1
|
Sinnathamby A, Lee LY, Ng GMC. " Why Are we Giving up on my Brother?"-The Unmet Needs of the Adolescent Facing End-of-Life Care in a Sibling. J Palliat Med 2024. [PMID: 38905128 DOI: 10.1089/jpm.2023.0395] [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: 06/23/2024] Open
Abstract
Adolescence is a challenging time at baseline, and a sibling receiving end-of-life care can alter an adolescent's life irrevocably. It is imperative for the medical team to understand the unique needs and perspectives of such an adolescent sibling. This in turn facilitates the anticipation of an adolescent's grief response, and allows for parents to be appropriately guided. However, more can be done to evaluate the needs of adolescent siblings and improve their support. This can be through establishing a validated needs-based questionnaire, empowering families and the multidisciplinary team to engage siblings, and diverting resources toward culturally sensitive support groups for siblings with critical illness. A framework to involve key players in the adolescent's circle is presented.
Collapse
Affiliation(s)
- Annushkha Sinnathamby
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
- Division of Palliative Care, National University Cancer Institute, Singapore, Singapore
| | - Le Ye Lee
- Foundation Healthcare Holdings, Singapore, Singapore
| | | |
Collapse
|
2
|
Zhang X, Xie J, Wu W, Cao L, Jiang Z, Li Z, Li Y. The mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants: Cross-sectional study. J Pediatr Nurs 2024; 74:1-9. [PMID: 37979333 DOI: 10.1016/j.pedn.2023.10.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/20/2023]
Abstract
PURPOSE This study aimed to examine the relationship of stress, mental resilience, and coping style, and the mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants. DESIGN AND METHODS A cross-sectional design was used. A total of 231 parents of children with cochlear implants were recruited from May 1, 2022, to February 28, 2023 at a comprehensive tertiary hospital and a cochlear implant rehabilitation center in China. Parenting Stress Index-Short Form (PSI-SF), the Connor-Davidson Resilience Scale (CD-RISC) and the Simplified Coping Style Questionnaire(SCSQ) were used to measure stress, mental resilience, and coping style respectively. RESULTS The mean score observed for PSI-SF, CD-RISC, active coping, and passive coping was 87.85 ± 24.59, 55.63 ± 16.11, 21.36 ± 6.73, and 9.05 ± 4.52, respectively. Mental resilience was a significant mediator explaining the effect of stress on active coping (β = -0.294; 95% bias-corrected bootstrap CI: -0.358 to -0.164). CONCLUSIONS Attention should be paid to the status of stress, mental resilience and coping style in parents of children with cochlear implants. Mental resilience mediated stress and coping style. PRACTICE IMPLICATIONS This study provides a theoretical basis for establishing an active coping care program for parents of children with cochlear implants. There is a need to identify strategies that can help increase the level of mental resilience of parents of children with cochlear implants and more subjective and objective social support should be provided to reduce their stress and to encourage active coping style.
Collapse
Affiliation(s)
- Xiaodan Zhang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiao Xie
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Otolaryngology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Weijing Wu
- Department of Otolaryngology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lifang Cao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zheyi Jiang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhu Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
| |
Collapse
|
3
|
Chavan SS, Mendonca TL. Effectiveness of Psychosocial Intervention on Quality of Life of Mothers of Children with Cancer: A Feasibility Study. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1758527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract
Background Mothers of children with cancer are reported to experience stress more often. For children with cancer, parents are the primary source of social and emotional support, and they are also in charge of how successfully patients manage their illness. The degree of difficulty parents suffer after learning that their child has cancer significantly influences the child's psychological adjustment.
Aim The study aimed to assess the effectiveness of psychosocial intervention on quality of life (QoL) among mothers of children with cancer.
Materials and Methods Quasi-intervention study design was undertaken, and a purposive sampling technique was used to select the 60 mothers of children with cancer who were assigned randomly to the intervention and control groups. A pretested and validated self-administered questionnaire was used; the sociodemographic, WHOQOL-BREF scale with 26 items was studied.
Statistical Analysis Prevalence, demographic pro forma of mother and child was analyzed in terms of frequency, percentage, mean, and standard deviation. Two-factor repeated measures analysis of variance was used to establish the effectiveness of the psychosocial intervention on QoL. Association was done by using the chi-square test. SPSS package was used for analysis.
Results Psychosocial intervention was found to be effective in improving QoL scores in psychological health domain (p = 0.02*, p < 0.05), social relationship domain (p = 0.04*, p < 0.05), and environmental health domain (p = 0.001**, p < 0.05). A significant association was found between the physical health domain and information on cancer (p = 0.01*), psychological health domain and financial status (p = 0.03*), social relationship domain and cost of treatment (p = 0.04*), Q1 and Q2 with the place of residence (p = 0.004**, p = 0.02*), and Q2 and financial status (p = 0.03*).
Conclusion Mothers of children with cancer undergo a lot of stress and emotional turmoil and are at risk of deteriorating their QoL. Hence, they need to be provided support to address their issues. Thus, health professionals must develop and implement interventions to promote the QoL.
Collapse
Affiliation(s)
- Seema S. Chavan
- Department of Pediatric Nursing, Father Muller College of Nursing, Mangaluru, Karnataka, India
- Department of Pediatric Nursing, Laxmi Memorial College of Nursing, Mangaluru, Karnataka, India
- Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
| | - Theresa L. Mendonca
- Department of Pediatric Nursing, Father Muller College of Nursing, Mangaluru, Karnataka, India
- Department of Pediatric Nursing, Laxmi Memorial College of Nursing, Mangaluru, Karnataka, India
- Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
| |
Collapse
|
4
|
Pediatric Cancer as a Factor of Changes in the Family. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095002. [PMID: 35564396 PMCID: PMC9105820 DOI: 10.3390/ijerph19095002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022]
Abstract
The occurrence of pediatric cancer is an example of a non-normative situation that reorganizes family life. The aim of the study was to evaluate the functioning of a family with a child affected by cancer. The study was conducted on 339 families. The study group consisted of 153 families with children with cancer (mean age 36.4 ± 6.8 years). The control group was composed of 186 families with healthy children (mean age 39.0 ± 6.3 years). All of them completed the author’s survey questionnaire on family functioning and the Resilience Measurement Scale (RMS). A statistically significant association was found between the place of residence (p < 0.001), education (p < 0.001), assessment of the material status (p < 0.001) and employment structure (p < 0.001) of parents and the membership in the study group or the control group. Statistical significance was achieved for the main effects as measured on the RMS (5 factors and 2 groups). The study group showed consistently lower levels of the factors of the scale. Statistically significant observations were reported for Factor 1 (perseverance, proactive approach) and Factor 4 (tolerance to failure, life as a challenge) (12.0 vs. 14.5, p < 0.001, 13.4 vs. 14.2, p = 0.04, respectively). Parents of children with cancer were characterized by lower persistence, determination and tolerance to failure, which could affect the quality of life of the whole family. In addition, different socio-economic conditions of family functioning were found in families with children with cancer as compared to families with healthy children.
Collapse
|
5
|
Rasouli O, Aarseth Bø M, Reinfjell T, Moksnes UK, Eilertsen MEB. Protective and risk factors associated with psychological distress in cancer-bereaved parents: A cross-sectional study. Eur J Oncol Nurs 2021; 51:101929. [PMID: 33713920 DOI: 10.1016/j.ejon.2021.101929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/30/2020] [Accepted: 03/01/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Research shows that knowledge about mental health status, both protective and risk factors, is limited in cancer-bereaved parents. The study aimed to investigate (1) the extent of psychological distress in bereaved parents 2-8 years after the loss of a child to cancer compared to non-bereaved parents, and (2) psychological distress in association with resilience, the extent of having coped with the grief, time since the loss, and past psychological distress in cancer-bereaved parents. DESIGN Retrospective, cross-sectional study. METHODS A Norwegian nationwide study-specific questionnaire was completed by 162 parents who had lost a child to cancer, and 77 matched non-bereaved parents. We used the Cohort Norway-Mental Health Index and Resilience Scale for Adults to measure psychological distress and resilience, respectively. The extent of having coped with grief was also measured. RESULTS Bereaved parents experienced significantly more symptoms of psychological distress, albeit not clinical psychological distress, compared to non-bereaved parents. The bereaved parents who have coped with their grief or had higher resilience reported lower psychological distress. Positive "Perception of self" and well "Planned future" were the strongest predictors of psychological distress in both bereaved fathers and mothers. CONCLUSION Both fathers and mothers experience more psychological distress symptoms 2-8 years after losing a child to cancer than non-bereaved parents. The findings also highlight the need for long-term support to bereaved parents in order to help to improve their resilience and to better cope with their grief.
Collapse
Affiliation(s)
- Omid Rasouli
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Malin Aarseth Bø
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Child and Adolescent Psychiatric Out-patient Clinic (BUP) Orkanger, Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway.
| | - Trude Reinfjell
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Unni Karin Moksnes
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Faculty of Nursing and Health Sciences, North University, Norway.
| | - Mary-Elizabeth B Eilertsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| |
Collapse
|
6
|
Psychosocial Factors Predicting Resilience in Family Caregivers of Children with Cancer: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020748. [PMID: 33477253 PMCID: PMC7830523 DOI: 10.3390/ijerph18020748] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/02/2020] [Accepted: 12/09/2020] [Indexed: 01/10/2023]
Abstract
Chronic diseases in childhood can affect the physical and mental health of patients and their families. The objective of this study was to identify the sociodemographic and psychosocial factors that predict resilience in family caregivers of children with cancer and to define whether there are differences in the levels of resilience derived from these sociodemographic variables. Three hundred and thirty family caregivers of children with cancer, with an average age of 32.6 years were interviewed. The caregivers responded to a battery of tests that included a questionnaire of sociodemographic variables, the Measuring Scale of Resilience, the Beck Depression Inventory, the Inventory of Quality of Life, the Beck Anxiety Inventory, an interview of caregiver burden and the World Health Organization Well-Being Index. The main findings indicate that family caregivers of children with cancer reported high levels of resilience, which were associated positively with quality of life, psychological well-being and years of study and associated negatively with depression, anxiety and caregiver burden. The variables that predicted resilience in families of children with cancer were quality of life, psychological well-being, depression and number of children. Family caregivers who were married and Catholic showed higher resilience scores. We conclude that being a caregiver in a family with children with cancer is associated with symptoms of anxiety and with depressive episodes. These issues can be overcome through family strength, well-being, quality of life and positive adaptation processes and mobilization of family resources.
Collapse
|
7
|
Mezgebu E, Berhan E, Deribe L. Predictors of Resilience Among Parents of Children with Cancer: Cross-Sectional Study. Cancer Manag Res 2020; 12:11611-11621. [PMID: 33235494 PMCID: PMC7678500 DOI: 10.2147/cmar.s276599] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/04/2020] [Indexed: 12/31/2022] Open
Abstract
Purpose Resilience is an ability to overcome adversities in response to a potentially traumatic event. It relieves parents’ discomfort and builds personal capacity when facing a stressful situation like childhood cancer. Therefore, the study’s objective is to assess the magnitude of resilience and its predictors among the parents of children with cancer at Jimma medical center, Ethiopia, 2020. Methods The institutional-based cross-sectional design was employed on 126 parents of children with cancer at Jimma Medical Center. All study populations who attend the hospital from February 25 to April 25, 2020, and fulfill the inclusion criteria were included. Data were entered into Epi data version 4.6.0.2 and analyzed by SPSS version 25. Descriptive analysis was used to describe the study variables. Furthermore, linear regression analysis was calculated to assess predictors of resilience. Results The level of resilience among parents’ children with cancer were a mean scored 51.41±12.02. In this study, factors associated with resilience were receiving support from friends (β=5.67, 95% CI=1.58, 9.77; P=0.007), attend recreational activities (β=13.8, 95% CI=5.32, 22.37; P=0.03) and receiving health information from health care professionals (β=6.37; 95% CI= (1.75, 11.00), P=0.007), parents depression (β= −0.827, 95% CI= (−1.619,-0.034), P=0.041) and parents stress (β =−0.88,95% CI (−1.54,-0.23), P=0.031). Conclusion The magnitude of resilience among parents of children with cancer was low relative to other studies. Support from friends, attending recreational activities, and receiving health information from health care professionals were positively associated with resilience. In contrast, parents’ depression and stress were negatively associated with resilience.
Collapse
Affiliation(s)
| | - Emebet Berhan
- Addis Ababa University College of Health Science, School of Nursing and Midwifery, Addis Ababa, Ethiopia
| | - Leul Deribe
- Addis Ababa University College of Health Science, School of Nursing and Midwifery, Addis Ababa, Ethiopia
| |
Collapse
|
8
|
Vercasson C, Auquier P, Michel G, Bertrand Y, Ansoborlo S, Tabone MD, Leverger G, Gandemer V, Baruchel A, Contet A, Dalle JH, Paillard C, Poirée M, Thouvenin-Doulet S, Sirvent N, Kanold J, Freycon C, Hamidou Z, Berbis J. Quality of life in parents of childhood leukemia survivors. A French Childhood Cancer Survivor Study for Leukemia study. Pediatr Blood Cancer 2020; 67:e28419. [PMID: 32798263 DOI: 10.1002/pbc.28419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Our objectives were to assess the quality of life (QoL) of parents of childhood leukemia survivors compared with population norms and to identify the determinants of parents' long-term QoL. METHODS Parents of minors who had survived childhood leukemia participating in the French LEA cohort (Leucémie de l'Enfant et de l'Adolescent-French Childhood Cancer Survivor Study for Leukemia) were asked to complete the French version of the WHOQOL-BREF. Results were compared with age- and sex-matched values from a French reference population. Parents' and survivors' characteristics likely to be associated with QoL, long after the child's leukemia diagnosis, were explored using multivariate analysis. RESULTS We included 487 parents (mean age 42.9 ± 6.0 years, mean follow-up time from diagnosis 7.3 ± 3.3 years). Compared with the reference population, scores for physical health and social relationships for parents of childhood leukemia survivors were significantly lower (P < 0.001, effect size = 0.24 and P < 0.001, effect size = 0.29, respectively) contrary to scores for psychological health which were significantly higher (P < 0.001, effect size = 0.29). Even if health- and cancer-related characteristics were associated with parents' QoL in some dimensions, the only factor associated with each of the three dimensions (social relationships, physical health, and psychological) in the multivariate analysis was the parent's financial situation. CONCLUSIONS Long after leukemia diagnosis, the parents reported lower scores in the physical health and social relationship domains. Despite the difficulties of actually influencing socioeconomic characteristics, it is important to consider the social situation of each family in the long-term care of survivors and their families.
Collapse
Affiliation(s)
- Camille Vercasson
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France
| | - Pascal Auquier
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France
| | - Gérard Michel
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France.,Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille Univ, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology and Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Guy Leverger
- Department of Pediatric Hematology and Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - André Baruchel
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Audrey Contet
- Department of Pediatric Onco-Haematology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, University Hospital, Strasbourg, France
| | - Maryline Poirée
- Department of Pediatric Hematology and Oncology, University Hospital L'Archet, Nice, France
| | | | - Nicolas Sirvent
- Department of Pediatric Hematology and Oncology, University Hospital, Montpellier, France
| | - Justyna Kanold
- Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Claire Freycon
- Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, Grenoble, France
| | - Zeinab Hamidou
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France.,National Clinical Research Quality of Life in Oncology Platform, Nancy, France
| | - Julie Berbis
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France
| |
Collapse
|
9
|
Seko Y, Lamptey DL, Nalder E, King G. Assessing resiliency in paediatric rehabilitation: A critical review of assessment tools and applications. Child Care Health Dev 2020; 46:249-267. [PMID: 31944352 DOI: 10.1111/cch.12743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/12/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUNDS Resiliency has attracted a growing interest in paediatric rehabilitation as a key capacity for disabled children and their families to thrive. This study aimed to identify measures used to assess resiliency of disabled children/youth and their families and critically appraise the current use of resiliency measures to inform future research and practice. METHODS A two-stage search strategy was employed. First, systematic reviews of resiliency measures published since 2000 were searched. Second, full names of measures identified in at least two systematic reviews were searched across four electronic databases. Included studies assessed resiliency among children/youth (0-18 years old) with chronic health conditions and/or disabilities and their families. Identified articles were then analysed to discern the study's definition of resiliency, authors' rationales for measurement selection, and types of perceived adversities facing the study participants. RESULTS From an initial yield of 25 measures identified in five systematic reviews, 11 were analysed in two or more reviews. The second stage yielded 41 empirical studies published between 2012 and 2018, which used 8 of the 11 resiliency measures searched by name. Of 41, 17 studies measured resiliency of disabled children/youth, 23 assessed resiliency within family members, and 1 studied both children/youth and their families. Our critical appraisal identified inconsistencies between the studies' definition of resiliency and chosen measures' operationalization, implicit assumption of disabilities as a developmental risk that automatically results in life adversities, and the tendency among family studies to reduce resiliency down to stress coping skills. Research that encompasses contextual factors and developmental influences is lacking. CONCLUSIONS There is a need for a situated measurement approach that captures multiple interacting factors shaping resiliency over one's life course. Resiliency measures would benefit from a greater focus on a person-environment transaction and an alternative definition of resiliency that accounts for multiple capacities to navigate through disabling environments.
Collapse
Affiliation(s)
- Yukari Seko
- School of Professional Communication, Ryerson University, Toronto, Ontario, Canada
| | | | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Gillian King
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
10
|
Yaxing L, Xia S, Shu L, Zhihong L, Qiaoju Y, Yanwei W, Tianxue G, Jun Z. Parents’ Resilience Affects Condition of Children With Henoch-Schönlein Purpura Nephritis. J Nurse Pract 2019. [DOI: 10.1016/j.nurpra.2019.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
Rosenberg AR, Bradford MC, Junkins CC, Taylor M, Zhou C, Sherr N, Kross E, Curtis JR, Yi-Frazier JP. Effect of the Promoting Resilience in Stress Management Intervention for Parents of Children With Cancer (PRISM-P): A Randomized Clinical Trial. JAMA Netw Open 2019; 2:e1911578. [PMID: 31532518 PMCID: PMC6751761 DOI: 10.1001/jamanetworkopen.2019.11578] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE Parents of children with serious illness, such as cancer, experience high stress and distress. Few parent-specific psychosocial interventions have been evaluated in randomized trials. OBJECTIVE To determine if individual- or group-based delivery of a novel intervention called Promoting Resilience in Stress Management for Parents (PRISM-P) improves parent-reported resilience compared with usual care. DESIGN, SETTING, AND PARTICIPANTS This parallel, phase 2 randomized clinical trial with enrollment from December 2016 through December 2018 and 3-month follow-up was conducted at Seattle Children's Hospital. English-speaking parents or guardians of children who were 2 to 24 years old, who had received a diagnosis of a new malignant neoplasm 1 to 10 weeks prior to enrollment, and who were receiving cancer-directed therapy at Seattle Children's Hospital were included. Parents were randomized 1:1:1 to the one-on-one or group PRISM-P intervention or to usual care. Data were analyzed in 2019 (primary analyses from January to March 2019; final analyses in July 2019). INTERVENTIONS The PRISM-P is a manualized, brief intervention targeting 4 skills: stress management, goal setting, cognitive reframing, and meaning making. For one-on-one delivery, skills were taught privately and in person for 30 to 60 minutes approximately every other week. For group delivery, the same skills were taught in a single session with at least 2 parents present. MAIN OUTCOMES AND MEASURES Participants completed patient-reported outcome surveys at enrollment and at 3 months. Linear regression modeling evaluated associations in the intention-to-treat population between each delivery format and the primary outcome (Connor-Davidson Resilience Scale scores, ranging from 0 to 40, with higher scores reflecting greater resilience) and secondary outcomes (benefit finding, social support, health-related quality of life, stress, and distress) at 3 months. RESULTS In total, 94 parents enrolled, were randomized to 1 of the 3 groups, and completed baseline surveys (32 parents in one-on-one sessions, 32 in group sessions, and 30 in usual care). Their median (interquartile range) ages were 35 to 38 (31-44) years across the 3 groups, and they were predominantly white, college-educated mothers. Their children had median (interquartile range) ages of 5 to 8 (3-14) years; slightly more than half of the children were boys, and the most common cancer type was leukemia or lymphoma. One-on-one PRISM-P delivery was significantly associated with improvement compared with usual care in parent-reported outcomes for resilience (β, 2.3; 95% CI, 0.1-4.6; P = .04) and for benefit finding (β, 0.5; 95% CI, 0.2-0.8; P = .001). No significant associations were detected between either platform and other parent-reported outcomes. CONCLUSIONS AND RELEVANCE When delivered individually, PRISM-P was associated with improved parent-reported resilience and benefit finding. This scalable psychosocial intervention may help parents cope and find meaning after their child receives a diagnosis of a serious illness. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02998086.
Collapse
Affiliation(s)
- Abby R. Rosenberg
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle
- Division of Bioethics/Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Seattle
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
| | - Miranda C. Bradford
- Children’s Core for Biomedical Statistics, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Courtney C. Junkins
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Mallory Taylor
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Chuan Zhou
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington
- Division of General Pediatrics, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Nicole Sherr
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Erin Kross
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle
| | - J. Randall Curtis
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle
| | - Joyce P. Yi-Frazier
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
| |
Collapse
|
12
|
Baran G, Arda Sürücü H, Hülya Üzel V. Resilience, life satisfaction, care burden and social support of mothers with a child with acute lymphoblastic leukaemia: a comparative study. Scand J Caring Sci 2019; 34:340-347. [PMID: 31250939 DOI: 10.1111/scs.12734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/06/2019] [Indexed: 01/05/2023]
Abstract
The study aimed to make comparison between the resilience, life satisfaction, care burden and social support of mothers with a child with acute lymphoblastic leukaemia (ALL) and those with a healthy child. The study was carried out using the comparative and descriptive methods, and the study group included mothers with ALL children hospitalised in the Paediatric Haematology Clinic of a university hospital (n = 51) and those with healthy children who applied to a family health centre (n = 53). While collecting the data, Personal Information Form, Resilience Scale for Adults, Life Satisfaction Scale, Zarit Care Burden Scale and Multidimensional Scale of Perceived Social Support Scale were used. The data were statistically analysed using the SPSS program, percentages, mean scores, standard deviations, Mann-Whitney U test and pearson correlation. For the comparison of the personal information about the mothers with ALL children and about those with healthy children, chi-square or student t test for independent groups depending on the data set was used. When the mothers with ALL children were compared with those with healthy children, it was found that the methods with ALL children had statistically lower mean scores for life satisfaction (13.92 ± 6.26, p < 0.001) and resilience (17.90 ± 7.09, p < 0.001) and statistically higher mean scores for care burden (42.23 ± 16.54, p < 0.05). In this study, when the mothers of ALL children were compared with those of healthy children, it was found that the former had lower levels of resilience and life satisfaction and higher levels of care burden.
Collapse
Affiliation(s)
- Gülbeyaz Baran
- Child Health and Pediatric Nursing, Atatürk School of Health, Dicle University, Diyarbakır, Turkey
| | - Hamdiye Arda Sürücü
- Internal Medicine Nursing, Atatürk School of Health, Dicle University, Diyarbakır, Turkey
| | - Veysiye Hülya Üzel
- Faculty of Medicine, The Pediatric Hematology Clinic, Dicle University, Diyarbakır, Turkey
| |
Collapse
|
13
|
Toledano-Toledano F, Domínguez-Guedea MT. Psychosocial factors related with caregiver burden among families of children with chronic conditions. Biopsychosoc Med 2019; 13:6. [PMID: 30899323 PMCID: PMC6407238 DOI: 10.1186/s13030-019-0147-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of looking after children who live with complex chronic conditions is a growing public health issue. However, it is unclear whether sociodemographic and psychosocial variables can be used to predict the burden on the caregiver and how the profiles of families of children with chronic diseases are defined and structured. The objective of this study was to identify multivariate sociodemographic and psychosocial variables as well as sociocultural and familial factors to analyze the caregiver burden of family caregivers of children with chronic diseases. METHODS A cross-sectional study was conducted involving 416 family caregivers of children with chronic diseases at the National Institute of Health in Mexico City. The participants responded to a questionnaire on sociodemographic variables and a battery of 7 instruments that examined caregiver burden, family support, parental stress, anxiety, support networks, family functioning, historic-psycho-socio-cultural premises and the World Health Organization Well-Being Index. RESULTS A multivariate analysis using hierarchical multiple regression models showed that the variables included in the psychosocial and sociodemographic profile as a whole explained 40% of the variance in caregiver burden, taking sociocultural historical premises, stressors and anxiety into account as positive individual predictors. Negative individual predictors for caregiver burden included upper secondary education, social support networks, family support, family functioning and well-being. The sociodemographic profiles of family caregivers were as follows: female (81.7%); mean age, 31.7 years (standard deviation [SD], 8 years); married (79.3%); nuclear family (60%); basic education (62.7%); unpaid work (66.3%); and a daily household income of approximately 4 USD (61.1%). CONCLUSIONS The caregiver burden of family caregivers of children with chronic diseases is defined and structured based on personal, family, and sociocultural factors. These features provide evidence to conduct research and implement intervention strategies with regard to families facing adversity, risk and vulnerability during a child's disease.
Collapse
Affiliation(s)
- Filiberto Toledano-Toledano
- Evidence-Based Medicine Research Unit, Children’s Hospital of Mexico Federico Gómez, National Institute of Health, Mexico. Dr. Márquez 162, Col. Doctores, Del. Cuauhtémoc, C.P. 06720 Mexico City, Mexico
| | - Miriam Teresa Domínguez-Guedea
- Department of Psychology and Communication Sciences, University of Sonora. Blvd. Luis Encinas y Rosales, Col. Centro S/N, 83000 Hermosillo, Sonora Mexico
| |
Collapse
|
14
|
Habibpour Z, Mahmoudi H, Nir MS, Areshtanab HN. Resilience and its Predictors among the Parents of Children with Cancer: A Descriptive-Correlational Study. Indian J Palliat Care 2019; 25:79-83. [PMID: 30820107 PMCID: PMC6388604 DOI: 10.4103/ijpc.ijpc_128_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Context: As a common debilitating illness, cancer is among the leading causes of child mortality in developed and developing countries. Cancer diagnosis for children is considerably stressful for their parents. Resilience is a key factor behind effective coping with cancer-related problems. This study evaluated resilience and its predictors among the parents of children with cancer. Aim: This study evaluated resilience and its predictors among the parents of children with cancer. Settings and Design: This cross-sectional descriptive-analytical study was conducted in 2017 on 400 parents of children with cancer in Tabriz Children's Hospital, Iran. Methods: A demographic questionnaire and the Connor-Davidson Resilience Scale were used to collect the data. Parents were conveniently recruited from Tabriz Children's Hospital. Statistical Analysis: Data were analyzed using the SPSS for Windows program (v. 16) via descriptive and inferential statistical methods. Results: The mean score of parents’ resilience was 66.83 ± 14.28. Fathers obtained significantly higher resilience scores than mothers (P < 0.001). The predictors of parents’ resilience were financial status, parents’ gender, fathers’ employment status, and children's gender. Conclusion: The parents of cancer-afflicted children, particularly their mothers, have low resilience and therefore may be at risk for different physical and mental health problems. Health-care providers need to identify at-risk parents and provide them with greater psychological and educational support.
Collapse
Affiliation(s)
- Zeinab Habibpour
- Department of Medical-surgical Nursing, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Hosein Mahmoudi
- Trauma Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.,Behavioral Sciences Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Masoud Sirati Nir
- Department of Psychiatric Nursing, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Hossein Namdar Areshtanab
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
15
|
Bovero M, Giacomo C, Ansari M, Roulin MJ. Role of advanced nurse practitioners in the care pathway for children diagnosed with leukemia. Eur J Oncol Nurs 2018; 36:68-74. [PMID: 30322512 DOI: 10.1016/j.ejon.2018.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 08/05/2018] [Accepted: 08/16/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE The development of advanced nursing practices (ANP) can meet challenges presented by evolving needs of health care. We aimed at describing the approach taken to implement ANP in a pediatric oncology-hematology unit. METHOD The Participatory, Evidence-informed, Patient-centered Process for Advanced practice was considered as a conceptual framework for the development, implementation and evaluation of the nursing role. Successive steps were taken for identifying patients and family needs, defining the health care priorities, and establishing a new health care model. RESULTS The seven steps of the PEPPA framework were carried out over a year and contributed to the identification of the tasks and the role of the advanced nurse practitioner in the patient care pathway. The implementation of ANP was gradually achieved with the development of new evidenced-based health care procedures. The subsequent approval of a contract specification for advanced nurse practitioners facilitated the onset of a specific consultation, which facilitated a holistic approach. CONCLUSION The impact of the implementation can be appreciated at different levels: i) the patient and his or her family, with improvement of communication and continuity of care; ii) the interdisciplinary team, with development of a dynamic and greater motivation of the health care providers; and iii) the profession, with a greater recognition of the competencies and conceptualization of the new role. An assessment of the process, the structure and the results should be carried out to validate the role of the advanced nurse practitioner throughout the long journey of a child with leukemia.
Collapse
Affiliation(s)
- Maryline Bovero
- Pediatric Oncology and Hematology Unit, Department of Pediatrics, Geneva Children's Hospital, University Hospitals of Geneva, Rue Willy Donzé, 6, Geneva, Switzerland.
| | - Cristiano Giacomo
- Pediatric Oncology and Hematology Unit, Department of Pediatrics, Geneva Children's Hospital, University Hospitals of Geneva, Rue Willy Donzé, 6, Geneva, Switzerland
| | - Marc Ansari
- Pediatric Oncology and Hematology Unit, Department of Pediatrics, Geneva Children's Hospital, University Hospitals of Geneva, Rue Willy Donzé, 6, Geneva, Switzerland
| | - Marie-José Roulin
- Directorate of Nursing and Allied Health Professions, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil, 4, 1205, Geneva, Switzerland
| |
Collapse
|
16
|
Morote R, Hjemdal O, Martinez Uribe P, Corveleyn J. Psychometric properties of the Resilience Scale for Adults (RSA) and its relationship with life-stress, anxiety and depression in a Hispanic Latin-American community sample. PLoS One 2017; 12:e0187954. [PMID: 29125876 PMCID: PMC5681258 DOI: 10.1371/journal.pone.0187954] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 10/30/2017] [Indexed: 01/20/2023] Open
Abstract
Resilience is a multi-dimensional construct associated with health and well-being. At present, we do not yet have a valid, scientific instrument that is designed to evaluate adult resilience in Spanish-speaking countries and that accounts for family, social and individual components. This study aimed at investigating the construct and cross-cultural validity of the Resilience Scale for Adults (RSA) by combining Confirmatory Factor Analysis (CFA), Multidimensional Scaling (MDS) and Hierarchical Regression models in a Hispanic Latin-American group. A community sample of 805 adults answered the RSA, Spanish Language Stressful Life-Events checklist (SL-SLE), and the Hopkins Symptom Checklist-25 (HSCL-25). First-order CFA verified the six factors structure for the RSA (RMSEA = .037, SRMR = .047, CFI = .91, TLI = .90). Five RSA scales and total score have good internal consistency (scales α > .70; total score α = .90). Two second-order CFA verified the intrapersonal and interpersonal dimensions of the protector factors of resilience, as well as their commonality and uniqueness with affective symptoms (anxiety and depression). An exploratory MDS reproduced the relations of RSA items and factors at first and second-order levels against random simulated data, thereby providing initial evidence of its cross-cultural validity in a Spanish-speaking group. The Four-steps hierarchical model showed that the RSA scales are the strongest predictors of anxiety and depression–greater than gender, age, education and stressful life-events. Three RSA scales are significant unique predictors of affective symptoms. In addition, similar to findings in diverse cultural settings, resilience is positively associated with age but not with education. Women report higher scores of Social Resources and Social Competence and lower scores of Perception of the Self. In conclusion, this study demonstrates the construct and criterion-related validity of the RSA in broad, diverse and Spanish speaking sample.
Collapse
Affiliation(s)
- Roxanna Morote
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychology, Catholic University of Peru, Lima, Peru
- * E-mail:
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Jozef Corveleyn
- Department of Psychology, University of Leuven, Leuven, Belgium
| |
Collapse
|
17
|
Morote R, Hjemdal O, Krysinska K, Martinez Uribe P, Corveleyn J. Resilience or hope? Incremental and convergent validity of the resilience scale for adults (RSA) and the Herth hope scale (HHS) in the prediction of anxiety and depression. BMC Psychol 2017; 5:36. [PMID: 29078801 PMCID: PMC5659010 DOI: 10.1186/s40359-017-0205-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 10/19/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Hope and resilience protect against inner vulnerabilities or harsh life circumstances; they explain individual differences in physical or mental health outcomes under high stress. They have been studied in complementary or competing theoretical frameworks; therefore, the study of measures of hope and resilience should be undertaken prior to explore if they are truly value-added for research. This study investigates the convergent and incremental validity of the Resilience Scale for Adults (RSA) and the Herth Hope Scale (HHS), in the prediction of anxiety and depression (HSCL-25). METHODS Participants in this community-based sample are 762 adults from 18 to 74 years old. They answered the RSA, HHS, Spanish Language Stressful Life-Events Checklist (SL-SLE), and the Hopkins Symptom Checklist-25 (HSCL-25). Incremental validity analyses combined hierarchical regression and structural equation models (SEM). First, hierarchical regression models were compared based on three criteria (R 2Diff., ΔF, and semi-partial r), then the direct effect of resilience on affective symptoms was compared with the mediated effect of resilience on affective symptoms through hope. RESULTS The hierarchical models showed that (1) hope and resilience account significantly for the variance of affective symptoms above age, sex, and life-stress; (2) Resilience Total score has greater incremental validity than positive scales of HHS Hope; and (3) RSA Total score, HHS Optimism/Spiritual support, Stressful life-events and sex are unique predictors of affective symptoms. The SEM analyses verified a stronger direct effect of resilience in the prediction of affective symptoms above the significant partial mediated effect of resilience through hope. Additionally, results show that age and better educational opportunities were associated with protection (i.e. resilience and hope) and emotional well-being (i.e. affective symptoms and hopelessness). Women showed higher scores in social competences and resources (RSA), interconnectedness and initiative to take action (HHS). However, they have poorer evaluations of own abilities and efficacy (RSA), and higher scores in all the affective symptoms assessed. CONCLUSION The RSA has incremental validity above the HHS, however, both the RSA and the HHS are effective, differentiated and complementary measures of protection that are of high relevance for research on psychosocial and emotional well-being.
Collapse
Affiliation(s)
- Roxanna Morote
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychology, Catholic University of Peru, Lima, Peru
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Karolina Krysinska
- Dementia Collaborative Research Centre, University of New South Wales, Sidney, Australia
| | | | - Jozef Corveleyn
- Department of Psychology, University of Leuven, Leuven, Belgium
| |
Collapse
|
18
|
Cancer-bereaved siblings' positive and negative memories and experiences of illness and death: A nationwide follow-up. Palliat Support Care 2017. [DOI: 10.1017/s1478951517000529] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:Our aim was to explore bereaved siblings' positive and negative memories and experiences of their brother's or sister's illness and death.Method:In our nationwide Swedish study, 174 of 240 (73%) bereaved siblings participated, and 70% responded to two open-ended statements, which focused on siblings' positive and negative memories and experiences of illness and death. The data were analyzed using systematic text condensation.Results:The bereaved siblings' responses were categorized into four different themes: (1) endurance versus vulnerability, (2) family cohesion versus family conflicts, (3) growth versus stagnation, and (4) professional support versus lack of professional support. The first theme expressed endurance as the influence that the ill siblings' strong willpower, good mood, and stamina in their difficult situation had on healthy siblings, whereas vulnerability was expressed as the feeling of emptiness and loneliness involved with having an ill and dying sibling. In the second theme, family cohesion was expressed as the bonds being strengthened between family members, whereas family conflicts often led siblings to feel invisible and unacknowledged. In the third theme, most siblings expressed the feeling that they grew as individuals in the process of their brother's or sister's illness and death, whereas others experienced stagnation because of the physical and mental distress they bore throughout this time, often feeling forgotten. In the last theme—professional support—most siblings perceived physicians and staff at the hospital as being warm, kind, and honest, while some siblings had negative experiences.Significance of results:The study shows that bereaved siblings can have positive memories and experiences. The significance of the positive buffering effect on bereaved siblings' own endurance, personal growth, family cohesion, and social support should be noted. This knowledge can be valuable in showing healthcare professionals the importance of supporting the siblings of children with cancer throughout the cancer trajectory and afterwards into bereavement.
Collapse
|
19
|
Coping as a Multifaceted Construct: Associations With Psychological Outcomes Among Family Members of Mechanical Ventilation Survivors. Crit Care Med 2017; 44:1710-7. [PMID: 27065467 DOI: 10.1097/ccm.0000000000001761] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To develop and evaluate a preliminary multifaceted model for coping among family members of patients who survive mechanical ventilation. DESIGN AND SETTING In this multicenter cross-sectional survey, we interviewed family members of mechanically ventilated patients at the time of transfer from the ICU to the hospital ward. We constructed a theoretic model of coping that included characteristics attributable to family members, family-clinician rapport, and patients. We then explored relationships between coping factors and symptoms of psychological distress (anxiety, depression, and posttraumatic stress). SUBJECTS Fifty-six family members of survivors of mechanical ventilation. MEASUREMENTS AND MAIN RESULTS Psychological distress measured by the Hospital Anxiety and Depression Scale and Posttraumatic Stress Scale. Optimism measured using the Life Orientation Test scale, resiliency by Conner-Davidson Resilience Scale, and social support using the Patient Reported Outcomes Measurement Information System inventory. Family members had moderate levels of psychological distress with median total Hospital Anxiety and Depression Scale equal to 14 (interquartile range, 5-20) and Posttraumatic Stress Scale equal to 22 (interquartile range, 15-31). Among family member characteristics, greater optimism (p = 0.001, Hospital Anxiety and Depression Scale; p = 0.010, Posttraumatic Stress Scale), resilience (p = 0.012, Hospital Anxiety and Depression Scale), and social support (p = 0.013, Hospital Anxiety and Depression Scale) were protective against psychological distress. On the contrary, characteristics of family-clinician rapport such as communication quality and presence of conflict did not have any associations with psychological distress. CONCLUSION To our knowledge, this is the first study to explore coping as a multifaceted construct and its relationship with family psychological outcomes among survivors of mechanical ventilation. We found certain family characteristics of coping such as optimism, resilience, and social support to be associated with less psychological distress. Further research is warranted to identify potentially modifiable aspects of coping that might guide future interventions.
Collapse
|
20
|
Prevalence and predictors of posttraumatic stress symptoms in parents of children with ongoing treatment for cancer in South China: a multi-centered cross-sectional study. Support Care Cancer 2016; 25:1159-1167. [PMID: 27966022 DOI: 10.1007/s00520-016-3506-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Parents of children with ongoing cancer treatment are exposed to risks of developing posttraumatic stress symptoms (PTSS), but little is known about the prevalence and predictors of PTSS among Chinese parents of children with cancer. This study aimed to examine the predictors of PTSS, and explored the correlation of depression, resilience, and family functions with severe PTSS. METHODS This cross-sectional survey was conducted from May 2014 to September 2015 among the parents of cancer children treated in four general hospitals in South China. PTSS in the parents were measured using post-traumatic stress checklist-civilian version (PCL-C). Multiple regression analyses were performed to evaluate the predictive values of depression, resilience, family functioning, and the demographic variables for severe PTSS. RESULTS A total of 279 parents (192 mothers and 87 fathers) participated in the survey. Severe PTSS, as defined by a PCL-C score ≥50, were reported in 32.97% (n = 92) of the total participants, 26.44% (23/87) in the fathers and 35.94% (69/192) in the mothers. The level of PTSS was positively correlated with depression (r = 0.782, P < 0.01) and a poor general family function (r = 0.325, P < 0.01) and negatively correlated with resilience (r = -0.236, P < 0.01). Multivariate analyses indicated that depression, general family function, gender, and education level were significant predictive factors of severe PTSS in the overall parents, accounting for 64.2% of the variance in the prediction of PTSS (R 2 = 0.642, F = 122.602, P = 0.000). For the mothers, depression and family function accounted for 66.5% of the variance in the prediction of PTSS (R 2 = 0.665, F = 187.451, P = 0.000); for the fathers, depression and educational level accounted for 58.8% of the variance in the prediction of PTSS (R 2 = 0.588, F = 59.829, P = 0.000). CONCLUSION Parents, especially the mothers, of children with ongoing treatment for cancer are at risk of developing PTSS. Supportive psychological interventions to attenuate the negative emotions of the parents and improve their family functions are important means to promote their natural protective mechanisms to cope with the stressful events.
Collapse
|