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Ma H, He Y, Wu W, Ye Q, Wu Q, Hu K, Jiang X, Tang L, Yang Q. Association Between Dyadic Coping and Psychosocial Adjustment and the Mediation Effect of Fear of Disease Progression in Patients With Malignancy and Their Caregivers: Based on the Actor-Partner Interdependence Model. Cancer Nurs 2024:00002820-990000000-00286. [PMID: 39190805 DOI: 10.1097/ncc.0000000000001395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
BACKGROUND Psychosocial adjustment (PSA) in patients exhibits a positive correlation with dyadic coping (DC) and a negative correlation with fear of disease progression (FoP). However, few studies have explored how DC impacts PSA and whether FoP mediates this relationship. OBJECTIVE To investigate the status of DC, FoP, and PSA in patients with malignancy and their caregivers and to explore the actor-partner and mediating effect of FoP on the association between PSA and DC. METHODS This study employed a cross-sectional design with convenience sampling to select patients with malignancy and their caregivers from 2 hospitals in China. SPSS and AMOS were used for data analysis. RESULTS The model showed the mediation effect accounts for 28.30% of the total effect. For the actor effects, patients' and their caregivers' DC influenced their PSA directly (both β = -.138, P < .05) or through their FoP (β = -.050 and β = -.55, both P < .05). As for partner effects, patients' DC influenced the caregivers' PSA directly or through the patients' FoP (β = -.118 and β = -.020, both P < .05). Caregivers' DC also influenced patients' PSA directly (β = -.118, P < .05) or through the patients' or caregivers' FoP (β = -.098 and β = -.018, both P < .05). CONCLUSIONS The model revealed a significant mediating effect of FoP on the association between the PSA and DC of patients with malignancy and their caregivers. IMPLICATIONS FOR PRACTICE Nurses should adopt a comprehensive perspective that includes caregivers in holistic care to improve their PSA by improving their level of DC or mitigating FoP.
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Affiliation(s)
- Hualong Ma
- Author Affiliations: School of Nursing, Jinan University (Mr Ma, Ms Q Wu, Ms Hu, and Dr Yang); and Tianhe Shipai Huashi Community Health Service Center (Ms Ye), Guangdong, China; St Mark's School, Southborough, Massachusetts (Ms W Wu); Shanwei Second People's Hospital, Guangdong, China (Ms Jiang, Ms Tang, and Mr He)
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Webb K, Sharpe L, Butow P, Dhillon H, Zachariae R, Tauber NM, O'Toole MS, Shaw J. Caregiver fear of cancer recurrence: A systematic review and meta-analysis of quantitative studies. Psychooncology 2023; 32:1173-1191. [PMID: 37303263 DOI: 10.1002/pon.6176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/10/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is reported by both cancer survivors and caregivers however less is known about caregiver FCR. This study aimed to (a) conduct a meta-analysis to compare survivor and caregiver FCR levels; (b) examine the relationship between caregiver FCR and depression, and anxiety; (c) evaluate psychometric properties of caregiver FCR measures. METHODS CINAHL, Embase, PsychINFO and PubMed were searched for quantitative research examining caregiver FCR. Eligibility criteria included caregivers caring for a survivor with any type of cancer, reporting on caregiver FCR and/or measurement, published in English-language, peer-review journals between 1997 and November 2022. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy was used to evaluate content and psychometric properties. The review was pre-registered (PROSPERO ID: CRD42020201906). RESULTS Of 4297 records screened, 45 met criteria for inclusion. Meta-analysis revealed that caregivers reported FCR levels as high as FCR amongst survivors, with around 48% of caregivers reporting clinically significant FCR levels. There was a strong correlation between anxiety and depression and medium correlation with survivor FCR. Twelve different instruments were used to measure caregiver FCR. Assessments using the COSMIN taxonomy revealed few instruments had undergone appropriate development and psychometric testing. Only one instrument met 50% or more of the criteria, indicating substantial development or validation components were missing in most. CONCLUSIONS Results suggest FCR is as often a problem for caregivers as it is for survivors. As in survivors, caregiver FCR is associated with more severe depression and anxiety. Caregiver FCR measurement has predominately relied on survivor conceptualisations and unvalidated measures. More caregiver-specific research is urgently needed.
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Affiliation(s)
- Kyra Webb
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Phyllis Butow
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Haryana Dhillon
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- Centre for Medical Psychology & Evidence-Based Decision Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Robert Zachariae
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Department of Oncology, Unit for Psychooncology and Health Psychology (EPoS), Aarhus University Hospital, Aarhus, Denmark
| | - Nina Møller Tauber
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Mia Skytte O'Toole
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
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Rautmann L, Witt S, Theiding C, Odenwald B, Nennstiel-Ratzel U, Dörr HG, Quitmann JH. Caring for a Child with Congenital Adrenal Hyperplasia Diagnosed by Newborn Screening: Parental Health-Related Quality of Life, Coping Patterns, and Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4493. [PMID: 36901502 PMCID: PMC10002056 DOI: 10.3390/ijerph20054493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Diagnosing a child by newborn screening with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH) causes multiple challenges for the affected parents and the whole family. We aimed to examine the health-related Quality of Life (HrQoL), coping, and needs of parents caring for a child with CAH to develop demand-responsive interventions for improving the psychosocial situation of affected families. In a retrospective cross-sectional design, we assessed HrQoL, coping patterns, and the needs of parents caring for a CAH-diagnosed child using specific questionnaires. Data of 59 families with at least one child diagnosed with CAH were analyzed. The results show that mothers and fathers in this study reached significantly higher HrQoL scores compared to reference cohorts. Decisive for the above-average parental HrQoL were effective coping behaviors and the parental needs being met. These findings verify the importance of helpful coping patterns and rapid fulfillment of parental needs for maintaining a good and stable HrQoL of parents with a child diagnosed with CAH. It is crucial to strengthen the parental HrQoL to build a reasonable basis for a healthy upbringing and improve the medical care of CAH-diagnosed children.
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Affiliation(s)
- Laura Rautmann
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W26, 20246 Hamburg, Germany
| | - Stefanie Witt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W26, 20246 Hamburg, Germany
| | - Christoph Theiding
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W26, 20246 Hamburg, Germany
| | - Birgit Odenwald
- Bavarian Screening Center, Bavarian State Office for Health and Food Safety, Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Uta Nennstiel-Ratzel
- Bavarian Screening Center, Bavarian State Office for Health and Food Safety, Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Helmuth-Günther Dörr
- Department of Pediatric Endocrinology, University Children’s Hospital Erlangen, Loschgestr. 15, 91054 Erlangen, Germany
| | - Julia Hannah Quitmann
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W26, 20246 Hamburg, Germany
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Yang Y, Zhang Y, Liang L, Liao X, Meng J, Cai R, Ye H, Hu J, He X, Shi L. Fear of progression and its associated factors in parents of children undergoing cancer treatment: A CROSS-SECTIONAL STUDY. Psychooncology 2022; 31:1737-1744. [PMID: 36073576 DOI: 10.1002/pon.6027] [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: 12/14/2021] [Revised: 07/04/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Fear of progression (FoP) is a common psychosocial problem among adult cancer patients, but data on parents of children undergoing cancer treatment are scarce. This study aimed to determine the prevalence of FoP in parents of children undergoing cancer treatment and explore the associated factors. METHODS Overall, 285 parents of children undergoing cancer treatment were recruited from three general hospitals in China. FoP in the parents was assessed using the Chinese version of the Fear of Progression Questionnaire-parent version (FoP-Q-SF/PR). Other questionnaires included the Self-Compassion Scale, Pittsburgh Sleep Quality Index, Posttraumatic Stress Disorder Checklist-Civilian Version, and items on socio-demographic and medical characteristics. Pearson correlation and multiple linear regression analysis were used to identify factors associated with FoP. RESULTS A total of 75.1% of the participants showed dysfunctional levels of FoP. The mean FoP-Q-SF/PR score was 39.98 (standard deviation=9.18). Parental FoP was significantly associated with a shorter time since diagnosis, lower levels of self-compassion, poor sleep quality, and severe posttraumatic stress symptoms (Adjusted R Squared=0.369, F=12.838, p<0.01). CONCLUSIONS FoP is a frequently reported problem among parents of children undergoing cancer treatment. In this cohort, parents of children with a shorter time since cancer diagnosis were at higher risk of suffering from FoP. Interventions to enhance self-compassion, improve sleep quality, and mitigate posttraumatic stress symptoms may help with the psychological adjustment and well-being of parents whose children are undergoing cancer treatment. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yiling Yang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yuwei Zhang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Lichan Liang
- Department of Pediatric Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaomei Liao
- Department of Pediatric Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiangnan Meng
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ruiqing Cai
- Department Pediatric Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Hongyu Ye
- Department of Pediatric Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiamin Hu
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Xiaofeng He
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Nursing, Southern Medical University, Guangzhou, China
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Richter D, Clever K, Mehnert-Theuerkauf A, Schönfelder A. Fear of Recurrence in Young Adult Cancer Patients—A Network Analysis. Cancers (Basel) 2022; 14:cancers14092092. [PMID: 35565220 PMCID: PMC9105535 DOI: 10.3390/cancers14092092] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Fear of cancer recurrence is a main concern for the majority of cancer patients during their disease. Young adults with cancer may experience fear of recurrence throughout their lives, given their relatively long potential survival time. More research is needed to identify evidence-based interventions that can adequately address this fear. Investigating the underlying mechanisms that trigger and sustain fear of cancer recurrence is an important step toward this goal. Network analysis is a useful tool to study symptoms and their structural relationships. The aim of this study is to apply the network analysis approach in a sample of young cancer patients to comprehend their specific symptomatology and define the optimal structure of a questionnaire to assess fear of recurrence in this patient group. Future studies may seek to replicate our findings among different age group samples to identify network structures and potential targets for clinical intervention. Abstract Due to the high survival rates of many young cancer patients and a high risk of second tumors, fear of cancer recurrence (FCR) can cause serious impairment for adolescent and young adult (AYA) cancer patients. The aim of this study is to analyze the structure of the Fear of Disease Progression Questionnaire (FoP-Q-12) to better understand the construct of FCR. We performed a cross-sectional survey on a sample of AYA patients aged 15–39 years with different tumor entities. FCR was measured using the FoP-Q-12, and a network analysis was conducted to examine the relationship of FCR symptoms. The importance of individual items in the network was determined using centrality analyses. A total of 247 AYA patients (81.8% female, median age 31.0 years) participated in the study. The mean FCR score in the sample was 35.9 (SD = 9.9). The majority of patients reported having high FCR (59.5%), according to the established cut-off. The two questionnaire items with the strongest association related to fears about work, and the most central symptom was the fear of serious medical interventions. The centrality of emotional issues in the sample indicates that these symptoms should be prioritized in the development of interventions targeting FCR. Further research should address this topic with larger samples of patients in other age groups and in longitudinal studies.
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Affiliation(s)
- Diana Richter
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, 04103 Leipzig, Germany; (A.M.-T.); (A.S.)
- Correspondence: ; Tel.: +49-341-97-15438
| | - Katharina Clever
- Department of Psychosomatics and Psychotherapy, MEDIAN Centre for Rehabilitation Schmannewitz, 04774 Dahlen, Germany;
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, 04103 Leipzig, Germany; (A.M.-T.); (A.S.)
| | - Antje Schönfelder
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, 04103 Leipzig, Germany; (A.M.-T.); (A.S.)
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Wang Q, Chen S, Liu W, Zan C, Sheng Y. Validation of the Chinese version of the Family Crisis Oriented Personal Evaluation Scales in families of patients with dementia. Geriatr Nurs 2022; 45:131-139. [PMID: 35421839 DOI: 10.1016/j.gerinurse.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
Abstract
Caring for people with dementia causes heavy care burdens to their families. Family coping is important in decreasing burdens and promoting family adaptation. To comprehensively assess and understand these issues, we validated the Chinese version of the Family Crisis Oriented Personal Evaluation Scales (F-COPES) which is widely used to evaluate family coping. Data for psychometric property evaluation were obtained from 215 family members of patients with dementia. The instrument showed satisfactory content validity (scale content validity index 0.98), convergent validity (r = 0.50, P < 0.01), and internal consistency (Cronbach's alpha 0.86). The confirmatory factor analysis identified six factors, namely, acquiring relatives' support, acquiring friends' support, acquiring neighbors' or others' support, seeking spiritual support, reframing, and passive appraisal (χ2/df 1.86, CFI 0.88, TLI 0.87, PGFI 0.68, RMSEA 0.06). This instrument may serve as a useful scale for assessing the coping behaviors of families of patients with dementia in mainland China.
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Affiliation(s)
- Qingyan Wang
- Department of Clinical Nursing, School of Nursing, Xuzhou Medical University, Xuzhou Medical University Affiliated Oriental People's Hospital, Xuzhou, 221004, China
| | - Sanmei Chen
- Department of Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Weiwei Liu
- School of Nursing, Army Medical University, Chongqing, 400038, China
| | - Chang Zan
- Department of Clinical Nursing, School of Nursing, Xuzhou Medical University, Xuzhou Medical University Affiliated Oriental People's Hospital, Xuzhou, 221004, China
| | - Yu Sheng
- School of Nursing, Peking Union Medical College, Beijing, 100144, China.
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Herzog K, Schepper F, Kamm R, Engelhardt‐Lohrke C, Kreisch A, Pletschko T, Hauer J, Christiansen H, Suttorp M, Kiel J, Martini J. Illness perceptions in patients and parents in paediatric oncology during acute treatment and follow‐up care. Psychooncology 2022; 31:950-959. [DOI: 10.1002/pon.5883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Kristina Herzog
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Florian Schepper
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Remo Kamm
- Sonnenstrahl e.V. Dresden – Förderkreis für krebskranke Kinder und Jugendliche Germany
| | | | - Andrea Kreisch
- Department of Paediatrics Paediatric Haematology and Oncology University Hospital Carl Gustav Carus Dresden Germany
| | - Thomas Pletschko
- Department of Paediatric and Adolescent Medicine Medical University Vienna Austria
| | - Julia Hauer
- Department of Paediatrics Paediatric Haematology and Oncology University Hospital Carl Gustav Carus Dresden Germany
| | - Holger Christiansen
- Department of Paediatric Oncology Haematology and Haemostaseology Leipzig University Germany
| | - Meinolf Suttorp
- Faculty of Medicine of the Technische Universität Dresden Germany
| | - Julia Kiel
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy Faculty of Medicine of the Technische Universität Dresden Germany
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Bąk J, Zarzycka D. Parents' from Poland coping with the illness of a child-Preliminary research. Cultural adaptation and evaluation of the psychometric properties of the coping health inventory for parents - polish version. J Pediatr Nurs 2022; 62:69-77. [PMID: 34799204 DOI: 10.1016/j.pedn.2021.11.001] [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: 08/06/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE The goal was to present preliminary research results on how parents cope with the illness of a child using the Coping Health Inventory for Parents (CHIP) after it had been culturally adapted and its psychometric properties evaluated. DESIGN AND METHODS Taking part in the study were 459 parents of children with asthma (n = 230) or suffering pain (n = 229).A. RESULTS The content validity of the coefficient of variation ratio (CVR) for each item on the scale ranged from 0.84 to 1.00. Exploratory factor analysis by principal components method with Equamax rotation confirmed the three-factor structure of the test. THe theoretical validity of the tool was confirmed by intercorrelation matrix analysis, and the criterion validity of the CHIP test was evaluated based on analysis of intergroup differences regarding individual measurements of coping by parents of children diagnosed with asthma but differentiated by need of regular medication. CHIP has high Cronbach alpha coefficients values: 0.80-0.86. Results indicate that the children's parents rate as moderately helpful the Support (2.23, ± 0.60) and Family (2.17, ± 0.55) styles. Parents rated the Medical style as least helpful in coping (1.75, ± 0,59). CONCLUSIONS This study confirms both the accuracy and the reliability of the CHIP test, and the obtained coefficient values indicate that the tool can be used for individual and for scientific research. PRACTICE IMPLICATIONS The study shows that assessment of the manner of a parent's coping with the illness of a child is influenced by the child's gender and place of residence.
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Affiliation(s)
- Jadwiga Bąk
- Faculty of Health Sciences, Medical University of Lublin, Poland.
| | - Danuta Zarzycka
- Department of Paediatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Poland
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Peikert ML, Inhestern L, Krauth KA, Escherich G, Rutkowski S, Kandels D, Schiekiera LJ, Bergelt C. Fear of progression in parents of childhood cancer survivors: prevalence and associated factors. J Cancer Surviv 2021; 16:823-833. [PMID: 34302272 PMCID: PMC9300493 DOI: 10.1007/s11764-021-01076-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/14/2021] [Indexed: 10/29/2022]
Abstract
PURPOSE Recent research demonstrated that fear of progression (FoP) is a major burden for adult cancer survivors. However, knowledge on FoP in parents of childhood cancer survivors is scarce. This study aimed to determine the proportion of parents who show dysfunctional levels of FoP, to investigate gender differences, and to examine factors associated with FoP in mothers and fathers. METHODS Five hundred sixteen parents of pediatric cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system (CNS) tumor) were consecutively recruited after the end of intensive cancer treatment. We conducted hierarchical multiple regression analyses for mothers and fathers and integrated parent-, patient-, and family-related factors in the models. RESULTS Significantly more mothers (54%) than fathers (41%) suffered from dysfunctional levels of FoP. Maternal FoP was significantly associated with depression, a medical coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and lower family functioning (adjusted R2 = .30, p < .001). Paternal FoP was significantly associated with a lower level of education, depression, a family coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and fewer siblings (adjusted R2 = .48, p < .001). CONCLUSIONS FoP represents a great burden for parents of pediatric cancer survivors. We identified associated factors of parental FoP. Some of these factors can be targeted by health care professionals within psychosocial interventions and others can provide an indication for an increased risk for higher levels of FoP. IMPLICATIONS FOR CANCER SURVIVORS Psychosocial support targeting FoP in parents of childhood cancer survivors is highly indicated.
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Affiliation(s)
- Mona L Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology and Oncology, Klinik Bad Oexen, Oexen 27, 32549, Bad Oeynhausen, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Louis J Schiekiera
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Murphy LK, Heathcote LC, Prussien KV, Rodriguez EM, Hewitt JA, Schwartz LE, Ferrante AC, Gerhardt CA, Vannatta K, Compas BE. Mother-child communication about possible cancer recurrence during childhood cancer survivorship. Psychooncology 2020; 30:536-545. [PMID: 33227159 DOI: 10.1002/pon.5600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/29/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Providing opportunities to communicate about possible cancer recurrence may be adaptive for youth in remission, yet parents may experience difficulty guiding discussions related to fears of cancer recurrence (FCR). This study aimed to characterize mother-child discussions about potential cancer recurrence during post-treatment survivorship and to determine predictors of maternal communication. METHODS Families (N = 67) were recruited after the child's initial cancer diagnosis (age 5-17 years) and mothers self-reported their distress (post-traumatic stress symptoms; PTSS). During survivorship 3-5 years later, mothers were video-recorded discussing cancer with their children. Presence and length of discussion about potential cancer recurrence, triggers for FCR, expressed affect, and conversational reciprocity were examined. Hierarchical regressions were used to assess maternal PTSS near the time of cancer diagnosis and child age as predictors of maternal communication. RESULTS Three-quarters of dyads spontaneously discussed risk for or fears about cancer recurrence; mothers initiated the topic more frequently than their children. Dyads discussed internal (bodily symptoms) and external (medical, social) triggers of FCR. Higher maternal PTSS at diagnosis predicted significantly lower levels of maternal positive affect (β = -0.36, p = 0.02) and higher levels of maternal negative affect (β = 0.30, p = 0.04) during discussion of recurrence 3-5 years later. Older child age significantly predicted higher levels of maternal negative affect (β = 0.35, p = 0.02). Higher maternal PTSS at diagnosis predicted shorter discussions about recurrence for younger children (β = 0.27, p = 0.02). CONCLUSIONS Understanding predictors and characteristics of mother-child discussions about recurrence can guide family-based FCR interventions, particularly those promoting communication as a supportive tool. Both maternal PTSS and child age are important to consider when developing these interventions.
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Affiliation(s)
- Lexa K Murphy
- Department of Psychology & Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Lauren C Heathcote
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Kemar V Prussien
- Department of Psychology & Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Erin M Rodriguez
- Department of Psychology, University of Texas at Austin, Austin, Texas, USA
| | - Jackson A Hewitt
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura E Schwartz
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - Amanda C Ferrante
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Cynthia A Gerhardt
- The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA
| | - Kathryn Vannatta
- The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA
| | - Bruce E Compas
- Department of Psychology & Human Development, Vanderbilt University, Nashville, Tennessee, USA
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