moderate to low. Conclusions Cancer patients experience significant psychological stress while raising children, which can lead to a reduction in their quality of life and influence treatment decisions. These findings elucidate the parenting concerns experienced by cancer patients, allowing medical staff to understand their emotions and treatment preferences. Additionally, healthcare professionals should pay attention to the special needs of this group and develop targeted interventions to support and reduce patients' psychological stress and burden.
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Affiliation(s)
- Jing-Ling Li
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Qin Ye
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Ning Liu
- Department of Basic Teaching and Research in General Medicine, Department of Fundamentals, Zhuhai Campus of Zunyi Medical University, Guangdong, China
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Le Fel J, Fyot P, Thery JC, Thery C. [Multidisciplinary support in cancer care: Pair working physician/psychologist in the support of children of affected parents by cancer]. Bull Cancer 2024:S0007-4551(24)00188-7. [PMID: 38821774 DOI: 10.1016/j.bulcan.2024.04.013] [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: 02/08/2024] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 06/02/2024]
Abstract
Supporting children of affected parents by cancer is challenging whether for patients, families and healthcare teams. Several care methods have been developed to support these children (e.g. individual psychological support, support group). However, professionals may feel uncomfortable with their own theoretical and practical limits. Thus, pair working physician/psychologist can make sense in order to melt the different expertise and to provide advices, open discussion and remediation in the family behaviors and feelings. The aim is to help parents communicate with their children about the disease in order to respond appropriately to the child's needs and questions. Our study is observational, around five clinical situations. We deal with parental psychological function, family communication, marital function, and parent-child relationship… Most of the time, children of cancer patients live a stressful experience with major psycho-emotional impact. Inappropriate coping mechanism can be subjected to misperception and lack of interaction with their parents. The question often expressed is the balance between telling the truth and protecting children. However, studies have reported positive effects of interventions around children needs. Thus, the doctor-psychologist pair allows for adaptability of responses to family functioning, children and parents, and thus ensures holistic support for the patient with cancer.
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Affiliation(s)
- Johan Le Fel
- Département des soins de support, centre de lutte contre le cancer Henri-Becquerel, rue d'Amiens, 76038 Rouen, France.
| | - Pauline Fyot
- Service de pneumologie, CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - Jean-Christophe Thery
- Département des soins de support, centre de lutte contre le cancer Henri-Becquerel, rue d'Amiens, 76038 Rouen, France
| | - Cathy Thery
- Département des soins de support, centre de lutte contre le cancer Henri-Becquerel, rue d'Amiens, 76038 Rouen, France
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Kim KW, Lopresti M, Graff SL, Witherby S, Dizon DS, Fenton MA. Fulfilling the Role of a Parent While Undergoing Treatment for Cancer: A Review of the Literature and the Potential Impact of Childcare Support on Cancer Outcomes. Am J Clin Oncol 2024:00000421-990000000-00188. [PMID: 38651681 DOI: 10.1097/coc.0000000000001102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Breast cancer is the most prevalent malignancy among adolescents and young adults (AYAs). Despite the efficacy of chemotherapy, AYA patients contend with psychosocial challenges, including psychological distress and financial toxicity, exacerbated further by those with dependent children. Parenting responsibilities intersect with cancer care, impacting both family dynamics and treatment adherence. Despite recognized needs, however, the impact of parenting concerns or even parenting status and the presence of dependents has not been systematically addressed and there is a paucity of interventional research regarding patients with cancer as concomitant caregivers. A feasibility study conducted by the Brown University Oncology Cooperative Group demonstrated the potential benefits of providing financial assistance for childcare, both improving treatment adherence and reducing distress among participants. Similar interventions have shown promise in addressing financial hardships for AYA patients with cancer who are concomitant caregivers. Ultimately, parenting concerns have a significant impact on medical decision-making, and further interventional research on childcare support is required to examine the ways in which health systems can improve family stability, stress, and quality of life.
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Affiliation(s)
- Kang Woo Kim
- Department of Medicine, Warren Alpert Medical School, Brown University
| | - Mary Lopresti
- Department of Medicine, Lifespan Cancer Institute, Rhode Island Hospital and Legorreta Cancer Center at Brown University, Providence, RI
| | - Stephanie L Graff
- Department of Medicine, Lifespan Cancer Institute, Rhode Island Hospital and Legorreta Cancer Center at Brown University, Providence, RI
| | - Sabrina Witherby
- Department of Medicine, Lifespan Cancer Institute, Rhode Island Hospital and Legorreta Cancer Center at Brown University, Providence, RI
| | - Don S Dizon
- Department of Medicine, Lifespan Cancer Institute, Rhode Island Hospital and Legorreta Cancer Center at Brown University, Providence, RI
| | - Mary Anne Fenton
- Department of Medicine, Lifespan Cancer Institute, Rhode Island Hospital and Legorreta Cancer Center at Brown University, Providence, RI
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9
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Kuswanto CN, Stafford L, Schofield P, Sharp J. Self-compassion and parenting efficacy among mothers who are breast cancer survivors: Implications for psychological distress. J Health Psychol 2024; 29:425-437. [PMID: 38262920 PMCID: PMC11005311 DOI: 10.1177/13591053231222162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
Mothers who are breast cancer survivors may experience psychological distress in relation to diminished parenting efficacy. Self-compassion may protect mothers from psychological distress, yet little is known about self-compassion in this population. The extent to which self-warmth (self-kindness, mindfulness and sense of common humanity) and self-coldness (self-judgement, isolation and over-identification) dimensions of self-compassion moderate parenting efficacy in predicting depression, anxiety and stress was examined in a sample of 95 mothers who were breast cancer survivors. Independently, poorer parenting efficacy was associated with more depression and stress symptoms. Within regression models, self-coldness was a direct predictor of depression, anxiety and stress, while self-warmth moderated the relationship between parenting efficacy and stress. Self-warmth presents as a potential protective factor for stress associated with poor parenting efficacy, while self-coldness is a potential direct risk factor for psychological distress. Mothers who are breast cancer survivors may benefit from self-compassion focused psychosocial interventions.
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Affiliation(s)
| | | | - Penelope Schofield
- Swinburne University of Technology, Australia
- University of Melbourne, Australia
- Peter MacCallum Cancer Centre, Australia
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10
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Ann-Yi S, Milbury K, Jones M, Necroto V, Whisenant M, Li Y, Bruera E. Supportive Care for Dual Caregivers who Care for Their Partner With Cancer and Their Young Children. J Pain Symptom Manage 2023; 66:e603-e609. [PMID: 37482225 DOI: 10.1016/j.jpainsymman.2023.07.012] [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] [Received: 04/10/2023] [Revised: 06/23/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE Advanced cancer patients and their spouses who parent minor children report parenting concerns and increased psychological distress. This single-arm trial examined the feasibility and initial evidence for efficacy of a novel parent support program. METHODS Patients with a metastatic solid malignancy and their spouses completed self-reported assessments of psychological distress (HADS), parenting concerns (PCQ) and efficacy (CaPSE) at baseline. Both patients and spouses jointly attended the first two sessions addressing illness communication and family routines. Spouses individually attended two additional sessions focusing on caregiver support and death preparedness. All four sessions were delivered via videoconference by a licensed psychological counselor. Dyads completed program evaluations and were reassessed six and 12 weeks postintervention. RESULTS With a consent rate of 61%, 10 patients (50% female; 90% non-Hispanic White; mean age = 42 years) and their spouses (50% female; 70% non-Hispanic White; mean age = 42 years) completed the assessments. All patients and 90% of spouses attended all intervention sessions and evaluated the program favorably. Paired t-tests revealed significant improvements in patients' parenting concerns at the six weeks (P = 0.003) and parenting efficacy at the six weeks (P = 0.03) and 12 weeks (P = 0.03) follow-ups. For spouses, we found significant improvements in parenting efficacy (P < 0.001) and depressive symptoms (P = 0.04) at six weeks and parenting concerns at both six weeks (P = 0.006) and 12 weeks (P = 0.001) follow-ups. CONCLUSIONS The initial testing of our parenting intervention yielded promising results regarding feasibility and an initial signal of intervention efficacy. Thus, a randomized controlled trial for further testing is warranted.
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Affiliation(s)
- Sujin Ann-Yi
- Department of Palliative (S.A-Y., E.B.), Rehabilitation & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kathrin Milbury
- Department of Behavioral Science (K.M., M.J., V.N., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Morgan Jones
- Department of Behavioral Science (K.M., M.J., V.N., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Victoria Necroto
- Department of Behavioral Science (K.M., M.J., V.N., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Meagan Whisenant
- Department of Behavioral Science (K.M., M.J., V.N., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yisheng Li
- Department of Biostatistics (Y.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative (S.A-Y., E.B.), Rehabilitation & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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11
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Romare Strandh M, Hovén E, Sörensdotter R, Stålberg K, Enebrink P, Ljungman L, Wikman A. Psychosocial interventions targeting parenting distress among parents with cancer - A systematic review and narrative synthesis of available interventions. Crit Rev Oncol Hematol 2023; 191:104119. [PMID: 37683815 DOI: 10.1016/j.critrevonc.2023.104119] [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: 06/22/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Balancing having cancer and parenting a major stressor, and may result in parenting distress, negatively affecting the whole family. To provide adequate support, knowledge of existing psychosocial interventions are crucial to guide future interventions. This study aimed to describe available psychosocial interventions for parents with cancer and dependent children (<18 years). METHOD We conducted a systematic review, and four databases were searched from January 2000 to March 2023. RESULTS Thirty studies were included, reporting on 22 psychosocial interventions for parents with cancer. They aimed to improve different aspects of parenting distress, and included psychoeducation and communication strategies. Interventions were beneficial to and acceptable among parents, but only a few had been evaluated. The study quality was, overall, assessed as moderate. CONCLUSIONS The results of this review highlight the diversity of available psychosocial interventions for parents with cancer and the outcomes on parenting distress, as well as methodological challenges.
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Affiliation(s)
- Maria Romare Strandh
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER), Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden.
| | - Emma Hovén
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
| | - Renita Sörensdotter
- Centre for Gender Research, Uppsala University, Engelska parken, Humanistiskt centrum, Thunbergsvägen 3G, Box 527, SE-751 20 Uppsala, Sweden
| | - Karin Stålberg
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
| | - Pia Enebrink
- Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A 5th floor, SE-171 77 Stockholm, Sweden
| | - Lisa Ljungman
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
| | - Anna Wikman
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER), Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
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12
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Kogan LR, Currin-McCulloch J, Cook LS. Breast cancer treatment and recovery: pets' roles as emotional buffers and stressors. BMC Womens Health 2023; 23:540. [PMID: 37848911 PMCID: PMC10583337 DOI: 10.1186/s12905-023-02662-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Research suggests pets foster affection, connection, and physical activity, yet has failed to address the challenges people diagnosed with cancer face in caring for their pets. The objective of this study was to better understand how pets serve as emotional buffers and/or stressors for people diagnosed with breast cancer, and how their ability to meet their pet's needs affects their well-being. METHODS A cross-section study of people diagnosed with breast cancer in the United States was conducted. Adults diagnosed with stages 0 (in situ) -IV breast cancer and currently the primary guardian of at least one dog or cat and owned the animal(s) for at least 6 months, were recruited for the study. A total of 211 responses, obtained between July - November 2022 were analyzed. The survey included questions about participants' demographics; attachment to their pets; physical, emotional, and functional well-being; social support received from their pet; and 'pet parenting' concerns. Descriptive statistics were calculated to describe participants' demographics. Multiple regression analyses were conducted to determine predictors of pet attachment, well-being, support from pet, and 'pet parenting' concerns. RESULTS People diagnosed with breast cancer derive substantial support from their pets (80% feel their pet makes them feel loved, needed, and offers a positive presence in the home), yet only 50% of participants feel this relationship is supported by their medical team. Controlling for owner demographics, heightened levels of pet-related guilt and concerns, along with lower perceived support from their pet, are all significant predictors of a lower quality of life. CONCLUSIONS Findings highlight the benefits pets offer people diagnosed with breast cancer, yet also the distress they feel in trying to meet their pet's needs. Assessment conversations about pet ownership, including pet-related support systems, are needed to validate people's concerns and support the identification and development of pet support teams. Medical team facilitated discussions about pet care needs is suggested to demonstrate support for the pet-parent bond and help normalize feelings of guilt related to challenges in meeting their pet's needs. These discussions could be aided through the development of research-driven intervention strategies and online, freely accessible targeted tools.
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Affiliation(s)
- Lori R Kogan
- Clinical Sciences Department, Colorado State University, 1680 Campus Delivery, Fort Collins, CO, 80523, USA.
| | - Jennifer Currin-McCulloch
- School of Social Work, Colorado State University, 1586 Campus Delivery, Fort Collins, CO, 80523, USA
| | - Linda S Cook
- Colorado School of Public Health, CU Anschutz Medical Campus, Building 500, 13001 East 17Th Place, B119, Aurora, CO, 80045-2601, USA
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13
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Romare Strandh M, Hovén E, Sörensdotter R, Stålberg K, Enebrink P, Ljungman L, Wikman A. The Complexity of Being a Parent in the Hospital and a Patient at Home: A Qualitative Study on Parenting Concerns and Challenges Among Parents With Cancer. Cancer Nurs 2023:00002820-990000000-00168. [PMID: 37731179 DOI: 10.1097/ncc.0000000000001276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
BACKGROUND Parents given a diagnosis of cancer must balance the demands of their illness and caregiving responsibilities. This can result in parental stress and have a negative impact on the well-being of the whole family. A greater understanding of the experiences of parents with cancer is necessary to provide adequate support. OBJECTIVE The aim of this study was to explore parenting concerns and challenges among parents with cancer who were caring for dependent children younger than 18 years. METHODS Semistructured interviews were carried out with 22 parents with cancer. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. RESULTS Parental concerns and challenges affected parents in their parental role and their everyday family life. Three overarching themes described the struggles in balancing life as a parent and as a patient: navigating dual roles as a parent with cancer, impact of cancer on parenting, and impact on family life. Parents' primary focus was on their children's well-being, and they struggled to manage their own expectations of parenting and the demands on their role in the family. CONCLUSION The results highlight the complexity of being a parent with cancer while caring for dependent children. To support parents during the cancer journey, it is important to understand the consequences of their illness on their parental role and the family. IMPLICATIONS FOR PRACTICE Supporting parents to feel secure in their parental role and providing support to them during their cancer journey should be integrated into routine cancer care, where parenting concerns and challenges are addressed.
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Affiliation(s)
- Maria Romare Strandh
- Author Affiliations: Department of Women's and Children's Health (Ms Romare Strandh, and Drs Hovén, Stålberg, Ljungman, and Wikman), Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER) (Ms Romare Strandh and Dr Wikman), and Centre for Gender Research (Dr Sörensdotter), Uppsala University; and Department of Clinical Neuroscience, Karolinska Institutet (Dr Enebrink), Stockholm, Sweden
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14
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Søby AKH, Moos CM, Andersen AH, Ravn SL, Andersen CM, Roessler KK. Adolescents' needs for information and psychosocial support during their mother's breast cancer trajectory: A systematic review. Psychooncology 2023; 32:1163-1172. [PMID: 37271880 DOI: 10.1002/pon.6172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/28/2023] [Accepted: 05/12/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Breast cancer is the most common cancer diagnosis among women. The acute crisis and uncertainty that often follow diagnosis put the family at risk of exhaustion and dysfunction. Adolescents have been identified as a particularly vulnerable group of relatives. To investigate how to prevent distress in this group, we systematically reviewed research on adolescents' (11-21 years) needs for information and psycho-social support during their mothers' breast cancer trajectory. METHOD Systematic searches were conducted in five bibliometric databases. Peer-reviewed, original research of adolescents aged 11-21 with a mother diagnosed with breast cancer was included. Two researchers conducted screening, quality assessment, and data extraction independently. Thematic synthesis was applied to the included studies. RESULTS A total of 8066 studies were screened, and five quantitative and six qualitative studies were included. The results indicated that adolescents' information and psycho-social support needs were poorly met. Many were reluctant to share feelings with family and peers and experienced abandonment during the crisis. Adolescents who were not well informed experienced distress. Poor family functioning increased the level of adolescents' distress. CONCLUSIONS Despite limitations regarding heterogeneity among the studies, eligibility criteria, and quality assessment, this review provides clear clinical implications. Encounter groups may support adolescents during their mother's breast cancer trajectory. Furthermore, healthcare professionals could provide more indirect support to adolescents by providing support and clearer guidelines to parents. Finally, adolescents from poor-functioning families need extra attention.
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Affiliation(s)
| | - Caroline M Moos
- Department of Clinical Research, Hospital Sønderjylland, Aabenraa, Denmark
| | | | - Sophie Lykkegaard Ravn
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Specialized Hospital for Polio and Accident Victims, Rødovre, Denmark
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15
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Whisenant M, Jones M, Ann-Yi S, Necroto V, Skrljac A, Bruera E, Milbury K. Living With an Advanced Cancer While Parenting Minor Children: A Needs Assessment Study. J Pain Symptom Manage 2023; 66:160-167.e3. [PMID: 37148983 DOI: 10.1016/j.jpainsymman.2023.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/21/2023] [Accepted: 04/30/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Evidence-based interventions addressing the needs of couples co-parenting young children while facing an advanced cancer diagnosis are lacking. Thus, this study seeks to identify parenting-related intervention needs and delivery preferences of advanced cancer patients and their spouses/co-parents. METHODS Twenty-one couples completed quantitative measures of cancer-related parenting concerns, relationship and family functioning, and service needs along with individual semi-structured interviews. RESULTS Patients (mean age=44 years, 48% female, 91% White) and spouses (mean age=45 years, 52% female, 91% White) reported family distress (62% of couples) and marital distress (29% of couples). Parenting concerns were generally high with patients revealing concerns particularly regarding the practical impact of the cancer on the child(ren). Spouses rated concerns about the co-parent significantly higher (P<.001) than patients. Parenting concerns were inversely associated with relationship (P<.001 for patients; P=.03 for spouses) and family functioning (P<.001 for patients). Themes identified through qualitative interviews include needs related to maintenance of family routines and traditions, childcare, transportation, meals, home maintenance, and finances. Couples who endorsed marital distress also indicated a need for conflict resolution skills. All patients and 89% of spouses would like to receive parenting-related education/services; up to 50% of couples preferred targeted, self-led readings without therapist support; and up to 50% desired counseling sessions indicating a preference towards dyadic and video conferenced intervention delivery. CONCLUSIONS The delivery of optimal supportive care involves a family-focused perspective such as screening for parenting status and referrals to social work services to address the need of tangible resources and manage parenting-related distress.
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Affiliation(s)
- Meagan Whisenant
- Department of Behavioral Science (M.J., V.N., K.M.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Morgan Jones
- Department of Behavioral Science (M.J., V.N., K.M.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sujin Ann-Yi
- Department of Palliative, Rehabilitation & Integrative Medicine (S.A.-Y., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Victoria Necroto
- Department of Behavioral Science (M.J., V.N., K.M.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ashley Skrljac
- Department of Research (M.W., A.S.), The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation & Integrative Medicine (S.A.-Y., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kathrin Milbury
- Department of Behavioral Science (M.J., V.N., K.M.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
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16
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Fugmann D, Richter P, Karger A, Ernstmann N, Hönig K, Bergelt C, Faller H, Maatouk I, Hornemann B, Stein B, Teufel M, Goerling U, Erim Y, Geiser F, Albus C, Senf B, Wickert M, Weis J. Caring for dependent children impacts practical and emotional problems and need for support, but not perceived distress among cancer patients. Psychooncology 2023; 32:1231-1239. [PMID: 37277899 DOI: 10.1002/pon.6173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/26/2023] [Accepted: 05/14/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE More than one in 10 cancer patients care for dependent children. It is unclear whether this status makes a difference in terms of the distress and associated problems they experience, or whether it is linked to differences in the need for or utilization of psychosocial support. METHODS Secondary analysis of a cross-sectional German study in National Comprehensive Cancer Centers using self-report standardized questionnaires administered to inpatients. Patients living with dependent children (n = 161) were matched by age and sex with a subsample of 161 cancer patients not living with dependent children. The resulting sample was tested for between-group differences in Distress Thermometer (DT) scores and the corresponding DT Problem List. Additionally, between-group differences in measures of the need for and utilization of psychosocial support were examined. RESULTS More than 50% of all patients suffered from clinically relevant distress. Patients living with dependent children reported significantly more practical (p < 0.001, η2 p = 0.04), family (p < 0.001, η2 p = 0.03), and emotional problems (p < 0.001, η2 p = 0.01). Although reporting a greater need for psychological support, parents with cancer were not found to more frequently utilize any type of psychosocial support. CONCLUSIONS The specific problems and needs of parents with cancer who care for dependent children are currently not sufficiently addressed in the clinical care pathways. All families should be helped to establish open and honest communication as well as understand the available support systems and what they can provide. Tailored interventions should be implemented for highly distressed families.
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Affiliation(s)
- Dominik Fugmann
- Medical Faculty, Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Peter Richter
- Medical Faculty, Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - André Karger
- Medical Faculty, Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nicole Ernstmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research (CHSR), University Hospital Bonn, Bonn, Germany
| | - Klaus Hönig
- Ulm University Clinic Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, Greifswald Medical School, Greifswald, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Imad Maatouk
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Beate Hornemann
- Comprehensive Cancer Center, University Clinic Center Dresden, Dresden, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Essen (WTZ) and LVR Hospital, University of Duisburg-Essen, Essen, Germany
| | - Ute Goerling
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität and Berlin Institute of Health, Berlin, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine, University Clinic Center Erlangen, Erlangen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine, University Clinic Center Bonn, Bonn, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine & Center Psychooncology (CePO), University Clinic Center Cologne, Cologne, Germany
| | - Bianca Senf
- University Clinic Center Frankfurt University Cancer Center, Frankfurt, Germany
| | - Martin Wickert
- Comprehensive Cancer Center, University Clinic Center Tübingen, Tübingen, Germany
| | - Joachim Weis
- Department of Self-Help Research, Faculty of Medicine and Medical Center, Comprehensive Cancer Center, University of Freiburg, Freiburg, Germany
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17
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Li ZHJ, MacDonald K, Preston K, Giuliani M, Leung B, Melosky B, Simmons C, Hamilton S, Tinker A, Ingledew PA. Evaluating the childcare needs of cancer patients undergoing radiation therapy. Support Care Cancer 2023; 31:463. [PMID: 37439947 DOI: 10.1007/s00520-023-07923-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE About one-fifth of newly diagnosed cancer patients are parents to young children. These patients are at higher risk of psychosocial stress and inability to attend treatment due to having to balance their own healthcare needs with childcare duties. This study aims to explore the impact of childcare on cancer parents and elicit their perspectives on potential supports. The results could help inform the implementation of suitable childcare programs to remove this barrier in accessing care. METHODS Patients at a large Canadian cancer treatment center were screened by oncologists for having minor children at home. Secure electronic surveys were then distributed to consenting participants. Domains surveyed included patient demographics, childcare burden, impact on treatment, and preference for childcare supports. RESULTS The mean age of correspondents was 43.9 (range 33-54), 46 patients (92%) were female, and breast cancer was the most common primary tumor. The median number of children per correspondent was two, and their mean age was 8.4. Balancing childcare with cancer treatment had a significant impact on self-reported stress levels for most correspondents. Twenty (40%) participants had to reschedule and 7 (14%) participants missed at least one appointment due to childcare conflicts. During the COVID-19 pandemic, access to childcare resources decreased while childcare responsibilities increased. Three-quarters of correspondents reported that a flexible childcare would make it easier for them to adhere to appointment schedules. CONCLUSION Childcare is a significant psychosocial barrier for patients accessing cancer care. Our results indicate that most parents undergoing treatment may benefit from hospital-based childcare services.
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Affiliation(s)
- Zhang Hao Jim Li
- Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada
- BC Cancer, Vancouver, British Columbia, Canada
| | - Kenzie MacDonald
- Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine Preston
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Meredith Giuliani
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Bonnie Leung
- BC Cancer, Vancouver, British Columbia, Canada
- Division of Medical Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Barbara Melosky
- BC Cancer, Vancouver, British Columbia, Canada
- Division of Medical Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christine Simmons
- BC Cancer, Vancouver, British Columbia, Canada
- Division of Medical Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Hamilton
- Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada
- BC Cancer, Vancouver, British Columbia, Canada
| | - Anna Tinker
- BC Cancer, Vancouver, British Columbia, Canada
- Division of Medical Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paris-Ann Ingledew
- Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
- BC Cancer, Vancouver, British Columbia, Canada.
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18
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Kelada L, Zamir O. What Promotes Positive Parenting During Breast Cancer? A Cross-Sectional Analysis of Social Support, Emotion Regulation, and Meaning in Life. Int J Behav Med 2023:10.1007/s12529-023-10196-9. [PMID: 37415037 DOI: 10.1007/s12529-023-10196-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Motherhood and maintaining the child-parent relationship are top priorities for mothers with breast cancer (BC). The current study aimed to assess the positive intra- and inter-personal resources related to positive parenting among mothers with BC, as these may be promotive factors for positive parenting. Specifically, we examined whether social support (family, friend, spiritual), emotion regulation, and a sense of meaning in life are related to positive parenting among mothers undergoing BC treatments. METHODS The sample consisted of 100 Israeli mothers (mean age = 46.02 years, SD = 6.06 years) who were undergoing treatment for BC. Participating mothers had at least one child aged 6-17 years. Participants were recruited via closed social media groups to complete a questionnaire containing: the Alabama Parenting Questionnaire, Cancer Perceived Agents of Social Support tool, Emotion Regulation Questionnaire, Meaning in Life Questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and sociodemographic and clinical questions. We used structural equation modeling to regress the study variables on positive parenting. RESULTS Friend support (β = .35, p = .009) and meaning in life (β = .30, p = .012) were significantly related to positive parenting. Family support, spiritual support, cognitive reappraisal, and the sociodemographic and clinical variables were not related to positive parenting. CONCLUSIONS Our study suggests that promoting meaning in life and friend support may be key to helping mothers to sustain positive parenting behaviors throughout their cancer treatment. Future research may examine whether psychosocial interventions which foster meaning in life and friend support impact positive parenting among mothers with BC.
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Affiliation(s)
- L Kelada
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Mt. Scopus, 9190501, Jerusalem, Israel.
- School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney, Australia.
- Kids Cancer Centre, Behavioural Sciences Unit, Sydney Children's Hospital, Randwick, Australia.
| | - O Zamir
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Mt. Scopus, 9190501, Jerusalem, Israel
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Communication between mothers with breast cancer and minor children: a qualitative systematic review and meta-synthesis. Support Care Cancer 2023; 31:169. [PMID: 36786856 DOI: 10.1007/s00520-023-07630-9] [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: 05/18/2022] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Both women with breast cancer and their minor children were affected by a breast cancer diagnosis. The purpose of this review was to synthesize the evidence from qualitative studies on illness-related communication between mothers with breast cancer and their minor children from mothers' perspectives. METHODS A thorough systematic review and meta-synthesis of qualitative studies was conducted. English articles published prior to 6 November 2021 were searched from five databases, including PubMed/ MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO. After screening the titles, abstracts, and full texts, seven articles were finally included in the quality appraisal and meta-aggregation. RESULTS Four synthesized findings were derived from seven articles, including disclosure dilemma, factors impacting disclosure, methods of communication, and information needs. CONCLUSIONS This systematic review offered insight into the communication between mothers with breast cancer and their minor children. Various factors influenced the decision-making process on illness-related disclosure, as well as the methods and contents of the communication. Future studies should be undertaken to explore the common model shared by mothers and children who have had comparable experiences, as well as to completely analyze the differences between different cultures in this topic.
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20
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Kleinhaus H, Brähler E, Romer G, Ernst J. [Communicating about Parental Cancer with Minor Children: Necessity, Burden, and Issues from a Parent's Perspective]. Psychother Psychosom Med Psychol 2023; 73:85-88. [PMID: 36413984 DOI: 10.1055/a-1961-1219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND In addition to coping with their own stresses, parents of minor children with cancer face the difficult task of communicating the diagnosis and its effects to their children. The aim of this study is to examine parents' perceptions of conversations with their children and to identify key topics for psychosocial support. METHODS Using a questionnaire, N=82 cancer patients with N=162 minor children were asked about their experiences when talking to their children about the disease. RESULTS Communication about the disease was perceived as necessary by most parents. This was especially the case for older children. With 143 out of 162 children (88.3%), the conversation was held. Of the 82 parents interviewed, 16.5% felt no burden as a result of the talks, 15.2% reported a very high burden. The feeling of not being able to protect the children was perceived as particularly stressful. DISCUSSION Most parents consider communication with the children to be important and seek it. However, many find this difficult, e. g. because they actually want to protect their children. Additional stress can be caused by questions from the children to which the parents cannot give an answer. CONCLUSION Psychosocial support can be helpful here. Experiences discussed by parents can help other parents in similar situations.
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Affiliation(s)
- Hannah Kleinhaus
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Mainz, Mainz, Germany
| | - Georg Romer
- Klinik für Kinder- und Jugendpsychiatrie, -psychosomatik und -psychotherapie, Universitätsklinikum Münster, Münster, Germany
| | - Jochen Ernst
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Leipzig, Germany
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21
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Kuswanto CN, Sharp J, Stafford L, Schofield P. Fear of cancer recurrence as a pathway from fatigue to psychological distress in mothers who are breast cancer survivors. Stress Health 2023; 39:197-208. [PMID: 35751136 PMCID: PMC10084015 DOI: 10.1002/smi.3180] [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] [Received: 09/15/2021] [Revised: 05/19/2022] [Accepted: 06/19/2022] [Indexed: 02/05/2023]
Abstract
Fatigue is prevalent and pervasive among breast cancer survivors. Mothers are particularly susceptible to fatigue due to the ongoing demands of their caring role. While fatigue has been associated with psychological distress in prior research, the pathway by which fatigue translates into psychological distress is unclear. Given the theoretical and empirical links between fatigue, fear of cancer recurrence (FCR) and psychological distress, the role of FCR in mediating the relationship between fatigue and psychological distress in mothers who are breast cancer survivors was investigated. Ninety-two mothers who were breast cancer survivors completed the Depression, Anxiety and Stress Scale, PROMIS-Cancer Fatigue Short Form and Concerns About Cancer Recurrence scale in an online survey. Mediation analysis via PROCESS was used to examine whether fatigue predicted depression, anxiety or stress through FCR. Fear of cancer recurrence mediated the relationships between fatigue and anxiety and fatigue and stress, while fatigue directly predicted depression. This study highlights FCR as a potential pathway to anxiety and stress in response to ongoing fatigue, and as a mechanism of action to reduce psychological distress among mothers who are breast cancer survivors. Future research examining this pathway from fatigue to psychological distress should also explore the nature of mothers' fears about their cancer recurring.
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Affiliation(s)
- Carissa Nadia Kuswanto
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jessica Sharp
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Lesley Stafford
- Women's Mental Health Team, The Royal Women's Hospital, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia.,Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.,Behavioural Sciences Unit, Health Services Research and Implementation Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
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22
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Maternal Cancer and Perception of Child Psychological Adjustment: The Role of Mother's Anxiety, Depression, and Parenting Stress. Cancers (Basel) 2023; 15:cancers15030910. [PMID: 36765868 PMCID: PMC9913337 DOI: 10.3390/cancers15030910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
A mother's cancer diagnosis may have consequences for all family members, particularly for children, since it makes a parent less physically and emotionally available, with effects on the relationship with the child and his/her development. The main aim of this study was to analyze children's psychological adjustment in the context of maternal cancer by considering factors related to the child (i.e., age and sex), the mother (psychological adjustment), and cancer (i.e., time elapsed from the diagnosis and current oncological treatment). Self-report questionnaires investigating mothers' parenting stress, depression, anxiety, and children's emotional and behavioral problems were administered to 124 mothers (mean age = 44.52 years; SD = 7.22) diagnosed with cancer. A hierarchical regression analysis highlighted that time since diagnosis and mothers' anxiety and parenting stress accounted for almost 44% of the variance of the children's difficulties. Maternal depression, current oncological treatment, and the child's age and sex were not statistically significant. Higher mothers' parenting stress and anxiety and a longer time elapsed since the first diagnosis predicted higher levels of children's emotional and behavioral problems. These findings highlight the need to identify precursors of childhood distress in the context of maternal cancer and to develop structured programs to support both mothers and children.
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23
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Fujimoto K, Kanda K. Experiences of Adolescent Daughters in Beginning to Live With Their Mothers' Cancer: A Qualitative Study. Clin Nurs Res 2023; 32:830-839. [PMID: 36688328 PMCID: PMC10126440 DOI: 10.1177/10547738221150425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
This study reveals the experiences of adolescent daughters who are beginning to live with their mothers' cancer diagnosis. Participants were 14 adolescent daughters who were either junior or senior high school students when their mothers were diagnosed with breast cancer. We analyzed semi-structured interviews using content analysis. Using interview data, four categories were created from 23 subcategories and 183 codes: (1) using trial and error to attempt to steady their minds against upset and anxiety; (2) minimizing the effect on their own school life and future; (3) moving forward with the help and support of those around them; and (4) advancing together with their family to protect and take care of their mother. As supporters, we must understand adolescent daughters' experiences in living with their mothers' cancer. Open communication with an important outside individual is essential in promoting adolescent daughters' ability to obtain support and live with their mothers' cancer.
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Affiliation(s)
| | - Kiyoko Kanda
- Takasaki University of Health and Welfare, Japan
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24
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Fu C, Glasdam S, Stjernswärd S, Xu H. A Qualitative Systematic Review About Children's Everyday Lives when a Parent Is Seriously Ill with the Prospect of Imminent Death - Perspectives of Children and Parents. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228221149767. [PMID: 36628967 DOI: 10.1177/00302228221149767] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Parental dying is a life changing experience for children. This study explores children's strategies and (inter)actions in their everyday life when facing critically ill parents and imminent death, from the children's and parents' perspectives. A qualitative systematic review was carried out, registered in PROSPERO (CRD42022306862). A literature search and screening in six databases resulted in eighteen articles. Thematic analysis showed that children were capable of developing various strategies to cope in everyday life, even in vulnerable situations. From parents' and children's perspectives, inclusion, openness, and communication about parents' situations, taking children's age and needs into consideration, were important to face and cope with the situation. Children were life-capable, also in vulnerable and difficult situations. This calls for the necessity of developing children-led support, by acknowledging, and taking the children's experiences, and resources, as starting points to tailor adequate support for children of critically ill parents.
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Affiliation(s)
- Cong Fu
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Stinne Glasdam
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Sigrid Stjernswärd
- Health-promoting Complex Interventions, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Hongxuan Xu
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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25
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Langer D, Tendler S, Bar-Haim Erez A. A broad perspective on breast cancer: Participation, quality of life and return to work throughout the recovery process. Work 2022; 75:325-337. [PMID: 36591684 DOI: 10.3233/wor-220085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Studies found that women with breast cancer struggle with significant physical and mental challenges that affect their participation in daily living, social and work activities. Although women express their need for rehabilitation, in Israel there has been scant research on the nature of these needs. OBJECTIVE To examine the implications of breast cancer for Israeli women in terms of their quality of life, body function, activities and participation in all facets of life, including work. METHODS The sample was composed of women diagnosed with breast cancer. The data were collected through: (a) an online electronic survey assessing cancer-related quality of life (QoL), function and disability, fatigue and sensory-motor functions, (n = 201) followed by (b) face-to-face interviews and assessments (n = 20), and a healthy control group (n = 61). RESULTS Women with breast cancer reported significantly lower QoL compared to the healthy control group. They reported higher levels of disability in areas such as, cognition, mobility, upper extremity, as well as overall difficulties in self-care, doing routine household activities and return to work. Roughly one-third of the women did not return to work. Interestingly, our sample did not perceive a decline in terms of their social support or networks, the women stated that family and social support were major enabling factors. CONCLUSION The results show that breast cancer has short and long-term functional effects on most facets of these women's life. The women's social support system served as an enabling factor. Many women expressed their frustration at the lack of rehabilitation services for their condition and needs in Israel.
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Affiliation(s)
- Danit Langer
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Shlomit Tendler
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Asnat Bar-Haim Erez
- Occupational Therapy Department, Faculty of Health Professions, Ono Academic College, Kiryat Ono, Israel
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26
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Dalton LJ, McNiven A, Hanna JR, Rapa E. Exploring healthcare professionals' beliefs, experiences and opinions of family-centred conversations when a parent has a serious illness: A qualitative study. PLoS One 2022; 17:e0278124. [PMID: 36441706 PMCID: PMC9704560 DOI: 10.1371/journal.pone.0278124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022] Open
Abstract
This study explored healthcare professionals' perceived role in talking to adult patients about sharing their diagnosis with children. Semi-structured interviews were conducted to explore healthcare professionals' beliefs about how families could and should be supported when a parent has a serious illness. Participants were 24 healthcare professionals working in primary, secondary and tertiary NHS services in the UK with adult patients diagnosed with a serious illness. Data were analysed thematically. Many healthcare professionals reported systems to identify patients' family relationships, but this information was rarely used to initiate conversations on what and how to talk to children. It was frequently assumed that someone else in the healthcare system was supporting patients with family communication. Others reported there were more urgent priorities for the consultation or considered that talking to children was a private family matter. However, several professionals did undertake these conversations, viewing this as a central part of their role. Some healthcare professionals felt they had inadequate skills or confidence to raise talking to children with their patients and indicated a need for specific training to address this. The results highlight the importance of systematically documenting patients' relationships with children so that this information can be used to inform ongoing discussions with the healthcare team about what children have been told. Patients consistently report wanting support about how to talk to children and the benefits of effective communication are well documented. Dissemination of this evidence could encourage professionals across all specialities to include family-centred communication in routine patient care. Training resources are needed so that staff feel empowered and equipped to raise these sensitive subjects with their patients.
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Affiliation(s)
- Louise J. Dalton
- Medical Sciences Division, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Abigail McNiven
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jeffrey R. Hanna
- Medical Sciences Division, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Elizabeth Rapa
- Medical Sciences Division, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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27
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Pritlove C, Dias LV. "You really need a whole community": a qualitative study of mothers' need for and experiences with childcare support during cancer treatment and recovery. Support Care Cancer 2022; 30:10051-10065. [PMID: 36227504 PMCID: PMC9559156 DOI: 10.1007/s00520-022-07399-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 10/07/2022] [Indexed: 12/01/2022]
Abstract
Purpose A cancer diagnosis poses unique challenges for moms with young children who must balance illness-management alongside existing paid (e.g., employment) and unpaid (e.g., domestic/caregiving) work. The goal of this study was to improve understanding of the support needs of mothers living with cancer and their experiences receiving psychosocial and childcare support from a community organization, the Nanny Angel Network (NAN). Methods Mothers who accessed NAN services during their cancer treatment and/or recovery (N = 20) participated in qualitative semi-structured interviews. Thematic analysis was used to inductively and deductively identify emerging patterns in the data and theoretical abduction was applied to further interpret participants’ accounts using a feminist political economy framework. Results Participants expressed how balancing the demands of patienthood and parenthood was challenging and how cancer treatment created new needs for support with care work. Mothers explained that NAN offered indispensable family-centered support largely missing from the health care system, promoting improved physical, psychosocial, and relational health for them and their families. While accessible from a cost-perspective, participants identified different pathways, including awareness, cross-system collaboration, and stable funding, that limited timely access to NAN. Conclusion Access to family-centered care, such as that offered through NAN, was vital to the health and healing of the study participants and their families. Improved collaboration with and investment in community organizations like NAN that have a strong infrastructure to support moms living with cancer offers a practical, feasible, and immediate solution to help address some of the distinct challenges this population faces.
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Affiliation(s)
- Cheryl Pritlove
- Applied Health Research Centre, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
- Dalla Lana School of Public Health, The University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
| | - Lisa V Dias
- Applied Health Research Centre, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
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28
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Tavares R, Brandão T, Matos PM. Communication concerns in mothers with cancer: Development and psychometric properties of a new measure. Eur J Cancer Care (Engl) 2022; 31:e13701. [DOI: 10.1111/ecc.13701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 07/27/2022] [Accepted: 08/12/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Rita Tavares
- Hospital Center of Vila Nova de Gaia/Espinho, EPE Vila Nova de Gaia Portugal
- Faculty of Psychology and Education Sciences University of Porto Porto Portugal
| | - Tânia Brandão
- Center for Psychology at University of Porto Porto Portugal
- CIP, Departamento de Psicologia Universidade Autónoma de Lisboa Luís de Camões Lisboa Portugal
| | - Paula Mena Matos
- Faculty of Psychology and Education Sciences University of Porto Porto Portugal
- Center for Psychology at University of Porto Porto Portugal
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29
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Tavares R, Oliveira AR, Brandão T, Matos PM. Psychological group intervention to support parenting: Qualitative study about needs and preferences of mothers with breast cancer. Eur J Oncol Nurs 2022; 61:102197. [DOI: 10.1016/j.ejon.2022.102197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022]
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30
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Marshall S, Fearnley R, Bristowe K, Harding R. 'It's not just all about the fancy words and the adults': Recommendations for practice from a qualitative interview study with children and young people with a parent with a life-limiting illness. Palliat Med 2022; 36:1263-1272. [PMID: 35766527 PMCID: PMC9446426 DOI: 10.1177/02692163221105564] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Healthcare professionals report challenges in supporting dying patients who have dependent children. These parents are often uncertain how to meet the needs of their children and require appropriate support from professionals. There is limited evidence based guidance for professionals around this issue, which is informed by the views and experiences of children themselves. AIM To develop an understanding of the perspective of children on living with parental life-limiting illness and inform recommendations for healthcare professionals. DESIGN Qualitative semi-structured interviews were conducted, with thematic analysis of the data. SETTING/PARTICIPANTS A diverse sample of 32 children aged 6-17, whose parent was living with life-limiting illness, were recruited from across the United Kingdom. RESULTS Despite the challenges of living with a parent with a life-limiting illness, the children display agency in their response. The children: feel a responsibility to look after their family; negotiate a relationship with healthcare; employ strategies to maintain some normality; and ensure that the inevitable sadness does not become overwhelming. CONCLUSIONS Five recommendations for healthcare professionals were developed from the findings. Clinicians should encourage dying parents to: (1) acknowledge the agency of children; (2) recognise children's caregiving roles; (3) engender children's trust in healthcare; (4) maintain some normality; and (5) discuss emotions with their children. Implementing these recommendations will assist parents with a life-limiting illness to provide evidence-based support to their dependent children.
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Affiliation(s)
- Steve Marshall
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Rachel Fearnley
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Katherine Bristowe
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
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31
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Wickramasinghe LM, Yeo ZZ, Chong PH, Johnston B. Communicating with young children who have a parent dying of a life-limiting illness: a qualitative systematic review of the experiences and impact on healthcare, social and spiritual care professionals. BMC Palliat Care 2022; 21:125. [PMID: 35820910 PMCID: PMC9277932 DOI: 10.1186/s12904-022-01007-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 06/20/2022] [Indexed: 12/03/2022] Open
Abstract
Background Healthcare professionals play a key role in interacting with children who have a parent with a life-limiting illness. While playing such a role can be challenging, not much is known about how such interactions impact these professionals and affect their ability to render support. Methods Four databases were searched with the intention to conduct a qualitative systematic review. Articles were selected based on pre-determined inclusion and exclusion criteria. Their quality was assessed using the tool "Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields”. Findings were analysed using thematic analysis techniques outlined by Thomas and Harden as well as Sandelowski and Barroso. Review was registered with the Review Registry database. Results Three themes emerged – healthcare professionals’ discomfort; their assumptions and actions; and potentiating workplace factors. The discomfort had several dimensions: fear of making a situation worse, concern of not being able to cope with emotionally charged situations, and internal conflict that arose when their values clashed with family dynamics. Conclusion Healthcare professionals’ sense of discomfort was very pronounced. This discomfort, together with their assumptions, could impact their ability to support children. The organisation played an important role, which was reflected in the work culture, workflow and ability to collaborate with other agencies involved in supporting children. The discomfort was mitigated by having more professional experience, workplace support systems and training on communicating with children. It was apparent that the individual professional did not work alone when supporting children but alongside others within an organisation. As such, issues raised in this review will benefit from multi-faceted solutions. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01007-1.
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Affiliation(s)
- Lasitha M Wickramasinghe
- HCA Hospice, 705 Serangoon Road, #03-01 Block A @ Kwong Wai Shiu Hospital, Singapore, 328127, Singapore.
| | - Zhi Zheng Yeo
- HCA Hospice, 705 Serangoon Road, #03-01 Block A @ Kwong Wai Shiu Hospital, Singapore, 328127, Singapore
| | - Poh Heng Chong
- HCA Hospice, 705 Serangoon Road, #03-01 Block A @ Kwong Wai Shiu Hospital, Singapore, 328127, Singapore
| | - Bridget Johnston
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, G12 8QQ, UK
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32
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How to support parenting in patients with cancer and co-parents? From research to practice. Curr Opin Oncol 2022; 34:285-293. [PMID: 35703229 DOI: 10.1097/cco.0000000000000839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW When a parent is diagnosed with cancer, the entire family is impacted. Patients with cancer and co-parents may no longer feel able to fulfill their parenting roles. The aims of this article are to describe interventions designed to support parenting in the oncological context and to make suggestions for the development and assessment of such interventions. RECENT FINDINGS Ten parenting support interventions published in the last 10 years in oncology were identified, among which four randomized controlled trials (RCTs). The therapeutic aims, techniques, and modalities of these interventions were heterogeneous. Five main therapeutic aims were addressed to: increase parents' knowledge, promote parents' emotion regulation, enhance parents' self-efficacy related to parenting, promote parents' support of their children's reactions and coping strategies, and promote open and appropriate parent-child communication. Few studies have combined informational resources with experiential techniques. SUMMARY Very few studies examining the efficacy of parenting support interventions have been published. There is still a need to develop, test, and compare interventions that meet the many needs of parents and their children. Suggestions are made about the contents and formats of parenting support interventions in oncology.
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33
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Usui Y, Kosugi K, Nishiguchi Y, Miura T, Fujisawa D, Uehara Y, Kawaguchi T, Izumi K, Takehana J, Matsumoto Y. Parenting experiences of cancer patients with minor children and their conversations about the possibility of death: a cross-sectional web-based survey for an online cancer community. Support Care Cancer 2022; 30:7715-7720. [PMID: 35701632 DOI: 10.1007/s00520-022-07220-1] [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: 11/24/2021] [Accepted: 06/09/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Many cancer patients with minor children experience difficulty talking about their illness with their children. This study aimed to investigate the parenting experiences of cancer patients with minor children and their conversations about the possibility of death. METHODS A cross-sectional web-based survey was conducted between April and May 2019. Cancer patients with at least one child aged < 18 years were recruited from an online peer support group called "Cancer Parents." The participants were asked to complete a questionnaire about their experiences of talking about their illnesses with their children. The participants were classified into those who disclosed their cancer to their children ("disclosing group"), and those who did not disclose ("non-disclosing group"). The association between whether they talked with their children about their cancer, and whether it included conversations about the possibility of death, was examined. RESULTS A total of 370 parents participated (with 80.8% female parents, with a median age of 43.0 years). The disclosing group (n = 274, 74.1%) wanted to know what their child felt, more than the non-disclosing group did (p < 0.001). Members of the non-disclosing group had a greater tendency than those in the disclosing group to report that they did not want their children to see their suffering (p = 0.002) and did not know how to explain their disease status (p < 0.002). Some members of both the disclosing (42.1%) and non-disclosing (6.5%) groups told their children about the possibility of death. CONCLUSION This study showed that 74.1% of the patients with minor children disclosed their cancer to their children. The parents' feelings when thinking about interacting with their children differed significantly between the disclosing and non-disclosing groups. It is important for healthcare professionals treating patients with cancer to provide appropriate multidisciplinary support for discussing their diagnosis and prognosis with their children.
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Affiliation(s)
- Yuko Usui
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan.,Department of Palliative Therapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan.,Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Tomofumi Miura
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan.
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Uehara
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan.,Department of Palliative Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan
| | - Kayo Izumi
- Insight & Analytics Department, Medilead Inc, Tokyo, Japan
| | - Jun Takehana
- Insight & Analytics Department, Medilead Inc, Tokyo, Japan
| | - Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
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34
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Phillips F, Prezio EA, Currin-McCulloch J, Jones BL. Wonders & Worries: A randomized clinical trial of a psychosocial intervention for children who have a parent with cancer. Psychooncology 2022; 31:1399-1411. [PMID: 35470518 DOI: 10.1002/pon.5943] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to test the effectiveness of Wonders & Worries, a psychosocial intervention for children who have a parent with cancer. Primary goals were to improve family quality of life, functioning and communication skills as reported by parent and child, enhance children's emotional/behavioral adjustment and parenting efficacy, while decreasing parenting concerns and ill parents' depression and anxiety. METHODS Sixty families were recruited from a community based non-profit agency. Parents diagnosed with Stage I-III cancer and their children ages 5-14 years were enrolled and randomized into intervention (n = 32) or wait-list control groups (n = 28). Families received 2 parent consults, six weekly 1-h individual child sessions, and 1 treatment center tour. The intervention was comprised of an age-appropriate understanding of cancer and expression of feelings, coping skills to ease feelings related to parent's cancer and enhanced ability to communicate about the disease. Controls received parent consult and access to W & W resources. Data were obtained from standardized measures at baseline; 6 and 10 weeks follow up. RESULTS Intervention group significantly improved on parenting concerns, parenting self-efficacy, and family quality of life. Children in the intervention group had significantly lower emotional and behavioral problems and worries related to cancer compared to controls. The intervention failed to significantly affect ill parent's anxiety, depressed mood, family functioning and child's anxiety. CONCLUSIONS The Wonders & Worries intervention promoted positive adaptation for ill parents and their children. This intervention is promising enough to warrant further refinement and testing with larger, more diverse samples.
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Risk factors for psychological morbidity and the protective role of coping self-efficacy in young women with breast cancer early in diagnosis: a national multicentre cohort study. Breast Cancer Res Treat 2022; 194:91-102. [DOI: 10.1007/s10549-022-06576-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/17/2022] [Indexed: 11/02/2022]
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36
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Analysis of patient experiences with gestational trophoblastic neoplasia reported on Instagram social media. Gynecol Oncol 2022; 165:603-609. [DOI: 10.1016/j.ygyno.2022.03.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 12/16/2022]
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Johannsen LM, Brandt M, Frerichs W, Inhestern L, Bergelt C. The Impact of Cancer on the Mental Health of Patients Parenting Minor Children: A Systematic Review of Quantitative Evidence. Psychooncology 2022; 31:869-878. [PMID: 35218110 DOI: 10.1002/pon.5912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To provide an overview of quantitative data on the impact of cancer on the mental health of patients parenting minor children. We focused on mental health outcomes, their levels and prevalence and applied measurement tools. METHODS MEDLINE, CINAHL, PsycInfo and Web of Science were searched up to March 2021. We included quantitative studies, published in a peer-reviewed journal and reporting outcomes on the mental health (e.g., depression, anxiety) of cancer patients parenting minor children (≤ 21 years). Study quality was assessed based on the NIH assessment tool for observational studies. This study is registered on PROSPERO (CRD42019141954). RESULTS A total of 54 articles based on 36 different studies were included in this systematic review. Studies differ markedly regarding study and sample characteristics (e.g., outcome measures, sample size, parental health status). Depression and anxiety levels range from normal to abnormal, according to applied measurement tools. 7%-83% of parents with cancer have depression scores indicating probable depression and 19%-88% have anxiety scores indicating anxiety disorder. CONCLUSIONS This review reveals the dimension of mental burden affecting cancer patients parenting minor children. To identify, address and timely treat potentially arising mental health problems and support needs, affected parents should be closely monitored by healthcare professionals and referred to specialized support offers, if necessary. In the context of a comprehensive patient- and family-oriented care, it is highly relevant to integrate mental health (including parental) issues routinely into oncological care by proactively asking for the patient's psychosocial situation and the family status. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Lene Marie Johannsen
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Maja Brandt
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Wiebke Frerichs
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany.,Department of Medical Psychology, University Medicine Greifswald, Germany
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Breidenbach C, Heidkamp P, Hiltrop K, Pfaff H, Enders A, Ernstmann N, Kowalski C. Prevalence and determinants of anxiety and depression in long-term breast cancer survivors. BMC Psychiatry 2022; 22:101. [PMID: 35139815 PMCID: PMC8827186 DOI: 10.1186/s12888-022-03735-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/26/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There is a significant number of long-term breast cancer survivors in Germany. However, research on the psychological challenges of cancer survivors is limited. This analysis describes prevalence, development and determinants of depression and anxiety 5 to 6 years after diagnosis and identifies predictors for an increase of anxiety and depression over time. METHODS Data from 164 women was collected by survey and tumour documentation during post-operative hospital stay, 40 weeks and 5 to 6 years after diagnosis. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. Sankey-diagrams were created for visual presentation of prevalence over time. Logistic and linear regression models were calculated to identify determinants of anxiety and depression. RESULTS Respondents had higher levels of depression and anxiety 5 to 6 years than 40 weeks after the diagnosis. Lower vocational status and having children were associated with depression, surgery type was correlated with anxiety, and age, as well as comorbidities, were predictors for both anxiety and depression 5 to 6 years after diagnosis. An increase of depression over time was more likely when having children and comorbidities. An increase in anxiety was less likely after cancer recurrence. CONCLUSIONS Findings highlight that anxiety and depression are relevant burdens for breast cancer survivors in Germany. Several sociodemographic and clinical predictors are identified. There is need for psychosocial support after acute treatment and in the long-term. Research on psychological burdens of long-term breast cancer survivors in the identified vulnerable groups is needed.
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Affiliation(s)
- Clara Breidenbach
- grid.489540.40000 0001 0656 7508German Cancer Society, Kuno-Fischer-Straße 8, 14057 Berlin, Germany
| | - Paula Heidkamp
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
| | - Kati Hiltrop
- grid.15090.3d0000 0000 8786 803XCenter for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Holger Pfaff
- grid.6190.e0000 0000 8580 3777Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
| | - Anna Enders
- grid.487225.e0000 0001 1945 4553Federal Centre for Health Education (BzgA), Maarweg 149-161, 50825 Cologne, Germany
| | - Nicole Ernstmann
- grid.15090.3d0000 0000 8786 803XCenter for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Christoph Kowalski
- grid.489540.40000 0001 0656 7508German Cancer Society, Kuno-Fischer-Straße 8, 14057 Berlin, Germany
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Borstelmann NA, Gray TF, Gelber S, Rosenberg S, Zheng Y, Meyer M, Ruddy KJ, Schapira L, Come S, Borges V, Cadet T, Maramaldi P, Partridge AH. Psychosocial issues and quality of life of parenting partners of young women with breast cancer. Support Care Cancer 2022; 30:4265-4274. [PMID: 35091846 PMCID: PMC9701537 DOI: 10.1007/s00520-022-06852-7] [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: 09/24/2021] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Data are lacking about the association between quality of life (QOL) and psychosocial issues of partners of young women with breast cancer who co-parent dependent children. METHODS We conducted a cross-sectional analysis of partners of women with breast cancer diagnosed at age ≤ 40. Among those partners reporting at least one dependent child under 18 years old at the time of diagnosis, we used multiple linear regression to examine associations between partner QOL and sociodemographic and psychosocial factors, and the patient's cancer stage and time since diagnosis. RESULTS Of the 219 parenting partners, all identified as male with a median age of 44 years; 96% (204/213) reported working full-time at the time of the survey. Fifty-four percent endorsed behaviors indicating maladaptive coping. In adjusted analyses, less than full-time employment (β = - 8.76; 95% CI = - 17.37, - 0.14), younger age (β = - 0.35; 95% CI = - 0.069, - 0.02), greater parenting concerns (β = 0.56; 95% CI = 0.36, 0.75), clinically relevant anxiety symptoms (β = 13.79; 95% CI = 10.24, 17.35), lower post-traumatic growth score (β = - 0.33; 95% CI = - 0.51, - 0.16), lower social support (β = - 0.21; 95% CI = - 0.29, - 0.12), lower sexual satisfaction (β = - 0.40; 95% CI = - 0.62, - 0.19), and breast cancer stages 3 (β = 7.61; 95% CI = 0.19, 15.02) and 4 (β = 12.63; 95% CI = 1.91, 23.34), when compared to stage 0, were associated with lower partner QOL. CONCLUSION Parenting partners of young women with breast cancer have substantial unmet psychosocial needs. Interventions are needed to enhance QOL and promote adaptive coping for this population.
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Affiliation(s)
| | - Tamryn F Gray
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.,Harvard Medical School, Boston, MA, USA
| | - Shari Gelber
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Shoshana Rosenberg
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.,Harvard Medical School, Boston, MA, USA
| | - Yue Zheng
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Meghan Meyer
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | | | | | - Steven Come
- Harvard Medical School, Boston, MA, USA.,Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Tamara Cadet
- Simmons College School of Social Work, Boston, MA, USA
| | - Peter Maramaldi
- Simmons College School of Social Work, Boston, MA, USA.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ann H Partridge
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.,Harvard Medical School, Boston, MA, USA
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Zamir O, Bentley G, He Y. A Promotive Process of Resource Gain Against Harsh and Inconsistent Discipline in Mothers Coping With Breast Cancer: A Serial Mediation Model. Front Psychiatry 2022; 13:859604. [PMID: 35782420 PMCID: PMC9243754 DOI: 10.3389/fpsyt.2022.859604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/27/2022] [Indexed: 12/09/2022] Open
Abstract
Breast cancer is a life-threatening disease and a source of enduring stress. The Family Stress Model posits that psychological distress provoked by stressful conditions may spill over and intensify harsh and inconsistent parental discipline. However, the Conservation of Resources theory posits that having more resources may lead to further resource gain, which may promote adaptive coping with adversities. Therefore, this study examined a serial mediation model in which financial resources (income) are predicted to be associated with more interpersonal resources (paternal involvement). The latter is expected to be linked with less maternal post-traumatic stress symptoms, which, in turn, should be associated with less harsh and inconsistent discipline in mothers coping with breast cancer. A sample of 100 Israeli mothers receiving breast cancer treatments was recruited through social media. The participants completed online self-report questionnaires. Structural Equation Modeling indicated significant serial mediation, in which a greater income level was associated with more paternal involvement, which was linked to a lower level of maternal post-traumatic symptoms. The latter, in turn, was associated with less harsh and inconsistent maternal discipline practices. We controlled for illness severity and the time since diagnosis, which did not predict maternal discipline practices. The study suggests that although breast cancer is a stressful condition for any family, having more financial resources can be a significant promotive factor predicting a cascading process by which paternal functioning facilitates better mental health of mothers, and, in turn, better maternal parenting practices.
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Affiliation(s)
- Osnat Zamir
- The Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gabriella Bentley
- The Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yaliu He
- Social Work & Marriage and Family Therapy Department, Iona College, New Rochelle, NY, United States
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41
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Hauskov Graungaard A, Hafting M, Davidsen AS, Lykke K. How is my child doing - parental understanding of their children when a parent has cancer. J Psychosoc Oncol 2021; 41:43-58. [PMID: 34961424 DOI: 10.1080/07347332.2021.2013386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
To explore the difficulties parents face when understanding their children's reactions to parental cancer and parents' reactions to their children's perceived needs. Qualitative interviews with cancer patients and their partners. Eleven patients and seven partners took part. Their children were aged 1-15 years. Eight patients were mothers and cancer was diagnosed median 28 (7-104) months ago. Inductive analysis with systematic text condensation. Parents were groping in the dark when understanding their children's reactions. They observed signs of distress in their children, but often avoided communication about emotional reactions. We suggest parental difficulties in containing own and children's emotions as an important cause for this situation. Parents lacked relevant support offers for the family as a unit. Identification of children's difficulties cannot be based on parental evaluation alone. We suggest family support as part of standard care for patients with minor children.
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Affiliation(s)
- Anette Hauskov Graungaard
- Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Denmark
| | | | - Annette Sofie Davidsen
- Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Kirsten Lykke
- Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Denmark
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42
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Steiner V, Joubert L, Shlonsky A, Morris A. Hospital Parenting Support for Adults with Incurable End-Stage Cancer: Multidisciplinary Health Professional Perspectives. HEALTH & SOCIAL WORK 2021; 46:289-298. [PMID: 34648638 DOI: 10.1093/hsw/hlab024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/18/2020] [Accepted: 07/30/2020] [Indexed: 06/13/2023]
Abstract
Patients with incurable end-stage cancer (IESC) who are parenting minor-age children often experience parenting-related distress. Parenting concerns are not always addressed as part of routine hospital-based psychosocial care. Currently, there is a lack multidisciplinary health professional (HP) perspectives in this area. An exploratory study of hospital-based HP perspectives of adult patients' and coparents' parenting experiences, support needs, and parenting supportive care practice was conducted. Twelve multidisciplinary HPs from one Australian tertiary hospital participated in a semistructured focus group and interviews. Data were audio recorded, transcribed, and analyzed using thematic analysis. Results showed HPs were cognizant of patients' and coparents' diverse parenting support needs and experiences and other aspects that comprise best practice. However, multilevel organization, HP, and patient/coparent barriers impeded optimal practice. Barriers included a nonsystemized approach to screening patients' parenting status and parenting support needs, inadequate resources, limited professional support, hospital environment, and parent psychosocial factors. This article provides feasible options for addressing practice barriers. Reviewing what factors influence optimal parenting focus from interdisciplinary HP perspectives helped identify potential strategies that could influence a shift from medical-focused care to more holistic family-focused patient care.
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43
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Martens K, Ulrich GR, Ranby KW, Kilbourn K. What Matters Most? Predictors of Quality of Life and Life Satisfaction Among Young Breast Cancer Survivors. Cancer Nurs 2021; 44:E727-E734. [PMID: 34694091 DOI: 10.1097/ncc.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Younger breast cancer survivors face unique challenges, and research is needed to better understand how to optimize their quality of life (QoL) and satisfaction with life (SwL). OBJECTIVE The aim of this study was to examine a biopsychosocial model of QoL and SwL in young breast cancer survivors. Biological, psychological, and social/practical factors were hypothesized to be associated with both distressing and adaptive reactions during survivorship, which in turn were hypothesized to be associated with QoL and SwL. METHODS Young (age = 19-45 years at diagnosis) breast cancer survivors (N = 284) completed an online survey assessing demographic and biopsychosocial factors, QoL, and SwL. Latent variables were created for adaptive and distressing reactions, and structural equation modeling was used to test the hypothesized relationships. RESULTS The model fit the data (χ2(100) = 332.92, P < .001, comparative fit index = 0.86, root mean square error of approximation = 0.09, standardized root mean square residual = 0.05) and accounted for large proportions of variance in QoL (R2 = 0.86) and SwL (R2 = 0.62). Social support, parenting concerns, and fertility concerns each significantly predicted adjustment. Adaptive reactions positively predicted SwL (β = 0.58, P < .001) but not QoL. Distressing reactions negatively predicted SwL (β = -0.26, P < .01) and QoL (β = -0.87, P < .001). CONCLUSIONS Adjustment in survivorship mediated the association of social support, parenting concerns, and fertility concerns on QoL and SwL in young breast cancer survivors. IMPLICATIONS FOR PRACTICE To support the psychological adjustment of young breast cancer survivors, attention should be given to survivors' social context including survivors' available social support and their concerns about fertility and parenting.
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Affiliation(s)
- Kellie Martens
- Author Affiliations: Department of Bariatric Surgery & Behavioral Health Services, Henry Ford Health System (Dr Martens), Detroit, Michigan; and Department of Psychology, University of Colorado Denver (Ms Ulrich and Drs Ranby and Kilbourn)
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44
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Lehmann V, Laan ETM, den Oudsten BL. Sexual health-related care needs among young adult cancer patients and survivors: a systematic literature review. J Cancer Surviv 2021; 16:913-924. [PMID: 34669141 PMCID: PMC9300501 DOI: 10.1007/s11764-021-01084-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/02/2021] [Indexed: 01/05/2023]
Abstract
Purpose Young adult cancer patients and survivors have age-specific care needs, but care needs related to sexual health are poorly understood. A systematic literature review was conducted to examine sexual health-related care needs among patients/survivors diagnosed with cancer during young adulthood (age: 18–39 years). The prevalence and types needs were assessed along with associated patient factors. Methods Four major databases were screened to identify relevant studies, which were also assessed for risk of bias; all following PRISMA guidelines. Results Identified studies (N = 35) often assessed sexual health-related care needs by whether participants experienced a generic need for support from providers. The prevalence of such needs ranged between 8 and 61.7% and was higher in female survivors and those with more health impairments. The type of diagnosis could also play a role in these varying prevalence rates, but was not systematically tested in included studies. Types of sexual health-related care needs were clustered into practical/emotional support needs (e.g., coping with physical side effects), information needs (e.g., more details), and communication needs (e.g., providers should initiate conversations, validate concerns, be empathetic/open). Needs should be addressed in-person and/or online. Conclusions The extent of needs related to sexual health varies among young adult patients and survivors, but types of needs center around improving provision of support and information by providers. Implications for Cancer Survivors Sexual health should routinely be addressed alongside other potential effects of cancer treatment to allow for constructive conversations between patients and providers. Referrals to (online) resources or specialists should be tailored to individual preferences. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01084-w.
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Affiliation(s)
- Vicky Lehmann
- Department of Medical Psychology, Amsterdam University Medical Center, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - Ellen T M Laan
- Department of Sexology and Psychosomatic Gynecology, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - Brenda L den Oudsten
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders, Tilburg University, Tilburg, Netherlands
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45
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Van Beek FE, Wijnhoven LMA, Custers JAE, Holtmaat K, De Rooij BH, Horevoorts NJE, Aukema EJ, Verheul S, Eerenstein SEJ, Strobbe L, Van Oort IM, Vergeer MR, Prins JB, Verdonck-de Leeuw IM, Jansen F. Adjustment disorder in cancer patients after treatment: prevalence and acceptance of psychological treatment. Support Care Cancer 2021; 30:1797-1806. [PMID: 34599663 PMCID: PMC8486632 DOI: 10.1007/s00520-021-06530-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/28/2021] [Indexed: 11/03/2022]
Abstract
Purpose To investigate the prevalence of adjustment disorder (AD) among cancer patients and the acceptance of psychological treatment, in relation to sociodemographic, clinical, and psychological factors. Methods Breast, prostate, and head and neck cancer patients of all stages and treatment modalities (N = 200) participated in this observational study. Patients completed the Hospital Anxiety and Depression Scale, Checklist Individual Strength, Distress Thermometer and problem list. Patients with increased risk on AD based on these questionnaires were scheduled for a diagnostic interview. Patients diagnosed with AD were invited to participate in a randomized controlled trial on the cost-effectiveness of psychological treatment. Participation in this trial was used as a proxy of acceptance of psychological treatment. Logistic regression analyses were used to investigate associated factors. Results The overall prevalence of AD was estimated at 13.1%. Sensitivity analyses showed prevalence rates of AD of 11.5%, 15.0%, and 23.5%. Acceptance of psychological treatment was estimated at 65%. AD was associated both with being employed (OR = 3.3, CI = 1.3–8.4) and having a shorter time since diagnosis (OR = 0.3, CI = 0.1–0.8). Conclusion Taking sensitivity analysis into account, the prevalence of AD among cancer patients is estimated at 13 to 15%, and is related to being employed and having a shorter time since diagnosis. The majority of cancer patients with AD accept psychological treatment.
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Affiliation(s)
- F E Van Beek
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - L M A Wijnhoven
- Department of Medical Psychology, Radboud Institute of Health Sciences, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - J A E Custers
- Department of Medical Psychology, Radboud Institute of Health Sciences, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - K Holtmaat
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - B H De Rooij
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - N J E Horevoorts
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,CoRPS - Center of Research On Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - E J Aukema
- Ingeborg Douwes Centrum, Center for Psycho-Oncology, Amsterdam, The Netherlands
| | - S Verheul
- Department of Medical Psychology, CWZ Nijmegen, Nijmegen, The Netherlands
| | - S E J Eerenstein
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - L Strobbe
- Department of Oncological Surgery, CWZ Nijmegen, Amsterdam, The Netherlands
| | - I M Van Oort
- Department Urology, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - M R Vergeer
- Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, VUmc, Amsterdam, The Netherlands
| | - J B Prins
- Department of Medical Psychology, Radboud Institute of Health Sciences, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - I M Verdonck-de Leeuw
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - F Jansen
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
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46
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Barel - Shoshani ZA, Kreitler S. Breast cancer surgery as expressed in self figure drawings. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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47
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Breaking the silence about illness and death: Potential effects of a pilot study of the family talk intervention when a parent with dependent children receives specialized palliative home care. Palliat Support Care 2021; 20:512-518. [DOI: 10.1017/s1478951521001322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objective
The entire family is affected when a parent is severely ill. Parents often need and appreciate professional support when talking to children about illness and death. The family talk intervention (FTI) is family-centered and intends to promote communication about the illness and its consequences, support parenting to enhance family coping and help family members share experiences with each other to create a shared family history. This study aimed to explore potential effects of FTI in specialized palliative home care, as reported by parents.
Method
This pre-post test intervention pilot was conducted in specialized palliative home care. A convergent mixed-method design was used to analyze interview and questionnaire data. Twenty families with dependent children were recruited from two specialized palliative home care units in Stockholm, Sweden.
Results
Parents reported that family communication improved after participation in FTI as family members learned communication strategies that facilitated open sharing of thoughts and feelings. Increased open communication helped family members gain a better understanding of each other's perspectives. Parents reported that relationships with their partner and children had improved as they now shared several strategies for maintaining family relationships. Parents were also less worried following participation in FTI. The ill parents stated that they gained a sense of security and were less worried about the future.
Significance of results
This study adds to the evidence that FTI may be a useful intervention for families with dependent children and an ill parent in a palliative care setting. This trial is registered at ClinicalTrials.gov Identifier NCT03119545.
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48
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Mapping childcare support for patients at a sample of North American hospitals and cancer centers: an environmental scan. Support Care Cancer 2021; 30:593-601. [PMID: 34347184 DOI: 10.1007/s00520-021-06460-x] [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: 05/24/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Approximately a quarter of cancer patients are parents to young children. One unique challenge faced by this patient group is the difficulty of accessing childcare support during medical appointments. Hospital-based childcare options could represent a solution to this problem, but to this point, no comprehensive scans have described existing on-site childcare centers. The purpose of this study is to identify and characterize on-site childcare services available to patients at selected North American hospitals. This information could inform the development of similar programs for cancer patients. METHODS Using publicly available information, an environmental scan of the grey literature was conducted to investigate Canadian and American hospitals for the presence of childcare services. A standardized data collection tool was used to extract center characteristics. RESULTS Twenty-six childcare centers were identified across 161 hospitals in both Canada and the USA, with 8/55 Canadian hospitals and 18/106 American hospitals having patient-accessible on-site services. The majority of the centers were associated with pediatric hospitals (77%). Only a single childcare center was associated with a cancer hospital. All centers accommodated children between the ages of 3 and 8. Most centers were open for over 30 h per week (77%) and were free of charge to users (89%). Other characteristics, including capacity and staffing, varied widely. CONCLUSIONS These results represent an inventory of patient-accessible, on-site childcare services currently available at selected North American hospitals. Cancer patients who are also parents may especially benefit from this kind of support.
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Maternal Experiences of Parenting Young Children While Battling Breast Cancer in Taiwan. Cancer Nurs 2021; 44:E193-E200. [PMID: 32209860 DOI: 10.1097/ncc.0000000000000813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Western mothers with breast cancer find themselves struggling with parenting responsibilities. Because parenting is culturally shaped, literature on ill mothers' experiences of parenting young children from a collectivist culture is limited. OBJECTIVE The aim of this study was to examine Taiwanese mothers' experiences of and cultural practices embedded in parenting young children while in treatment for breast cancer. METHODS Sixteen mothers with at least 1 child younger than 12 years were recruited from a breast cancer organization in Taiwan. Data were collected from November 2016 to June 2017 via a semistructured individual interview and analyzed using a content analysis technique. RESULTS Five themes, namely, "maternal limited disclosure, complementary with children's tacit knowledge," "the scar is no longer a scar but a symbol for intimate bonding," "issues of maternal absence for young children and school-aged children," "the power of 'We are a family'," and "to live a simple life and to live for one's self," elucidate how cultural beliefs and practices shape maternal parenting experiences during treatment of breast cancer. CONCLUSIONS The findings illustrate how Taiwanese mothers interpret their illness, contextualize illness-related messages in daily life, and maintain family ties while coping with breast cancer. The will to maintain the family's integrity, including the extended family, can empower mothers throughout the trajectory. IMPLICATIONS FOR PRACTICE Ill mothers may benefit from nurses' guidance on daily routines and cultural practices that they can exploit to frame illness messages for their children. Maternal efforts to change their outlook on life, vocalize their needs, and become more assertive should be acknowledged and supported.
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Chen H, He Q, Zeng Y, Wang L, Yu H, Yin W, Jiang Y, Liu L. Feeling like the sky is falling down: Experiences of parents of adolescents diagnosed with cancer in one-child families in China - A qualitative study. J Clin Nurs 2021; 31:733-743. [PMID: 34258803 DOI: 10.1111/jocn.15913] [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: 12/28/2020] [Revised: 04/26/2021] [Accepted: 05/21/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND As a result of the one-child policy of 1979, today there are numerous one-child families with adolescents in Mainland China. Little is known about the experiences of parents of such adolescents diagnosed with cancer. OBJECTIVES This study explored the experiences of parents whose adolescent child was diagnosed with cancer in one-child families in China. METHODS A qualitative methodology based on hermeneutic phenomenology was employed. The participants were parents of adolescent cancer patients in one-child families. Data were collected using in-depth semi-structured interviews and analysed using van Manen's hermeneutic phenomenological approach. The COREQ checklist was used for this study. RESULTS Fourteen parents (eleven mothers, three fathers) participated in the study. One overarching theme emerged: feeling like the sky is falling down. In addition, there were five related themes: self-condemnation; 'white lies' - that is, difficulty in telling the truth; struggling with a sense of collapse; fear of losing the child and hopelessness. Almost all the participants experienced insomnia after learning about the diagnosis. In a few cases, hopelessness-induced suicidal ideation or even suicidal behaviour. CONCLUSIONS Parents of adolescents diagnosed with cancer in one-child families in China experienced extremely painful emotions. The truth about their child's condition not only caused immense psychological trauma but also induced pessimism about their own future. IMPLICATIONS FOR CLINICAL PRACTICE The experiences of parents in one-child families where an adolescent child has been diagnosed with cancer should be taken seriously. In addition, support should be provided to help parents maintain a normal life and feel hopeful for their future.
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Affiliation(s)
- Huaying Chen
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qing He
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yuanyuan Zeng
- Department of Head and Neck Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Wang
- Nursing Department, West China Hospital of Sichuan University, Chengdu, China
| | - Huaqin Yu
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wenrong Yin
- Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Jiang
- Nursing Department, West China Hospital of Sichuan University, Chengdu, China
| | - Lei Liu
- Department of Head and Neck Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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