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Chong YY, Temesgen WA, Chan H, Wong CL, Cheng HY. Psychosocial interventions for improving mental health and family functioning in families with parental cancer: A systematic review. Eur J Oncol Nurs 2024; 68:102505. [PMID: 38309255 DOI: 10.1016/j.ejon.2024.102505] [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: 12/02/2023] [Accepted: 01/05/2024] [Indexed: 02/05/2024]
Abstract
PURPOSE Parental cancer significantly impacts both parents and children, necessitating psychosocial interventions to enhance family well-being. This systematic review aimed to assess the effectiveness of psychosocial interventions targeting parents with cancer on their mental health, quality of life, their children's well-being, and family functioning. METHODS A comprehensive search was conducted in Ovid MEDLINE, PubMed, PsycINFO, and Cochrane Central Register of Controlled Trials databases for relevant articles published from 2006 to 2023. The methodological aspects of eleven studies from diverse countries were critically evaluated. RESULTS The review included 496 parents, primarily female breast cancer patients, and their children. Narrative synthesis highlighted interventions that aimed to strengthen parent-child connection (Enhancing Connection (EC)), enhance family communication, improve psychological well-being of parents (Struggle for Life Intervention), and address children's mental health (Wonders and Worries (W&W)). Additionally, interventions like Cancer PEPSONE Program (CPP) aimed to expand social networks and support systems. These interventions demonstrated success in reducing depressive and anxiety symptoms, parenting stress, and mitigating children's externalizing and internalizing problems. However, they were not exempt from methodological limitations such as participant selection bias, lack of blinding, and low follow-up rates. CONCLUSIONS Based on the review, psychological support for parents with cancer is an emerging field, predominantly explored in Western countries with a significant emphasis on maternal experiences. The early stage of this field and inherent methodological limitations warrant cautious interpretation of these findings and further research for comprehensive understanding and application.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Worku Animaw Temesgen
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Hailey Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
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Bernstein RT, Garner-Purkis A, Gallagher JE, Newland-Pedley, Scambler S. A systematic review of social impacts of treatment and rehabilitation of head and neck cancer patients. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2023. [DOI: 10.1016/j.adoms.2023.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Matthews S, Brett J, Ramluggun P, Watson E. The psychosocial experiences of human papillomavirus (HPV) positive oropharyngeal cancer patients following (chemo)radiotherapy: A systematic review and meta-ethnography. Psychooncology 2022; 31:2009-2019. [PMID: 35726440 PMCID: PMC10084069 DOI: 10.1002/pon.5984] [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: 11/29/2021] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The UK incidence of oropharyngeal cancer has risen sharply over the last 30 years with an increase in human papillomavirus (HPV) associated diagnoses, most prevalent in younger, working age populations. This meta-ethnography explores the psychosocial needs of HPV+ve oropharyngeal cancer patients during early recovery following (chemo)radiotherapy. METHODS Meta-ethnography methods were used, based on the approach of Noblit and Hare. Systematic searches for relevant qualitative studies were conducted in five electronic databases (MEDLINE, PubMed, CINAHL, PsycINFO and Cochrane database) between 2010 and 2021, followed by citation searching. RESULTS Twenty-three papers exploring the psychosocial needs of HPV+ve oropharyngeal cancer patients after treatment were included. Findings were synthesised to develop five constructs: 'gaps in continuity of support from healthcare professionals' reflecting unmet needs; 'changes to self-identity' revealing the comprehensive disruption of this disease and treatment; 'unrealistic expectations of recovery' highlighting the difficulty of preparing for the impact of treatment; 'finding ways to cope' describing the distinct complexity of this experience; and 'adjusting to life after the end of treatment' exploring how coping strategies helped patients to regain control of their lives. CONCLUSIONS Completing (chemo)radiotherapy signalled a transition from hospital-based care to home-based support, challenging patients to address the constructs identified. An unexpectedly difficult and complex recovery meant that despite a favourable prognosis, poor psychosocial well-being may threaten a successful outcome. The provision of tailored support is essential to facilitate positive adjustment.
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Affiliation(s)
- Sara Matthews
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Jo Brett
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Pras Ramluggun
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Eila Watson
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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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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Child- and family-specific communication skills trainings for healthcare professionals caring for families with parental cancer: A systematic review. PLoS One 2022; 17:e0277225. [DOI: 10.1371/journal.pone.0277225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/22/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction
As part of high-quality cancer care, healthcare professionals (HCPs) play a significant role in identifying and addressing specific needs of cancer patients parenting minor children. However, HCPs experience various barriers to adequately support parents with cancer. This systematic review explores current CSTs incorporating child- and family- specific modules for HCPs in oncology. Moreover, outcome measures and effectiveness of trainings are systematically investigated.
Methods
The systematic review was registered within PROSPERO (registration code: CRD42020139783). Systematic searches were performed in four databases (PubMed, Cinahl, PsycInfo, Web of Science) in 12/2020, including an update in 12/2021 and 08/2022. Quantitative, primary studies fulfilling the pre-defined inclusion criteria were included. Due to the expected heterogeneity a meta-analysis was not conducted. Study selection and quality assessment were conducted by two independent researchers, data extraction by one. Study quality was assessed using an adapted version of the National Institutes of Health quality assessment tool for pre-post studies without control group.
Results
Nine studies were included in this review following an experimental pre-post design only. Two CSTs were specifically designed to improve communication with cancer patients parenting minor children, the remaining seven incorporated a brief family module only. Seven programs were face-to-face trainings, one an e-learning and one a webinar. Eight studies found at least one statistically significant improvement in communication after training. However, quality of most studies was fair.
Conclusion
This is the first review exploring specific CSTs for HCPs caring for cancer patients parenting minor children. As only two CSTs focused on parental cancer, evidence on the effectiveness of such CSTs is limited. Existing CSTs should be evaluated properly and include details on content of family modules. Further studies including and evaluating specific CSTs focusing on parental cancer are needed in order to strengthen HCPs’ competencies to meet specific needs of patients parenting minor children.
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Ann-Yi S, Bruera E. Psychological Aspects of Care in Cancer Patients in the Last Weeks/Days of Life. Cancer Res Treat 2022; 54:651-660. [PMID: 35790196 PMCID: PMC9296948 DOI: 10.4143/crt.2022.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/25/2022] [Indexed: 11/30/2022] Open
Abstract
Palliative care is comprised of an interdisciplinary team (IDT) approach with members from different disciplines who collaboratively work together to reduce multidimensional components of pain and suffering and improve quality of life for patients coping with a terminal illness. Psychosocial team members are integral to the palliative care IDT and provide expertise in assessment and empirically validated interventions to address psychological distress. The following paper will provide a review of different facets of psychological distress experienced by advanced cancer patients such as psychological disorders, existential distress, spiritual distress, caregiver distress, parental distress, and grief. Finally, an overview of commonly used screening and assessment tools as well as psychological interventions relevant for the palliative care population is presented.
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Kosugi K, Nishiguchi Y, Miura T, Fujisawa D, Kawaguchi T, Izumi K, Takehana J, Uehara Y, Usui Y, Terada T, Inoue Y, Natsume M, Yajima MY, Watanabe YS, Okizaki A, Matsushima E, Matsumoto Y. Association Between Loneliness and the Frequency of Using Online Peer Support Groups Among Cancer Patients With Minor Children: A Cross-Sectional Web-Based Study. J Pain Symptom Manage 2021; 61:955-962. [PMID: 32998056 DOI: 10.1016/j.jpainsymman.2020.09.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/14/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Abstract
CONTEXT Cancer patients with minor children are increasing; however, they do not receive sufficient support. OBJECTIVE This study aimed to investigate the association between loneliness and the frequency of using online peer support groups among cancer patients with minor children. METHODS A cross-sectional web-based survey was conducted from April to May 2019. Cancer patients with minor children were recruited from an online peer support group called "Cancer Parents." Individuals diagnosed with cancer and whose youngest children were younger than 18 years were enrolled. Materials included: the UCLA Loneliness Scale version 3 (UCLA-LS), K6 scale, abbreviated Lubben Social Network Scale, and the sociodemographic/clinical characteristics questionnaire. Multivariate logistics regression analysis was performed to determine the factors associated with the high loneliness group (defined as those above the median score on the UCLA-LS). RESULTS A total of 334 patients participated (79.9% female; mean age 43.1 years, standard deviation 5.8). The most common primary cancer type was breast (34.1%). The median score of the UCLA-LS was 45 (interquartile range 37-53). The multivariate logistics regression analysis revealed that the high loneliness group was significantly associated with the frequent use of online peer support group less than once a week (odds ratio [OR] = 0.47; 95% CI = 0.26-0.85; P = 0.012), with a smaller social network (OR = 0.78; 95% CI = 0.73-0.83; P < 0.001), and higher psychological distress (OR = 1.16; 95% CI = 1.09-1.23; P < 0.001). CONCLUSIONS Frequent use of online peer support groups was associated with less loneliness among cancer patients with minor children.
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Affiliation(s)
- 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
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Kayo Izumi
- Insight & Analytics Department, Medilead Inc, Tokyo, Japan
| | - Jun Takehana
- Insight & Analytics Department, Medilead Inc, Tokyo, Japan
| | - Yuko Uehara
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuko Usui
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tatsuto Terada
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yujiro Inoue
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Maika Natsume
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Midori Yuki Yajima
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Ayumi Okizaki
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Eisuke Matsushima
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
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Matuszczak-Świgoń J, Bakiera L. Experiences of adults as parents with cancer: a systematic review and thematic synthesis of qualitative studies. J Psychosoc Oncol 2021; 39:765-788. [PMID: 33423606 DOI: 10.1080/07347332.2020.1859662] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PROBLEM IDENTIFICATION This thematic synthesis is aimed at providing an overview of qualitative studies on parenting experiences during cancer and focuses on the investigation of the challenges parents face and the strategies they use to adapt to a new situation. LITERATURE SEARCH A search of five electronic databases was conducted, specifying publication dates between 1993 and 2020. Qualitative studies, which focused on parenting experiences of cancer patients with minor children from an ill parent perspective, were included in the review. Thematic synthesis was undertaken to examine the included studies by referring to a theoretical model of family resilience by Froma Walsh. DATA EVALUATION 12,345 articles were discovered and, after assessment for eligibility, 27 studies were included in the review. The thematic synthesis involved line by line coding of the findings of the primary studies and the development of descriptive and analytical themes. CONCLUSIONS This review showed that parenting is a process that requires restructuring in the face of cancer. After cancer diagnosis, requirements connected to the illness and its treatments are imposed on previous family life duties.
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Affiliation(s)
- Joanna Matuszczak-Świgoń
- Faculty of Psychology and Cognitive Science, Department of Developmental Psychology, Adam Mickiewicz University, Poznan, Poland.,Oncology and Hematology Ward in Medical Centre, Pleszew, Poland
| | - Lucyna Bakiera
- Faculty of Psychology and Cognitive Science, Department of Developmental Psychology, Adam Mickiewicz University, Poznan, Poland
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Inhestern L, Bultmann JC, Johannsen LM, Beierlein V, Möller B, Romer G, Koch U, Bergelt C. Estimates of Prevalence Rates of Cancer Patients With Children and Well-Being in Affected Children: A Systematic Review on Population-Based Findings. Front Psychiatry 2021; 12:765314. [PMID: 34899425 PMCID: PMC8656299 DOI: 10.3389/fpsyt.2021.765314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
This review assessed population-based estimate rates of cancer patients with minor and young adult children (≤ 25 years), children and young adults having a parent with cancer as well as the psychosocial situation and well-being of children and young adults affected by parental cancer. Eighteen publications on population-based studies were included. Studies varied in the age ranges of both cancer patients and children. The prevalence rates of cancer patients having children ranged from 14 to 24.7% depending on the sample structure (e.g., age, gender). Studies reported that between 1.6 and 8.4% of children resp. young adult children have a parent with a history of cancer. Seven publications reported on the psychosocial situation or well-being in children and young adults affected by parental cancer. Estimate rates of psychosocial problems, psychiatric diagnoses or distress ranged between 2.5 and 34% of children depending on the method of measurement and outcome. The differences in the sample structure between the studies impeded the comparison of prevalence rates. However, the findings help to determine the need for specific support services and health care planning. The results emphazise the importance to routinely include issues on the parental role of patients and questions on the well-being and coping of children into psychooncological care. If necessary, support should be provided to families living with a cancer diagnosis.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Lene Marie Johannsen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Volker Beierlein
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Möller
- Department of Social Work, Münster University of Applied Sciences, Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Münster, Münster, Germany
| | - Uwe Koch
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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10
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Inhestern L, Johannsen LM, Bergelt C. Families Affected by Parental Cancer: Quality of Life, Impact on Children and Psychosocial Care Needs. Front Psychiatry 2021; 12:765327. [PMID: 34858234 PMCID: PMC8631390 DOI: 10.3389/fpsyt.2021.765327] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/12/2021] [Indexed: 11/18/2022] Open
Abstract
Parental cancer poses major challenges for families with minor children. Due to diagnosis and treatment family life is disrupted. To prevent long-term consequences in all family members and to design needs-oriented family-centered interventions, further understanding of the family's situation including the impact on the children, quality of life levels and the parental psychosocial needs is necessary. This study aims at investigating the impact of parental cancer on the minor children, family-specific psychosocial needs and quality of life levels of parents and children. Cancer patients parenting at least 1 minor child (<18 years) were eligible for study participation. In total, n=86 cancer patients under treatment participated in the study. After excluding participants without a minor child, 78 patients remained for analyses. We assessed children's quality of life using the parent proxy version of the KIDSCREEN-10 and parental quality of life using the EORTC QLQ C30 quality of life questionnaire. Additionally, the questionnaire comprised open questions about positive and negative changes parents perceived in their children as well as questions on specific family- and child-related psychosocial needs. The majority of participants were mothers (91%), mainly diagnosed with breast cancer (59%). The participating parents provided data on 117 minor children. Parents mentioned positive changes in 38% of the children (e.g., being more attentive and helpful). Negative changes were reported in 37% of the children (e.g., being more anxious and clingy). Parents reported family-specific psychosocial supportive care needs for themselves as a parent (e.g., support regarding parenting concerns), support needs for the partner or the children. Moreover, parents expressed family-related information needs and needs regarding practical aspects (e.g., childcare, household help). Global quality of life was M = 55.7 (SD = 23.4) for parents and M = 57.5 (SD = 15.5) for children. Pearson's correlation coefficient between parental and children's quality of life was 0.377 (p < 0.001). To identify parents with cancer and children in need for additional support, health care providers should proactively inquire about the impact of the disease on the children. In terms of a comprehensive cancer care, the direct assessment of family impact and family-specific support needs in cancer patients with minor children allows for needs-based allocation to support offers.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lene Marie Johannsen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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Reid K, Soundy A. A Qualitative Study Examining the Illness Narrative Master Plots of People with Head and Neck Cancer. Behav Sci (Basel) 2019; 9:bs9100110. [PMID: 31627365 PMCID: PMC6826984 DOI: 10.3390/bs9100110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/10/2019] [Accepted: 10/14/2019] [Indexed: 12/16/2022] Open
Abstract
Background: There is a need to understand the common plots (master plots) of illness narratives for people who are treated for cancer. Improved insight would enhance therapeutic relationships and help reduce stress for health care professionals (HCPs). Aim: Identify and refine the most supported narrative master plots, which convey meaning for the tellers' lived experience from diagnosis to a year post-treatment for a group of Head and Neck Cancer (H&NC) patients. Method: A purposive sample of individuals with H&NC using a single qualitative interview was undertaken. A narrative analysis was used. Results: Eighteen people (57.8 years, six female and 12 male) with H&NC participated. The average time since treatment began was 10 months. Five master plots were identified: (1) The responsive and reflective narrative, (2) The frail narrative, (3) The recovery narrative, (4) The survive or die narrative and (5) The personal project narrative. Discussion: The identification of narrative master plots of people with H&NC enables HCPs to understand and prepare for the different stories and reactions presented to them. This is important to prevent people's reactions being labelled in restrictive ways. The implications of recognising the different experiences are discussed further within the manuscript. Research is needed to build on these findings to promote better patient-centred care in practice.
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Affiliation(s)
- Kate Reid
- Therapy Services University Hospitals Birmingham, Birmingham B15 2TW, UK.
| | - Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham and B15 2TT, UK.
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Sinclair M, Schofield P, Turner J, Rauch P, Wakefield C, Mann GB, Newman L, Mason K, Gilham L, Cannell J, Stafford L. Maternal breast cancer and communicating with children: A qualitative exploration of what resources mothers want and what health professionals provide. Eur J Cancer Care (Engl) 2019; 28:e13153. [PMID: 31441564 DOI: 10.1111/ecc.13153] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/09/2019] [Accepted: 08/01/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore the communication and resource needs of mothers diagnosed with breast cancer treated with curative intent in communicating with their young children and to identify gaps in the resources and support provided to these women. METHODS Data were collected via semi-structured telephone interviews from 13 mothers who were diagnosed with breast cancer while parenting a young child (age 3-12 years), and 10 health professionals in Victoria, Australia. Data were analysed qualitatively using the Framework Method. RESULTS AND CONCLUSION Mothers and health professionals prioritised communication with children about the cancer diagnosis; however, health professionals and mothers differed in their views of parents' communication needs both in terms of the nature of the support/information needed and the delivery of this support/information. Mothers wanted easily accessible resources that were both instructive and practical. Mothers also emphasised quality over quantity of support. Health professionals were mostly aware of mothers' needs, however, emphasised less instructive support and information. This study highlights the need for improved coordination and tailoring of psychosocial resources and supports for these parents and families communicating about a cancer diagnosis with their young children.
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Affiliation(s)
- Michelle Sinclair
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Vic., Australia
| | - Penelope Schofield
- Department of Psychological Sciences, Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Vic., Australia.,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia
| | - Jane Turner
- Discipline of Psychiatry, Faculty of Medicine, University of Queensland, Herston, Qld, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | - Paula Rauch
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Claire Wakefield
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - G Bruce Mann
- Breast Service, Victorian Comprehensive Cancer Centre, Parkville, Vic., Australia.,Department of Surgery, University of Melbourne, Melbourne, Vic., Australia
| | - Louise Newman
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Vic., Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Vic., Australia
| | - Kylie Mason
- Parkville Integrated Haematology Service, Victorian Comprehensive Cancer Centre, Parkville, Vic., Australia.,Department of Medicine, University of Melbourne, Melbourne, Vic., Australia
| | - Leslie Gilham
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Vic., Australia
| | - Julia Cannell
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Vic., Australia
| | - Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Vic., Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Vic., Australia
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13
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Castro EKD, Kenne Dornel AL, Alves de Sousa M. A EXPERIÊNCIA DA MATERNIDADE DURANTE O TRATAMENTO PARA O CÂNCER. PSICOLOGIA EM ESTUDO 2018. [DOI: 10.4025/psicolestud.v23i0.39559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo do estudo foi investigar a experiência da maternidade de mulheres com câncer com pelo menos um filho menor de dez anos. A partir de um delineamento qualitativo exploratório, foram realizadas entrevistas com dez mães, gravadas em áudio e transcritas. A análise de conteúdo identificou cinco categorias temáticas: 1) Ser mãe é... Sentir medo da morte/recidiva e de deixar o filho órfão; 2) Ser mãe é... Mudar os valores/sentido da vida com a doença; 3) Ser mãe é... Alterar a rotina da vida familiar/da criança; 4) Ser mãe é... Ter sentimentos conflitantes/de derrota/ambivalentes; 5) Ser mãe é... Ter dificuldade em atender aos filhos. A fala das mães foi avaliada por dois juízes independentes. Observou-se que as experiências do câncer e da maternidade se sobrepõem e intensificam o sofrimento dessas mulheres. Ao mesmo tempo, ambas as experiências colocam essas mulheres diante de situações que as levam a ressignificar sua vida e suas prioridades, o que pode potencializar a sua relação com os filhos de uma maneira positiva.
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Inhestern L, Bergelt C. When a mother has cancer: strains and resources of affected families from the mother's and father's perspective - a qualitative study. BMC WOMENS HEALTH 2018; 18:72. [PMID: 29801481 PMCID: PMC5970502 DOI: 10.1186/s12905-018-0562-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 05/11/2018] [Indexed: 11/16/2022]
Abstract
Background When a mother has cancer, families with minor children are confronted with major challenges for all family members. According to the Family Adjustment and Adaptation Response (FAAR) Model, the (im) balance between strains and resources of families affected by cancer can be an important indicator on the families’ adjustment to the situation. Hence, this study aims to explore the strains and resources of families of mothers with cancer from the mother’s and father’s perspective. Methods We conducted semi-structured interviews with 29 mothers diagnosed with cancer and ten fathers. The data was transcribed verbatim and analyzed using thematic analysis. Results Both, mothers and fathers, reported a general impact of the disease regarding social and practical changes as well as strong emotional reactions. Parents reported specific strains and stressors regarding their parental role e.g. changes in the self-concept as a parent or fears and concerns about the children. Many mothers additionally experienced feelings of guilt. All fathers reported an increase of responsibilities and pressure. Both, the ill and healthy parent, reported strains and stressors for their children, e.g. parents observed behavioral changes and strong emotional reactions in their children. Families used a variety of resources and coping strategies on external, family and intrapersonal levels to encounter the challenges of the disease. They reported that e.g. support networks, flexible working hours and competent medical staff were helpful. Moreover, on the family level e.g. family time, open communication and the children themselves were considered to be important resources. On the intrapersonal level, parents reported resources such as setting small aims for the future and taking time for oneself. Conclusions Our findings indicate a high amount and diversity of stressors and strains for the ill and healthy parent and for their children. At the same time, parents use diverse resources and coping strategies on external, family or intrapersonal level. The assessment of strains and resources may be an important indicator for the support needs of families when a mother has cancer. Enhancing and activating resources and coping strategies may help the families to manage the situation better and may prevent maladjustment in the family members.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Holst-Hansson A, Idvall E, Bolmsjö I, Wennick A. The narrow treatment road to survival: Everyday life perspectives of women with breast cancer from Iraq and the former Yugoslavia undergoing radiation therapy in Sweden. Eur J Cancer Care (Engl) 2018; 27:e12825. [PMID: 29345023 DOI: 10.1111/ecc.12825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2017] [Indexed: 11/28/2022]
Abstract
This study aimed at exploring how women from Iraq and the former Yugoslavia, diagnosed with breast cancer and living in Sweden, experience their everyday life during radiation therapy. A qualitative research design was used comprising interviews with ten women, five originating from Iraq and five from the former Yugoslavia. Striving to survive, the women experienced their everyday life during radiation therapy as extremely challenging. This experience can be placed into three categories: strategies for survival, keeping up appearances and staying in control. Because of these specific challenges, immigrant women may need additional information and guidance in conjunction with the diagnosis, which may enable them to identify possible sources of support from those closest to them. Also, greater attention should focus on acknowledging the woman behind the diagnosis, regardless of her origin, to develop an individualised support programme to help her cope with everyday life during radiation therapy.
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Affiliation(s)
- A Holst-Hansson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.,Department of Hematology, Oncology and Radiophysics, Skåne University Hospital, Lund, Sweden
| | - E Idvall
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - I Bolmsjö
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - A Wennick
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
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Grattan K, Kubrak C, Caine V, O’Connell DA, Olson K. Experiences of Head and Neck Cancer Patients in Middle Adulthood: Consequences and Coping. Glob Qual Nurs Res 2018; 5:2333393618760337. [PMID: 29568793 PMCID: PMC5858616 DOI: 10.1177/2333393618760337] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 01/11/2018] [Accepted: 01/17/2018] [Indexed: 12/19/2022] Open
Abstract
The head and neck cancer (HNC) rate is rising among the middle-aged adult population. This trend has been attributed primarily to human papillomavirus exposure. An HNC diagnosis and its complex treatments may trigger life-changing physical, emotional, and social consequences. An interpretive descriptive study was conducted to describe the experiences of a purposive sample of 10 middle-aged adults who had experienced HNC. Two main themes were identified: consequences of HNC and coping with HNC. Subthemes of consequences of HNC included: voicelessness; being or looking sick; shifts in family dynamics; and sexual practices, sexual feelings, and stigma. Subthemes of coping with HNC included seeking information, discovering inner strengths, relying on a support network, establishing a sense of normalcy, and finding meaning within the experience. Supportive nursing interventions were identified by considering results from the standpoint of King's theory of goal attainment.
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Affiliation(s)
- Kathryn Grattan
- University of Alberta, Edmonton, Alberta, Canada
- St. Joseph’s Health Care, London, Ontario, Canada
| | | | - Vera Caine
- University of Alberta, Edmonton, Alberta, Canada
| | | | - Karin Olson
- University of Alberta, Edmonton, Alberta, Canada
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Holst-Hansson A, Idvall E, Bolmsjö I, Wennick A. Hoping to reach a safe haven - Swedish families' lived experience when a family member is diagnosed with breast cancer. Eur J Oncol Nurs 2017; 31:52-58. [DOI: 10.1016/j.ejon.2017.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/08/2017] [Accepted: 10/09/2017] [Indexed: 11/30/2022]
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Lundquist M. Fathers Facing Advanced Cancer: An Exploratory Study. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2017; 13:266-283. [PMID: 29252160 DOI: 10.1080/15524256.2017.1403410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Adults who are living with cancer while raising young children are faced with distinct challenges particularly when that cancer is advanced. While the literature examining parental cancer continues to grow, very little has focused on families facing advanced cancer and the father's perspective is nearly absent. To address these gaps, grounded theory methods were used to study the experiences of 11 fathers living with advanced cancer while raising minor children. The participants were all married with between one and six children living in their household. Semistructured, in-person interviews revealed concerns for their children permeated the "ordeal" and these fathers described the ongoing challenge of "teeter-tottering between hope and despair." The fathers used key protective strategies to counterbalance the weight of the barriers to achieve resilience throughout the cancer experience. Primary barriers were characterized as physical impairments, uncertainty, and financial strain. Fathers described relying on flexibility in their roles as fathers, open communication patterns, use of supportive resources, and the ability to find meaning in their experiences as crucial to fostering resilience. Recommendations include interdisciplinary family centered interventions that consider gendered parental roles as well as financial burden.
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Affiliation(s)
- Melissa Lundquist
- a School of Social Work , University of St. Thomas, St. Paul , Minnesota , USA
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Lynch BM, McCance T, McCormack B, Brown D. The development of the Person-Centred Situational Leadership Framework: Revealing the being of person-centredness in nursing homes. J Clin Nurs 2017; 27:427-440. [PMID: 28677332 DOI: 10.1111/jocn.13949] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To implement and evaluate the effect of using the Person-Centred Situational Leadership Framework to develop person-centred care within nursing homes. BACKGROUND Many models of nursing leadership have been developed internationally in recent years but do not fit with the emergent complex philosophy of nursing home care. This study develops the Person-Centred Situational Leadership Framework that supports this philosophy. It forms the theoretical basis of the action research study described in this article. METHODS This was a complex action research study using the following multiple methods: nonparticipatory observation using the Workplace Culture Critical Analysis Tool (n = 30); critical and reflective dialogues with participants (n = 39) at time 1 (beginning of study), time 2 (end of study) and time 3 (6 months after study had ended); narratives from residents at time 1 and time 2 (n = 8); focus groups with staff at time 2 (n = 12) and reflective field notes. Different approaches to analyse the data were adopted for the different data sources, and the overall results of the thematic analysis were brought together using cognitive mapping. RESULTS The Person-Centred Situational Leadership Framework captures seven core attributes of the leader that facilitate person-centredness in others: relating to the essence of being; harmonising actions with the vision; balancing concern for compliance with concern for person-centredness; connecting with the other person in the instant; intentionally enthusing the other person to act; listening to the other person with the heart; and unifying through collaboration, appreciation and trust. CONCLUSIONS This study led to a theoretical contribution in relation to the Person-Centred Practice Framework. It makes an important key contribution internationally to the gap in knowledge about leadership in residential care facilities for older people. RELEVANCE TO CLINICAL PRACTICE The findings can be seen to have significant applicability internationally, across other care settings and contexts.
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Affiliation(s)
- Brighide M Lynch
- Faculty of Life and Health Sciences, Institute of Nursing and Health Research, Ulster University, Jordanstown, UK
| | - Tanya McCance
- Faculty of Life and Health Sciences, Ulster University, Jordanstown, UK
| | | | - Donna Brown
- Faculty of Life and Health Sciences, Institute of Nursing and Health Research, Ulster University, Jordanstown, UK
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Hirooka K, Otani H, Morita T, Miura T, Fukahori H, Aoyama M, Kizawa Y, Shima Y, Tsuneto S, Miyashita M. End-of-life experiences of family caregivers of deceased patients with cancer: A nation-wide survey. Psychooncology 2017; 27:272-278. [DOI: 10.1002/pon.4504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/26/2017] [Accepted: 07/17/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Kayo Hirooka
- Department of System Management in Nursing, Graduate School of Health Care Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Hiroyuki Otani
- Palliative Care Team, Department of Palliative and Supportive Care; National Kyushu Cancer Center; Fukuoka Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team; Seirei Mikatahara General Hospital; Hamamatsu-shi Japan
| | - Tomofumi Miura
- Department of Palliative Medicine; National Cancer Center Hospital East; Kashiwa Japan
| | - Hiroki Fukahori
- Department of System Management in Nursing, Graduate School of Health Care Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Maho Aoyama
- Department of Community Health, School of Health Sciences; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine; Kobe University Graduate School of Medicine; Kobe Japan
| | - Yasuo Shima
- Tsukuba Medical Center Hospital, Department of Palliative Medicine; Tsukuba Medical Center Foundation; Tsukuba Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Department of Health Sciences; Tohoku University Graduate School of Medicine; Miyagi Japan
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van der Ende PC, Korevaar L, van Busschbach JT, van Weeghel J. Professionals’ opinions on support for people with chronic illness in their roles as parents in mental or in general health care. AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION 2017. [DOI: 10.1080/15487768.2016.1267048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Peter C. van der Ende
- Research and Innovation Department of Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Lies Korevaar
- Research and Innovation Department of Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Jooske T. van Busschbach
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Professorship of Human Movement, Health and Well-being, Windesheim University of Applied Sciences, Zwolle, The Netherlands
| | - Jaap van Weeghel
- Department Tranzo, Tilburg University, Tilburg, The Netherlands
- Phrenos Centre of Expertise, Utrecht, The Netherlands
- Department of Research and Care Innovation, Dijk en Duin Mental Health Centre, Castricum, The Netherlands
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Penn A, Kuperberg A, Zebrack BJ. Psychosocial Issues in Adolescent and Young Adult Patients and Survivors. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_23] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Hendricks-Ferguson VL, Ott R. Palliative Care Considerations for Patients With Head and Neck Cancer With Children at Home. Clin J Oncol Nurs 2016; 20:585-587. [PMID: 27857249 DOI: 10.1188/16.cjon.585-587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adult patients diagnosed with head and neck cancer (HNC) who may have contact with children in the home setting are at risk of experiencing distress because of embarrassing and challenging oral symptoms often associated with an HNC diagnosis and the side effects of required treatments. This article features a case study involving a patient diagnosed with HNC and details how oncology nurses can provide patients with HNC and their caregivers with resources and support.
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Gullbrå F, Smith-Sivertsen T, Graungaard AH, Rortveit G, Hafting M. How can the general practitioner support adolescent children of ill or substance-abusing parents? A qualitative study among adolescents. Scand J Prim Health Care 2016; 34:360-367. [PMID: 27845596 PMCID: PMC5217276 DOI: 10.1080/02813432.2016.1253819] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES To explore significant experiences of adolescents as next of kin that the general practitioner (GP) should identify and recognize. DESIGN Qualitative study with focus-group interviews. SUBJECTS AND SETTING Three focus-group interviews were conducted with a total of 15 Norwegian adolescents each with an ill or substance-abusing parent. The participants were recruited from existing support groups. RESULTS The adolescents' days were dominated by unpredictability in their family situation and their own exhausting efforts to keep up an ordinary youth life. Mostly, they consulted GPs for somatic complaints. In encounters with the GP, they wanted to be met both as a unique person and as a member of a family with burdens. Their expectations from the GP were partly negatively formed by their experiences. Some had experienced that both their own and their parent's health problems were not addressed properly. Others reported that the GP did not act when he or she should have been concerned about their adverse life situation. The GP may contribute to better long-term psychosocial outcomes by ensuring that the adolescents receive information about the parent's illness and have someone to talk to about their feelings and experiences. In addition, the GP may help by supporting their participation in relieving activities. CONCLUSION Burdened adolescents seek a GP most often for somatic complaints. The GP has a potential to support them by taking the initiative to talk about their life situation, and by recognizing their special efforts. Key points Little is known about how a general practitioner can support adolescents with ill or substance-abusing parents. Adolescents experience unpredictability in life and strive to find balance between their own needs and the restrictions caused by parental illness. In encounters with adolescents having ill parents, the GP should take the initiative to talk about their family situation. The GP may help them by recognizing their experiences and struggles, give information, offer talks and support coping strategies.
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Affiliation(s)
- Frøydis Gullbrå
- Uni Research Health, Research Unit for General Practice, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- CONTACT Frøydis Gullbrå Research Unit for General Practice, Uni Research Health, Bergen Kalfarveien 31, 5018 Bergen, Norway
| | | | | | - Guri Rortveit
- Uni Research Health, Research Unit for General Practice, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Marit Hafting
- Uni Research Health, Regional Research Centre for Child and Adolescent Mental Health West, Bergen, Norway
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Kalavrezos N, Scully C. Mouth cancer for clinicians part 13: life after mouth cancer treatment. ACTA ACUST UNITED AC 2016; 43:672-4, 677-8, 681-2, 684-6. [DOI: 10.12968/denu.2016.43.7.672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nicholas Kalavrezos
- Maxillofacial and Reconstructive Surgeon of The Head, Face and Neck, University College London Hospital and The Harley Street Clinic. Assistant Secretary, European Association of Cranio-Maxillofacial Surgery, UCL, London, UK
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Inhestern L, Bultmann JC, Beierlein V, Möller B, Romer G, Koch U, Bergelt C. Understanding parenting concerns in cancer survivors with minor and young-adult children. J Psychosom Res 2016; 87:1-6. [PMID: 27411745 DOI: 10.1016/j.jpsychores.2016.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/20/2016] [Accepted: 05/21/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Parents with cancer are concerned about the impact of their disease on their children. However, parenting concerns and associated factors in cancer survivors have not previously been analyzed. The purpose of this study is to examine parenting concerns and to test a path model for understanding parenting concerns in cancer survivors. METHODS In a cross-sectional study, a total of 1416 parents with cancer (mean age 47.5years, 74% women) having minor or young-adult children were recruited through two cancer registries. Parenting concerns were assessed using the Parenting Concerns Questionnaire. Structural equation modeling (SEM) was used to analyze the associations between social support, parenting confidence, emotional distress, family functioning and parenting concerns. RESULTS Mothers reported higher total parenting concerns than fathers (p<0.001). We observed strong effects of emotional distress and parenting confidence on parenting concerns. Family dysfunctioning was associated with lower concerns. An indirect association between social support and parenting concerns was identified. CONCLUSION Parenting concerns in cancer survivors display the need for interventions and after care programs that focus on affected families with minor and young adult children. The results of the structural path model illustrate the associations between psychological and interactional factors. Supporting parents with cancer in their parenting confidence and strengthen social support and family functioning may not only reduce the long-term burden on the parents themselves but also the burden on the entire family.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | | | - Volker Beierlein
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Möller
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Muenster, Muenster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Muenster, Muenster, Germany
| | - Uwe Koch
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Inhestern L, Haller AC, Wlodarczyk O, Bergelt C. Psychosocial Interventions for Families with Parental Cancer and Barriers and Facilitators to Implementation and Use - A Systematic Review. PLoS One 2016; 11:e0156967. [PMID: 27276079 PMCID: PMC4898703 DOI: 10.1371/journal.pone.0156967] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/23/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Parental cancer has a significant impact on minor children and families. Psychosocial interventions for affected families can provide support where necessary. This systematic review aims at providing an overview of existing interventions and support programs and focuses on the systematic investigation of barriers and facilitators for using psychosocial interventions for families affected by parental cancer (PROSPERO; registration number CRD42014013020). METHODS A search of five electronic databases (EMBASE, MEDLINE, PsycInfo, Psyndex, CINAHL) was conducted in June 2014, and updated in September 2015. We included any kind of studies reporting psychosocial support services or interventions for families affected by parental cancer. Study quality was assessed using the Mixed Method Assessment Tool. Narrative synthesis and thematic analyses were undertaken to examine the included interventions and to identify barriers and facilitators for use and implementation. RESULTS A total of 36 studies covering 19 interventions and support services were included in the systematic review. Interventions focused on children, parents or several family members and analyses revealed a broad picture of theoretical background and primary aims. Several studies focused on developmental or implementation phases or descriptions of interventions. Other included studies reported results of evaluations using qualitative and quantitative methods. Results suggest that interventions are helpful and that participants improved in various outcomes. The thematic analyses indicate that barriers for use of support services refer to aspects concerning the patients and families, such as practical difficulties, perceived need for support or fear of stigma. Cancer patients who understood the need and benefit of support services may have used them more often. Additionally, intervention characteristics such as a flexible structure and accessibility were important to reach families affected by parental cancer. Disease characteristics and complications in collaborations were identified as potential barriers. The provision of information about interventions by clinicians and understanding the support as part of routine care seem to be key issues for implementation and use of psychosocial support. CONCLUSION This review identified a broad number of intervention concepts for families with minor children affected by parental cancer. Findings provide a basis for existing or future psychosocial interventions to anticipate potential barriers and facilitators to implementation and use and can help to reach a wider range of families in need for support.
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Affiliation(s)
- Laura Inhestern
- University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany
| | - Anne-Catherine Haller
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry and Psychotherapy, Hamburg, Germany
| | - Olga Wlodarczyk
- University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany
| | - Corinna Bergelt
- University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany
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Lalayiannis L, Asbury N, Dyson G, Walshe A. How do women with secondary breast cancer experience telling their adolescent children about their diagnosis? J Health Psychol 2016; 23:1223-1233. [PMID: 27270684 DOI: 10.1177/1359105316648484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study investigated how women with secondary breast cancer experience telling their adolescent children. Semi-structured interviews were conducted with women who had been diagnosed with secondary breast cancer at least 1 year prior to the interview. Seven women, who had at least one child between 12 and 19 years old living at home at the time of diagnosis, were interviewed. The interviews were analysed using interpretative phenomenological analysis for an in-depth understanding of women's experiences. Women found that it was easier to tell their children of their secondary breast cancer diagnosis compared to their primary cancer. However, they talked about the impact the diagnosis had on their family.
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O'Neill C, McCaughan E, Semple CJ, Ryan A. Fathers' experiences of living with cancer: a phenomenological study. Eur J Cancer Care (Engl) 2016; 27. [PMID: 27001026 DOI: 10.1111/ecc.12492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2016] [Indexed: 10/22/2022]
Abstract
There is a paucity of knowledge about fathers' experiences of cancer. This study explored the experiences of fathers diagnosed and living with cancer while also having parental responsibility for children. A hermeneutic phenomenological approach guided the study. Data were generated through 22 in-depth interviews with 10 fathers throughout Northern Ireland. The findings evidenced that fathers' identities are challenged and frequently re-shaped by the cancer experience, in many cases leading to an improved lifestyle behaviour. Heightened engagement with their children can provide a protective effect from the illness. On the other hand a lack of involvement led to frustration and low mood. The findings also demonstrated that father/child relationships were adversely affected by the social complexities that exist in the variances and diversity of fathers parenting roles and status. This knowledge contributes to our understanding of the complex relationships of fathers in non-traditional roles. It extends our understanding of how, when stereotyped gendered roles are ascribed to fathers it can impact on a fathers' ability to fulfil the traditional breadwinner's role. This is knowledge that will inform health care professionals and enable them to provide gendered-sensitive care that takes account of the masculine psychological responses that can shape the cancer experience.
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Affiliation(s)
- C O'Neill
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - E McCaughan
- Institute of Nursing & Health Research, University of Ulster, Coleraine, Northern Ireland
| | - C J Semple
- South Eastern Health and Social Care Trust, Cancer Services Ulster Hospital, Belfast, Northern Ireland
| | - A Ryan
- Institute of Nursing and Health Research, University of Ulster, Coleraine, Northern Ireland
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Wagner RW, Pritzker S. Cancer survivorship care-planning: Practice, research, and policy implications for social work. SOCIAL WORK IN HEALTH CARE 2016; 55:181-194. [PMID: 26933764 DOI: 10.1080/00981389.2015.1115800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Increasing numbers of cancer survivors are living longer than 5 years from their diagnosis date. This has resulted in a growing population of cancer survivors, expected to reach 19 million by 2024. Survivors frequently experience late effects caused by cancer and its treatment, reducing survivors' quality of life in multiple domains. Survivorship care-plans may aid the many physical, psychosocial, and financial needs that emerge posttreatment. However, the lack of reimbursement mechanisms, the limited amount of effectiveness research, and minimal guidelines for content and delivery are barriers to the widespread provision of survivorship care-plans. Challenges and opportunities for social work practice, research, and policy are identified and discussed.
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Affiliation(s)
- Richard W Wagner
- a Graduate College of Social Work , University of Houston , Houston , Texas , USA
| | - Suzanne Pritzker
- a Graduate College of Social Work , University of Houston , Houston , Texas , USA
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Inhestern L, Bultmann JC, Beierlein V, Möller B, Romer G, Muriel AC, Moore CW, Koch U, Bergelt C. Psychometric properties of the Parenting Concerns Questionnaire in cancer survivors with minor and young adult children. Psychooncology 2015; 25:1092-8. [PMID: 26677091 DOI: 10.1002/pon.4049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/02/2015] [Accepted: 11/12/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Although cancer patients with minor children have become more of a focus of psycho-oncological research, little is known about specific parenting concerns. Instruments to assess the concerns and worries of parents with cancer are rare. The Parenting Concerns Questionnaire (PCQ) addresses this issue. We analyzed parenting concerns in cancer survivors and evaluated the German version of the PCQ. METHODS A total of 1416 cancer survivors with minor and young adult children (≤21 years) were recruited in a register-based study. Descriptive analyses as well as reliability and validity analyses were conducted. We performed a confirmatory factorial analysis of the factor structure proposed by the authors of the original version on the PCQ. RESULTS Seventy-three percent of the cancer survivors were women, average age was 47.5 years (SD 5.9). Mean time since diagnosis was 44 months (SD 23.4). Between 18 and 31% of survivors reported that they were concerned about their children. The PCQ proved to be a reliable and valid instrument showing medium correlations with standardized measures in expected directions and discriminating between survivors with and without use of psychosocial support services. The factor structure was supported by the confirmatory factorial analysis. CONCLUSIONS Assessing parenting concerns gives an additional insight into the situation of parents with cancer. In our sample of cancer survivors, we identified one out of three survivors being concerned regarding the impact of their illness on their children. The PCQ can be considered as a valid and reliable instrument with regard to identifying concerned parents with cancer. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna C Bultmann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Volker Beierlein
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Möller
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Muenster, Muenster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Muenster, Muenster, Germany
| | | | | | - Uwe Koch
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Halliday LE, Boughton MA, Kerridge I. Liminal reproductive experiences after therapies for hematological malignancy. QUALITATIVE HEALTH RESEARCH 2015; 25:408-416. [PMID: 25216861 DOI: 10.1177/1049732314550006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this article, we discuss the psychosocial health of young women related to fertility, pregnancy, and motherhood after therapies for hematological malignancies. We utilized a hermeneutical phenomenological approach to conduct in-depth interviews with 12 women who had previously received treatment for a hematological malignancy and had experienced uncertainty surrounding their ability to start or extend their biological family. Our presented findings are interpretations of the women's own words as they articulated how they inhabited a liminal space. We concluded that although fertility and motherhood possibly might not be immediate concerns when they received a diagnosis of hematological malignancy, young women could subsequently experience ongoing issues and concerns related to reproductive uncertainty and motherhood capabilities, which have the potential to affect emotionally and psychosocially on their lives. These issues might possibly require longer-term support, counseling, and informational resources. We also discuss the strengths, limitations, and implications of the study.
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Affiliation(s)
| | | | - Ian Kerridge
- University of Sydney, New South Wales, Australia
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Asbury N, Lalayiannis L, Walshe A. How do I tell the children? Women's experiences of sharing information about breast cancer diagnosis and treatment. Eur J Oncol Nurs 2014; 18:564-70. [DOI: 10.1016/j.ejon.2014.07.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 06/24/2014] [Accepted: 07/09/2014] [Indexed: 10/24/2022]
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Lang H, France E, Williams B, Humphris G, Wells M. The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psychooncology 2013; 22:2648-63. [PMID: 23840037 DOI: 10.1002/pon.3343] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To summarise patients' experiences of head and neck cancer (HNC) by examining the findings of existing qualitative studies METHODS We undertook a systematic review and meta-synthesis of qualitative studies in 29 published articles using Noblit and Hare's 'meta-ethnography' approach to synthesise findings. The inclusion criteria were primary qualitative studies, focusing on HNC patients' experience and an English abstract. Seven databases were systematically searched. RESULTS The articles focused on the experience of having HNC, the experience of treatments and the role of information. Our synthesis identified six core concepts-uncertainty and waiting, disruption to daily life, the diminished self, making sense of the experience, sharing the burden and finding a path. People experienced significant disruption to normal daily activities, because of the physical and emotional effects of HNC and its treatment. Day-to-day challenges were compounded by social and existential changes and a palpable loss of the individual's sense of self and future. In order to find a way through the considerable uncertainty and daily challenge of living with and beyond HNC, patients made continual efforts to make sense of their experience. Supportive relationships with their social network, HNC peers and healthcare professionals were particularly important, but support following treatment completion was sometimes limited. Perceptions of the future were affected by whether they saw life as diminished, merely changed or even enhanced by the experience of cancer. CONCLUSIONS This review supports further specific research into these emerging themes and provides a context for future work, informing interventions to improve patients' experiences.
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Affiliation(s)
- Heidi Lang
- School of Nursing and Midwifery, University of Dundee, Dundee City, UK
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O'Neill C, McCaughan E, Semple C, Ryan A. Fatherhood and cancer: a commentary on the literature. Eur J Cancer Care (Engl) 2013; 22:161-8. [DOI: 10.1111/ecc.12021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2012] [Indexed: 11/26/2022]
Affiliation(s)
- C. O'Neill
- Institute of Nursing Research; University of Ulster; Coleraine; Northern Ireland; UK
| | - E. McCaughan
- Institute of Nursing Research; University of Ulster; Coleraine; Northern Ireland; UK
| | - C. Semple
- Institute of Nursing Research; University of Ulster; Coleraine; Northern Ireland; UK
| | - A. Ryan
- Institute of Nursing Research; University of Ulster; Coleraine; Northern Ireland; UK
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Semple C, McCaughan E. Family life when a parent is diagnosed with cancer: impact of a psychosocial intervention for young children. Eur J Cancer Care (Engl) 2012; 22:219-31. [DOI: 10.1111/ecc.12018] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2012] [Indexed: 11/28/2022]
Affiliation(s)
- C.J. Semple
- South Eastern Health and Social Care Trust; Ulster Hospital; Belfast; N Ireland; UK
| | - E. McCaughan
- Institute of Nursing Research; University of Ulster; Coleraine; Co. Londonderry; N Ireland; UK
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Albornoz CR, Pusic AL, Reavey P, Scott AM, Klassen AF, Cano SJ, Cordeiro PG, Matros E. Measuring health-related quality of life outcomes in head and neck reconstruction. Clin Plast Surg 2012; 40:341-9. [PMID: 23506775 DOI: 10.1016/j.cps.2012.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A qualitative study was undertaken to understand the impact of omitted health concepts in existing patient-reported outcome (PRO) instruments for health-related quality of life (HR-QOL) evaluation following head and neck (H&N) cancer reconstruction. Twenty-six patients were interviewed. Patients described a broad range of symptoms. Oral competence, rhinorrhea, facial sensation, smile, vision and eye discharge are missing from existing PRO instruments. Altered appearance was a major stressor; both function and appearance changes had a negative psychosocial impact leading to social isolation and embarrassment. This framework is the foundation for development of a more complete PRO instrument, the FACE-Q Oncology.
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Affiliation(s)
- Claudia R Albornoz
- Plastic and Reconstructive Surgical Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, MRI 1007, New York, NY 10065, USA
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Sutter C, Reid T. How do we talk to the children? Child life consultation to support the children of seriously ill adult inpatients. J Palliat Med 2012; 15:1362-8. [PMID: 22978620 DOI: 10.1089/jpm.2012.0019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Families with young children often struggle to talk about and cope with a parent's life-threatening illness and potential death. Adult interdisciplinary palliative medicine teams often feel unprepared to facilitate the open communication with these children that has been shown to reduce anxiety, depression, and other behavioral problems. In pediatric settings, child life specialists routinely provide this support to hospitalized children as well as their siblings and parents. Although these services are the standard of care in pediatrics, no research reports their use in the care of children of adults with serious illness. OBJECTIVE Our aim is to describe a pilot child life consultation service for the children of seriously ill adult inpatients. DESIGN We summarize the support needs of these children, their families, and the medical staff caring for them and report our experience with developing a child life consultation service to meet these needs. SETTING/SUBJECTS Our service assists seriously ill adult inpatients and their families in a university medical center. RESULTS Informal feedback from families and staff was uniformly positive. During consultations, family and child coping mechanisms were assessed and supported. Interventions were chosen to enhance the children's processing and self-expression and to facilitate family communication. CONCLUSION All hospitals should consider providing broad-based in-service training enabling their staff to improve the support they offer to the children of seriously ill parents. Medical centers with access to child life services should consider developing a child life consultation service to further enhance this support. More research is needed to evaluate both the short- and long-term clinical impact of these interventions.
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Affiliation(s)
- Camilla Sutter
- Newton-Wellesley Hospital, Newton, Massachusetts 02445, USA.
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