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Semendric I, Pollock D, Haller OJ, George RP, Collins-Praino LE, Whittaker AL. "Chemobrain" in childhood cancer survivors-the impact on social, academic, and daily living skills: a qualitative systematic review. Support Care Cancer 2023; 31:532. [PMID: 37606711 PMCID: PMC10444646 DOI: 10.1007/s00520-023-07985-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE To examine children's experiences of chemotherapy-induced cognitive impairment--colloquially "chemobrain"--and the impact on children's social, academic, and daily living skills via a qualitative systematic review. Experiencing chemotherapy as a child, when the brain is still developing, may cause lifelong detriment to survivors' lives. There is a significant gap in understanding their lived experience, including the self-identified barriers that children face following treatment. Such a gap can only be fully bridged by listening to the child's own voice and/or parent proxy report through an exploration of the qualitative research literature. METHODS A search of MEDLINE, Embase, PsycINFO, and CINAHL databases was conducted. Inclusion criteria were qualitative studies with a focus on children (0-18 years) during and/or following chemotherapy treatment and explored children's experiences of chemobrain. RESULTS Two synthesized findings were identified from six studies. (1) Chemobrain has an academic and psychosocial impact, which may not be understood by education providers. (2) Children and their parents have concerns about their reintegration and adaptation to school, social lives, and their future selves as independent members of society. Children's experiences primarily related to changes in their academic and social functioning. CONCLUSION This review highlights two important considerations: (1) the lived experiences of pediatric childhood cancer survivors guiding where future interventions should be targeted, and (2) a need to perform more qualitative research studies in this area, as well as to improve the quality of reporting among the existing literature, given that this is a current gap in the field.
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Affiliation(s)
- Ines Semendric
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Danielle Pollock
- Health Evidence Synthesis, Recommendations and Impact (HESRI), School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Olivia J Haller
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rebecca P George
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Alexandra L Whittaker
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia, Australia
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Leite ACAB, Rodrigues AL, Alvarenga WDA, Polita NB, Silva-Rodrigues FM, Bolis LO, Meherali S, Nascimento LC. School reintegration of children and adolescents with chronic illness from the mothers' perspective: A qualitative study. Child Care Health Dev 2023; 49:181-188. [PMID: 35790488 DOI: 10.1111/cch.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 04/11/2022] [Accepted: 06/28/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The diagnosis of chronic illness in childhood implies frequent hospitalizations and, consequently, the interruption of school attendance. This study aimed to understand the process of school reintegration of children and adolescents with chronic illness from the mothers' perspective. METHOD A qualitative descriptive-exploratory study was conducted with mothers who experienced the process of school reintegration of their child or adolescent, aged between 8 and 17 years old, and diagnosed with chronic illness. The participants were recruited by convenience and interviewed at the paediatric unit of a children's hospital. Data collection was interrupted when the data set was sufficient to answer the research question. The interviews were analysed using inductive thematic analysis. The study was approved by the research ethics committee. RESULTS Eleven interviews were conducted, 10 with mothers and one with a grandmother, who played the maternal role. Participants' age ranged between 33 and 58 years old. A theme was developed-"School reintegration under the maternal vigilance"-which encompasses four subthemes: (1) What matters? My child's health comes first; (2) How to keep in touch with the school? (3) Back to the school: Are we ready? (4) Sharing vigilance: reality and expectations. The themes highlighted a cyclical, dynamic, and subjective school reintegration process, constantly permeated by maternal vigilance. CONCLUSION A new understanding about school reintegration was evidenced, from the perspective of mothers of children and adolescents with different chronic illnesses. Mothers and children experience a nonlinear and recurrent process of leaving and returning to school, surrounded by a lack of communication and continuity in school activities. The results of this study may assist health professionals in planning care focused on the needs of the school reintegration of this population.
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Affiliation(s)
| | - Ana Laura Rodrigues
- University of São Paulo at Ribeirão Preto College of Nursing, Ribeirao Preto, Brazil
| | | | | | | | - Letícia Onelli Bolis
- University of São Paulo at Ribeirão Preto College of Nursing, Ribeirao Preto, Brazil
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Hen M. Mothers' and teachers' experience of school re‐entry after a child's prolonged absence due to severe illness. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Meirav Hen
- Department of Psychology Tel‐Hai Academic College Qiryat Shemona Israel
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Stavinoha PL, Trinh-Wong T, Rodriguez LN, Stewart CM, Frost K. Educational Pain Points for Pediatric Brain Tumor Survivors: Review of Risks and Remedies. CHILDREN 2021; 8:children8121125. [PMID: 34943320 PMCID: PMC8700207 DOI: 10.3390/children8121125] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 01/29/2023]
Abstract
Evolving treatment paradigms have led to increased survival rates for children diagnosed with a brain tumor, and this has increasingly shifted clinical and research focus to morbidity and quality of life among survivors. Among unfavorable outcomes, survivors of pediatric brain tumors are at risk for academic failure and low educational attainment, which may then contribute to lower health related quality of life, lower income and vocational status, and a greater likelihood of dependence on others in adulthood. Several specific risk factors for lower educational performance and attainment have been investigated. These are typically examined in isolation from one another which clouds understanding of the full range and potential interplay of contributors to educational difficulties. This review integrates and summarizes what is known about the direct and indirect barriers to educational success and performance (i.e., educational pain points) to enhance clinician knowledge of factors to consider when working with pediatric brain tumor survivors. Specific barriers to educational success include neurocognitive difficulties, school absences, psychosocial challenges, challenges to knowledge and communication, and physical and sensory difficulties. Finally, we discuss the current state of educational interventions and supports and offer recommendations for future research to improve educational outcomes for pediatric brain tumor survivors.
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Young K, Bowers A, Prain K, Bradford N. I could have used a lot more help than I had: A qualitative systematic review and synthesis of families' experiences of paediatric brain tumour and schooling. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2021; 92:e12474. [PMID: 34806170 DOI: 10.1111/bjep.12474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Brain tumours are the most common and fatal of all solid tumours for children and adolescents. The effects of the tumour and treatment (chemotherapy, radiation, and/or surgery) results in significant disruptions to childhood development and large amounts of missed schooling. Among other challenges for families, this produces obstacles for children and adolescents to achieve and maintain academic performance and experience positive schooling encounters. AIMS We thus aimed to systematically identify and synthesize qualitative evidence on how families experience paediatric brain tumour from diagnosis and beyond with regards to their schooling and education to identify gaps in service delivery, research, and policy. METHODS A protocol for this review was registered with PROSPERO (ID: CRD42020177165). Searches were conducted in Medline, CINAHL, PsycInfo, Embase, and Web of Science, and yielded 22 eligible papers (representing 17 studies). Data were extracted into NVivo12 and analysed by qualitative description. RESULTS We formed the following domain summaries: academic (perceived failure to keep up with peers and finding success where one could, the importance of encouragement for diagnosed children), social (the importance of friendships and the harm of bullying), and support (the defining factor in overall return-to-school experience, often not enough received from educational professionals and clinicians). Our review highlights the need for more comprehensive, individualized, and integrated support for diagnosed children to return to educational institutions, and for the need to address their social experiences, particularly with regards to bullying, potentially through a school-wide social and emotional learning approach. CONCLUSION Funding support, evidence-based guidelines, staff skill development, and clear communication structures across families, health care facilities, schools, and educational departments are essential to achieving this.
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Affiliation(s)
- Kate Young
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Alison Bowers
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Karen Prain
- Brainchild Foundation, Queensland, The Gap, Queensland, Australia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
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Bryan G, Kelly P, Chesters H, Franklin J, Griffiths H, Langton L, Langton L, Wakefield CE, Gibson F. Access to and experience of education for children and adolescents with cancer: a scoping review protocol. Syst Rev 2021; 10:167. [PMID: 34099059 PMCID: PMC8182947 DOI: 10.1186/s13643-021-01723-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 05/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer diagnosis in childhood or adolescence impacts significantly on school attendance, experience and educational outcomes. While there is longstanding recognition in clinical practice that these effects span the whole illness trajectory and continue beyond treatment completion, further clarity is required on the specific barriers and facilitators to education during cancer treatment and beyond, as well as on the experiences of children and adolescents across the full range of education settings (hospital, home, virtual, original school of enrolment), in order to determine which interventions are successful in improving access and experience from their perspective. The aim of this review is to identify what is known from the existing literature about access to and experience of education for children and adolescents with cancer during and post treatment. METHODS We have planned a scoping literature review searching the following databases from inception onwards: MEDLINE (Ovid), Embase and Embase Classic, Web of Science Core Collection, Education Resources Index, Sociological Abstracts, APA PsycINFO, SCOPUS, CINAHL Plus, Emcare and The Cochrane Library. In addition, DARE, conference abstracts, key journals, and institutional websites will be searched. Arksey and O'Malley's six-step process will be followed, including a consultation exercise. Studies, reports and policies from any country providing care and treatment for children and adolescents with cancer published in English will be considered eligible for inclusion. Two reviewers will independently screen all citations, full-text articles and abstract data. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., content and thematic analysis) methods. DISCUSSION This is a timely examination given the increased incidence of childhood cancer, more intensive treatment regimens and improved survival rates for childhood cancer. The inclusion of a substantive consultation exercise with families and professionals will provide an important opportunity to examine the scoping review outputs. Findings will assist the childhood cancer community in developing a comprehensive evidence-based understanding of a significant associated bio-psychosocial impact of cancer diagnosis and treatment and will form the first step towards developing effective interventions and policies to mitigate identified detrimental effects. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (osf/io/yc4wt).
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Affiliation(s)
- Gemma Bryan
- School of Health Sciences, University of Surrey, Stag Hill, Guildford, GU2 7XH, Surrey, UK.,Louis Dundas Centre for Children's Palliative Care, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
| | - Paula Kelly
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, 37 Queen Square, London, UK.
| | - Heather Chesters
- Great Ormond Street Institute of Child Health Library, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
| | - Jayne Franklin
- The Children's Hospital School at Great Ormond Street Hospital & UCH, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK
| | - Helen Griffiths
- Clinical Health Psychology Psychological Medicine, Oxford University Hospitals NHS Foundation Trust, Children's Psychological Medicine, John Radcliffe Hospital, Oxford, UK
| | | | | | - Claire E Wakefield
- School of Women's and Children's Health, UNSW MEDICINE, UNSW, Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia
| | - Faith Gibson
- School of Health Sciences, University of Surrey, Stag Hill, Guildford, GU2 7XH, Surrey, UK.,Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, 37 Queen Square, London, UK
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Delloso S, Gannoni A, Roberts RM. Maintaining Schooling for Children With Cancer During and Post Treatment: Parents' Perspectives of a Theory-Based Program. CONTINUITY IN EDUCATION 2021; 2:26-41. [PMID: 38774893 PMCID: PMC11104355 DOI: 10.5334/cie.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/30/2020] [Indexed: 05/24/2024]
Abstract
This study explored parents' perceptions of a hospital-based schooling intervention for children with cancer. A qualitative design using semi-structured interviews was employed. Participants were nine parents whose children had participated in the program. Parents participated in semi-structured interviews, which were transcribed verbatim and analysed thematically. Five major themes were identified: experiences with program components, the bigger picture of the program, communication, a burden of responsibility for parents, and perceived impacts of cancer on schooling. Results showed that the parents valued the focus upon schooling and viewed several aspects as being beneficial. Challenges for parents included a lack of communication and individualized planning, and a burden of responsibility. Findings suggest that schooling is important to families and should be a fundamental psychosocial consideration of service providers. The schooling-related needs of parents should also be addressed.
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Burns MA, Fardell JE, Wakefield CE, Cohn RJ, Marshall GM, Lum A, Ellis SJ, Donnan B, Walwyn T, Carter A, Barton B, Lah S. School and educational support programmes for paediatric oncology patients and survivors: A systematic review of evidence and recommendations for future research and practice. Psychooncology 2021; 30:431-443. [PMID: 33403751 DOI: 10.1002/pon.5606] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/18/2020] [Accepted: 11/06/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The Psychosocial Standards of Care (PSSC) in paediatric oncology prescribe the minimum standards for education support. It is unknown, however, if published education support programmes for children with cancer meet the PSSC standards for education support. Successful implementation of standards for education support is challenging but may be achieved with guidance. We aimed to (1) review education support programmes for childhood cancer patients and survivors against the PSSC standards and (2) provide practical recommendations for future research and implementation of education support programmes. METHODS We searched PsycINFO, PubMed, CINAHL, EMBASE, and Educational Resources Information and Center databases. We reviewed the education support programmes using five evaluation criteria derived from the PSSC and summarised the structure of identified programmes. We examined the features and limitations of programmes that met all evaluation criteria. RESULTS We identified 20 education support programmes in paediatric oncology, including peer programmes (n = 3), teacher programmes (n = 5), and school re-entry programmes (SRPs n = 12). We found that three SRPs met all evaluation criteria and that SRP components were timed according to the child's position on the cancer trajectory (e.g., diagnosis and treatment, school re-entry, and follow up throughout schooling). The supporting evidence of the programmes, however, is unclear due to the lack of adequately designed studies. CONCLUSIONS SRPs provide a promising structure for future education support programmes. We recommend strategies for developing and evaluating education support that adheres to the PSSC and adapts to international and local contexts.
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Affiliation(s)
- Mary A Burns
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Joanna E Fardell
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Glenn M Marshall
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Alistair Lum
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Sarah J Ellis
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Barb Donnan
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Thomas Walwyn
- Paediatric and Adolescent Clinical Haematology and Oncology, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Division of Paediatrics, Faculty of Health and Medical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
| | - Amanda Carter
- Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Belinda Barton
- Children's Hospital Education Research Institute, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Suncica Lah
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
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Ellis SJ, Fardell JE, Wakefield CE, Schilstra CE, Burns MA, Donnan B, Walwyn T, Lum A, Marshall G, Carter A, Barton B, Cohn RJ. Are we meeting the training needs of healthcare and education professionals supporting children with cancer in their return to school? Pediatr Blood Cancer 2019; 66:e27575. [PMID: 30537149 DOI: 10.1002/pbc.27575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 01/08/2023]
Affiliation(s)
- Sarah J Ellis
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Joanna E Fardell
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Claire E Wakefield
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Clarissa E Schilstra
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Mary A Burns
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Barb Donnan
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Thomas Walwyn
- Paediatric and Adolescent Clinical Haematology and Oncology, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Alistair Lum
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Glenn Marshall
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Amanda Carter
- Children's Health Queensland Hospital and Health Service, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia
| | - Belinda Barton
- Children's Hospital Education Research Institute, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Richard J Cohn
- Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
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