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Malmström N, Öhlén J, Jakobsson Larsson B, Nilsson S, Nygren I, M Andersen P, Ozanne A. Adolescents' challenging and grief-filled transitions when living with a parent with ALS: A qualitative interpretive study. Soc Sci Med 2024; 354:117063. [PMID: 38971043 DOI: 10.1016/j.socscimed.2024.117063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVE The study aimed to explore the meaning for adolescents of living with a parent with amyotrophic lateral sclerosis (ALS). METHODS The design is qualitative. Interviews were conducted between December 2020 and April 2022 with 11 adolescents (8-25 y), living in households with a parent with ALS in Sweden. The analysis was phenomenologically hermeneutical. RESULTS The adolescents were in a difficult and exposed situation, especially if the parent had a severe disability and assistant care providers were in the home. Witnessing the gradual loss of the parent in an indefinite battle against time, while still needing them, elicited grief-filled and hard-to-manage emotions. Everyday life was turned upside down, resulting in greater responsibility for the adolescents, not only in helping with household chores and assisting the ill parent, but also in emotionally protecting both parents. It forced the adolescents to mature faster and put their own life on hold, triggering experiences of being limited. This, together with changing family roles yet being more attached to home, reinforced the imbalance in the adolescents' lives. The interpreted whole of the adolescents' narratives revealed that living with a parent with ALS meant a challenging and grieving transition during an already transition-filled adolescence, which left the adolescents struggling to keep a foothold on a life torn apart. CONCLUSION The unbalanced life situation may hinder the adolescents' identity formation and emancipation, which are developmentally important for managing a healthy and independent adulthood. The results emphasize the importance of early targeted support to reach this vulnerable group in order to secure their health.
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Affiliation(s)
- Nina Malmström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centred Care, University of Gothenburg, Gothenburg, Sweden; Palliative Centre at the Sahlgrenska University Hospital Region Västra Götaland, Gothenburg, Sweden
| | - Birgitta Jakobsson Larsson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Department of Neurology, Uppsala University Hospital, Uppsala, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centred Care, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingela Nygren
- Department of Neurology, Uppsala University Hospital, Uppsala, Sweden; Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden
| | - Peter M Andersen
- Department of Clinical Sciences, Neurosciences, Umeå University, Umeå, Sweden
| | - Anneli Ozanne
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Söyünmez S, Seki Öz H. Childhood Traumatic Experiences and Happiness of Nursing Students: A Mixed Methods Study. CHILD MALTREATMENT 2024; 29:322-339. [PMID: 36460482 DOI: 10.1177/10775595221143530] [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: 06/17/2023]
Abstract
The aim of this study was to examine the childhood trauma experiences and current happiness levels of nursing students. The quantitative part of the study was carried out with 349 student nurses and the qualitative part with 25 student nurses. An explanatory-sequential mixed methods design was used. Data were collected using Demographic Information Form, Childhood Trauma Questionnaire-Short Form, Oxford Happiness Questionnaire-Short Form and semi-structured Interview Form between November 2020 and September 2021. Quantitative data were analysed using descriptive statistics with the SAS 9.4 package program. Transcribed qualitative data were analysed using Braun and Clarke's six stage thematic analysis approach, and this was performed with the MAXQDA 2020 package program. In the quantitative section, it was determined that as the participants' childhood traumatic experiences increased, their happiness levels decreased. In the qualitative section six themes were formed (Childhood Trauma, Effects of Childhood Trauma, Coping with Childhood Trauma, Growing Up After Trauma, Perceptions of Future Parenting, Empowerment Through Nursing Education). It was determined that participants had various childhood traumatic experiences and mostly been exposed to emotional neglect. Some of the participants' childhood traumas continued to affect them in adulthood, and nursing education contributed to coping with trauma and raising awareness about it.
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Affiliation(s)
- Selin Söyünmez
- Department of Nursing, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Hilal Seki Öz
- Department of Nursing, Kırşehir Ahi Evran University, Kırşehir, Turkey
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Ytterhus B, Hafting M, Vallesverd VU, Wiig EM, Kallander EK, Trondsen MV. Children as next of kin's experiences, practices, and voice in everyday life: a systematic review of studies with Norwegian data (2010-2022). Scand J Public Health 2024:14034948241232040. [PMID: 38506846 DOI: 10.1177/14034948241232040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Aims: This systematic review aims to identify and describe how children of parents with mental illness, substance dependence, or severe physical illness/injury, experience and practise their everyday life. Methods: The review followed the four stepwise recommendations of Harden and colleagues when including quantitative and qualitative studies on peoples' experiences and views. In all, 23 studies with data from Norway (2010-2022) have been included. Brown and Clark's thematic analysis was applied. Results: Three themes were constructed from the reviewed articles: (a) Children practice their relational agency by actively doing practical tasks, occasionally jobs to maintain family economy, and organising fun activities with the ill parent. (b) Emotional ambivalence when their own needs were set aside in favour of the parents. They loved their parents but also felt guilt, anger, disappointment, shame, fear of inheriting the illness and longed for a 'normal' everyday life. (c) Supportive contextual factors were, for example, at least one significant adult recognising them, participating in leisure activities, socialising with friends, and talking with other peers who shared similar experiences as next of kin. Obstructive factors were lack of information and recognition as well as silence and lack of dialogue within the family and/or health professional. Conclusions: There is a strong need for more knowledge and competence on the situation and needs of these children when it comes to professionals, parents and the public. Public health initiatives are needed to honour their agency and recognise their contributions in present time to prevent psychosocial problems later in life.
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Affiliation(s)
- Borgunn Ytterhus
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Vibecke Ulvær Vallesverd
- BarnsBeste (Children's Best Interests) - National Competence Network for Children as Next of Kin, Sørlandet Hospital Trust, Kristiansand, Norway
| | - Eli Marie Wiig
- KORUS Sør (Resource Centre for Addiction, southern region), Skien, Norway
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Chen CYC. Roles of physical functioning and comorbid mental illness of chronically ill parents and their spouses' health status in adolescent functioning. J Adolesc 2024; 96:381-393. [PMID: 38050767 DOI: 10.1002/jad.12282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023]
Abstract
INTRODUCTION Emerging research suggests that physically ill parents' psychological adjustment to illness and emotional well-being may affect adolescents' psychosocial functioning. As people with chronic medical conditions often develop mental disorders, it is important to examine the influence of comorbidity of parental physical and mental health conditions on adolescents' functioning. In addition, the physical and mental health status of the spouses/partners of chronically ill parents needs to be explored to further understand the potential impact of parental chronic illness on adolescents' psychological distress and academic performance. METHODS Cross-sectional data from 164 parent-adolescent pairs were collected through online surveys in the United States between 2018 and 2019. Parent participants (Mage = 42.69, SD = 5.96) included parents who had been diagnosed with a chronic physical illness (e.g., multiple sclerosis, diabetes, chronic pain, cancer). Adolescent participants were middle- and high-school-aged children who lived with their physically ill parents (Mage = 14.34, SD = 2.07). RESULTS Hierarchical regression analyses indicated that comorbid mental illness of parental chronic illness and spousal mental health status were associated with adolescents' distress. The level of physical functioning of chronically ill parents was related to adolescents' academic performance. CONCLUSION Parental chronic illness appears to affect adolescents' psychological and academic outcomes through distinct pathways. It is important to examine the comorbid mental health status of chronically ill parents and their spouses'/partners' mental health conditions to better understand the impact of parental chronic illness on adolescents' psychological adjustment.
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Affiliation(s)
- Cliff Yung-Chi Chen
- Educational and Community Programs, Queens College of the City University of New York, Flushing, New York, USA
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Mjøsund NH, Eide T, Kufås E, Faugli A, Eilertsen G. Mental health promotion as perceived by Norwegian adolescents with somatically ill parents - an interpretative phenomenological analysis. Health Psychol Behav Med 2023; 11:2213298. [PMID: 37201175 PMCID: PMC10187081 DOI: 10.1080/21642850.2023.2213298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/03/2023] [Indexed: 05/20/2023] Open
Abstract
Objective Having a somatically ill parent can influence adolescents' daily lives and mental health. This study aimed to explore the lived experiences of mental health promotion among adolescents with a somatically ill parent, based on a salutogenic orientation. Methods Individual interviews with 11 adolescents (13-18 years of age) with a somatically ill parent were conducted. The data were analysed according to interpretative phenomenological analysis. Results A superordinate theme, feeling at home in a house of mental health-promoting conversations, frames the participants' perceptions of a prominent mental health promotion experience, including decisive characteristics of the significant conversation partners and different important conversation contexts. The metaphor of feeling at home expresses that the participants ascribe the conversations taking place there as promoting mental health. The themes elucidate the superordinate theme: (a) significant conversation partners characterised by the three subthemes: (i) being available, (ii) being competent and (iii) being caring and (b) rooms reflecting conversation contexts containing four subthemes: (i) room of increased knowledge, (ii) room of disclosure, (iii) room for meeting points and (iv) room for breaks. Conclusion Adolescents with a somatically ill parent perceived that conversations about important topics with significant others with special characteristics in distinct contexts promoted mental health.
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Affiliation(s)
- Nina Helen Mjøsund
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
- Nina Helen Mjøsund Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, NO3004, Norway
| | - Torill Eide
- University of South-Eastern Norway – Campus Drammen, Drammen, Norway
| | - Elin Kufås
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Anne Faugli
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Grethe Eilertsen
- University of South-Eastern Norway – Campus Drammen, Drammen, Norway
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Huus K, Sundqvist AS, Anderzén-Carlsson A, Wahlqvist M, Björk M. Living an ordinary life – yet not: the everyday life of children and adolescents living with a parent with deafblindness. Int J Qual Stud Health Well-being 2022; 17:2064049. [PMID: 35437116 PMCID: PMC9037212 DOI: 10.1080/17482631.2022.2064049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction The family life of people living with one family member with deafblindness has been sparsely described. Purpose The aim of the study was to explore how children experience their everyday family life when having a parent with deafblindness. Methods An explorative study in which data have been collected by qualitative interviews of children. Qualitative content analysis has been used for analysing the data. Results Overall theme; Living an ordinary life—yet not, is based on four categories with subcategories. A family like any other describes: Having the same family life as their friends, Acting like other children and It is what it is. Different everyday life describes: Acknowledging differences, Adjusting to the parent’s needs and Financial strain. Being there for the parent describes: Helping the parent and Protecting the parent from harm. Being emotionally affected describes: Feelings of frustration, Feelings of compassion and Need for support. Conclusion Children as relatives of parents with deafblindness have been given a voice. The children live an ordinary life, but at the same time a different ordinary life. Professionals need to take the child and their needs into account when support is given.
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Affiliation(s)
- Karina Huus
- Department of Nursing Science, Jönköping University, Jönköping, Sweden
| | - Ann-Sofie Sundqvist
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Agneta Anderzén-Carlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Moa Wahlqvist
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
- Audiological Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Maria Björk
- Department of Nursing Science, Jönköping University, Jönköping, Sweden
- The Swedish National Resource Center for Deafblindness, Lund, Sweden
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Bergersen E, Larsson M, Lövgren M, Olsson C. Adolescents' and young people's needs and preferences for support when living with a parent with life-threatening cancer: a grounded theory study. BMC Palliat Care 2022; 21:164. [PMID: 36138453 PMCID: PMC9502590 DOI: 10.1186/s12904-022-01055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Living with a parent facing life-threatening illness and losing a mom or dad at a young age can cause both short- and long-term health problems. Without satisfactory support, adolescents' and young people are at risk of developing low self-esteem, behavioural difficulties (e.g., anger and aggression), long-term illness or premature death caused by severe mental illness, substance abuse, self-harm and suicide attempts. The aim of this study was to explore adolescents' and young people's needs and preferences for support as they live with a parent with life-threatening cancer. METHODS Qualitative interviews were conducted with 10 respondents (17-24 years) in Norway and Sweden. Data were analysed through grounded theory according to Charmaz. RESULTS Adolescents' and young peoples' needs and preferences for support were described through the main category 'To feel safe and secure and to be prepared' and further broken down into five subcategories 'Relationships in the immediate family-balancing support and protection'; 'The social network-support and normalcy in a carefully selected group'; 'Maintaining everyday life-challenges in school and working life'; 'The right support at the right time-competence, trust and continuity in meeting health care professionals'; and 'Support outside the home-an opportunity for full transparency'. CONCLUSION Adolescents' and young peoples' preferences for support when living with a parent facing life-threatening illness are individual and unique, but they share a common need to feel safe and secure and to be prepared. Adolescents and young people express that they primarily want support from parents and friends, but they also want support from health care professionals, especially in situations when the ill parent becomes worse. Therefore, it is of the utmost importance for health care professionals to identify the most vulnerable adolescents and young people by mapping their social networks and paying extra attention to their needs for support when there is deterioration in the parent's illness state. This study also highlights the importance for health care professionals to establish a good relationship with adolescents and young people to meet their needs and preferences for support. In addition, information and support are needed in a timely manner and adapted to the life-threatening ill parent's illness state and individual's needs and preferences to optimise preparedness.
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Affiliation(s)
- Emily Bergersen
- Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden. .,Inland Norway University of Applied Sciences, Strandvegen 3, 2206, Kongsvinger, Norway.
| | - Maria Larsson
- Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden
| | - Malin Lövgren
- Marie Cederschiöld University, Box 11189, 100 61, Stockholm, Sweden
| | - Cecilia Olsson
- Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden.,Lovisenberg Diaconal University College, Lovisenberggt. 15b, 0456, Oslo, Norway
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Vis SA, Lauritzen C, Christiansen Ø, Reedtz C. Do the Child Welfare and Protection Services Involve Children in Cases With Parental Mental Health Problems? A Norwegian Case-File Study. Front Psychiatry 2022; 12:784022. [PMID: 35069286 PMCID: PMC8777056 DOI: 10.3389/fpsyt.2021.784022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Parental mental health problems is a common source of concern reported to child welfare and protection services (CWPS). In this study we explored to what extent the child was invited to participate in the investigation process. We aimed to study: (a) what was the current practice in the child protection service in Norway when the CWPS received a report of concern about children whose parents were affected by mental health problems or substance abuse, (b) to what extent were children involved and consulted, (c) which factors predicted the decision to involve the children, and (d) in cases in which conversations with children were conducted: what was the main content of the conversations. Method: The study was a cross-sectional case file study (N = 1,123). Data were collected retrospectively from case records in 16 different child protection agencies. The cases were randomly drawn from all referrals registered in the participating agencies. Differences in how investigations were conducted in cases with and without concerns about parental mental health were analyzed using t-tests and chi-square testes. Predictors of child involvement in cases with parental mental health problems (N = 324) were estimated by logistic regression analyses. Results: When the referral to the CWPS contained concerns about parental mental health, there were more consultations with parents, more frequent home visits and the investigation took longer to conclude. The children, however, were less likely to be involved. Children in such cases were consulted in 47.5% of cases. Predictors for involving the children in those cases were child age, concern about the child's emotional problems and if the child was known from previous referrals. Conclusion: In Norwegian child protection investigations, in which there were concerns about the parent's mental health, conversations with children were conducted to a significantly lower degree compared to cases where the child's problem was the main concern. In such cases, the CWPS workers have to overcome a threshold before they consult with the child. The threshold decreases with child age and when case worker already knows the child.
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Affiliation(s)
- Svein Arild Vis
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Camilla Lauritzen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Øivin Christiansen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian Research Centre (NORCE), Bergen, Norway
| | - Charlotte Reedtz
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT-The Arctic University of Norway, Tromsø, Norway
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Plass-Christl A, Ravens-Sieberer U, Hölling H, Otto C. Trajectories of health-related quality of life in children of parents with mental health problems: results of the BELLA study. Qual Life Res 2021; 30:1841-1852. [PMID: 33651276 DOI: 10.1007/s11136-021-02783-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Children of parents with mental health problems (CPM) have an increased risk for impaired health-related quality of life (HRQoL). This study aims at investigating the age- and gender-specific course of HRQoL and at exploring predictors of HRQoL in CPM based on longitudinal data (baseline, 1-year and 2-year follow-up) of a German population-based sample. METHODS Longitudinal data from the German BELLA study was analyzed (n = 1429; aged 11 to 17 years at baseline). The SCL-S-9 in combination with the cutoff for the General Severity Index (GSI) from the longer SCL-90-R served to identify CPM (n = 312). At first, we compared domain-specific HRQoL according to the KIDSCREEN-27 in CPM versus Non-CPM. Focusing on CPM, we used individual growth modeling to investigate the age and gender-specific course, and to explore effects of risk and (personal, familial and social) resource factors on self-reported HRQoL in CPM. RESULTS Self-reported HRQoL was reduced in CPM compared to Non-CPM in all domains, but in social support & peers. However, a minimal important difference was only reached in girls for the domain autonomy & parent relation. Internalizing and externalizing mental health problems were associated with impaired HRQoL in CPM. Self-efficacy, social support and family climate were identified as significant resources, but parental mental health problems over time were not associated with any investigated domain of HRQoL in CPM. CONCLUSIONS Adolescent female CPM may be especially at risk for reduced HRQoL. When developing support programs for CPM, self-efficacy, social support and family climate should be considered, HRQoL and mental health problems in CPM should be addressed.
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Affiliation(s)
- Angela Plass-Christl
- Evangelical Hospital Alsterdorf Hamburg, Hamburg, Germany.
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Child Public Health, Hamburg, Germany.
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Child Public Health, Hamburg, Germany.
| | - Heike Hölling
- Robert Koch Institute, Department of Epidemiology and Health Reporting, Berlin, Germany
| | - Christiane Otto
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Child Public Health, Hamburg, Germany
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