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Han J, Zhang L, Yang F, Wang L. Illness cognition and associated socio-demographic and clinical factors in parents of children with leukemia. BMC Psychol 2024; 12:289. [PMID: 38783376 PMCID: PMC11119300 DOI: 10.1186/s40359-024-01798-3] [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: 10/20/2023] [Accepted: 05/19/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE Illness cognition is an important mediator between psychological and behavioral adjustment and the quality of life for patients and their caregivers. Evidence related to illness cognition among parents of children with leukemia is limited. The purpose of this study is to explore the illness cognition status and associated factors in parents of children with leukemia. METHODS A cross-sectional survey was conducted with the parents of 335 children with leukemia from three general children's hospitals in China from January to December 2022. A parents' version of the illness cognition questionnaire was used to collect data. This included three subscales: helplessness, acceptance, and perceived benefits. RESULTS The mean scores of helplessness, acceptance and perceived benefits of parents regarding their children's disease were 15.56 (4.60), 16.25 (4.41), and 19.96 (3.69) respectively. The multiple regression model indicated seven factors associated with the parents' illness cognition (adjusted R [2] ranged from 0.182 to 0.134): four socio-demographic factors (parent's age, role, education level, and family income) and three clinical factors (length of time spent each day caring for the child, the child's age at diagnosis, and the duration of the disease). CONCLUSION This study reports on different levels of illness cognition and associated factors among parents of children with leukemia. The results may help pediatric oncology medical staff identify risk factors for poor psychological adjustment to children's diseases. Parents may benefit from psychological support aimed at improving positive illness cognition.
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Affiliation(s)
- Jing Han
- School of Nursing, Xuzhou Medical University, Xuzhou, 221004, China.
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
| | - Li Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, 221004, China
| | - Feng Yang
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Linlin Wang
- School of Nursing, Xuzhou Medical University, Xuzhou, 221004, China
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2
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Keller MC, Needham A, Holden E, Engelke K, Foy K, Hart L, Hinderer K. We Are Done! Now What? Exploring End of Treatment Needs of Childhood Cancer Survivors and Their Parents. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:96-106. [PMID: 38238967 DOI: 10.1177/27527530231194598] [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: 04/16/2024]
Abstract
Background: Increased childhood cancer survival rates have spurred a new body of research pertaining to the cancer-survivorship continuum. Literature suggests a lack of research and guidelines for care at the end of treatment (EOT). To improve the transition to survivorship and determine any posttreatment challenges, this study explored the experiences of childhood cancer survivors (CCSs), parents/caregivers, and pediatric oncology health care professionals (HCPs) at EOT. Method: This study employed a mixed methods design. EOT Questionnaires were completed by CCSs and parents/caregivers within 6 months of completing treatment, and by pediatric oncology HCPs. Results: A total of 75 CCSs and parents/caregivers and 21 HCPs completed the study. The majority of parents/caregivers (78%) and older CCSs (94%) recalled having an EOT "meeting." Most were satisfied with the meeting, but described unexpected worries/problems following EOT. Family members stating they were "very satisfied" with the EOT meeting increased significantly relative to the number of EOT topics addressed. In contrast, the omission of certain psychosocial discussion topics negatively correlated with satisfaction. Oncologists provided the majority of EOT services, with infrequent provision by other HCPs. Less than 20% of HCPs characterized families as "very satisfied" with EOT services and suggested improvements to meet families' needs. Discussion: This study found unmet psychosocial and anticipatory guidance needs, indicating a lack of preparedness. The results suggest that end of cancer treatment requires a more standardized, comprehensive, and multidisciplinary approach. Enhanced education and support services are needed to promote the successful navigation of all families through this period of transition.
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Affiliation(s)
- Mary Conway Keller
- Division of Hematology/Oncology, Connecticut Children's, Hartford, CT, USA
| | - Andrew Needham
- Center for Cancer and Blood Disorders, Connecticut Children's, Hartford, CT, USA
| | - Elizabeth Holden
- Center for Cancer and Blood Disorders, Connecticut Children's, Hartford, CT, USA
| | - Karina Engelke
- Division of Hematology/Oncology, Connecticut Children's, Hartford, CT, USA
| | - Kelly Foy
- Child and Family Support Services, Connecticut Children's, Hartford, CT, USA
| | - Leigh Hart
- Center for Cancer and Blood Disorders, Connecticut Children's, Hartford, CT, USA
| | - Katherine Hinderer
- Institute of Nursing Research and Evidence-Based Practice, Connecticut Children's, Hartford, CT, USA
- Department of Pediatrics, UCONN School of Medicine, Farmington, CT, USA
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3
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Beeler D, Christensen V, Parker K, Cottrell E. "The place it puts us in emotionally and relationally with our child, it's damaging": understanding the real-world psychosocial needs of caregivers of childhood cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01461-7. [PMID: 37801177 DOI: 10.1007/s11764-023-01461-7] [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: 06/12/2023] [Accepted: 09/05/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE Understanding the lived experiences of childhood cancer caregivers can guide the development of effective psychosocial models of care. We conducted this qualitative study to understand triggers that impact the mental health, quality of life, and mental health supportive care needs of caregivers. METHODS A maximum variation sampling strategy was used to recruit study participants for semi-structured interviews. Using a grounded theory approach, transcripts were independently dual-coded using inductive thematic analysis. We conducted a secondary thematic analysis emphasizing the impact of pediatric oncology on caregiver mental health. RESULTS Our findings highlight caregiver experiences connected to their child's appearance, quality of life, or change in behavior. Caregivers reported the need to transition between the role of nurturer and protector and simultaneously be part of the care team, which increased trauma for caregivers and their children. Caregivers noted that the hardest part of being a caregiver is witnessing, participating, and forcing the child to comply with cancer treatment. Caregivers were left wishing there had been more support for these situations. CONCLUSION Our findings reveal real-world experiences that caregivers view as among the most stressful during their child's cancer journey. These events provide insight into the nuanced and most difficult experiences from the caregiver perspective in which emotional support services would be most useful. These insights will inform a future model for mental healthcare. IMPLICATIONS FOR CANCER SURVIVORS Caregivers' treatment-related stress is associated with the quality of life of pediatric cancer patients. Supporting the mental health, quality of life, and mental health supportive care needs of childhood cancer caregivers through supportive care guidelines may positively impact the caregiver-child relationship long into survivorship. Children's and their caregivers' treatment-related stress are indelibly connected to the quality of life concerns throughout the cancer journey. Supporting the mental health, quality of life, and mental health supportive care needs of childhood cancer caregivers through supportive care guidelines will positively impact the caregiver-child relationship long into survivorship.
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Affiliation(s)
- Dori Beeler
- Levine Cancer Atrium Health, Charlotte, NC, USA.
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4
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Parker K, Christensen V, Lindemulder S, Chan LHK, Saxton L, Cottrell E. Family perspectives on the transition from active treatment to survivorship for children with cancer. Pediatr Blood Cancer 2023; 70:e30490. [PMID: 37337303 PMCID: PMC10527349 DOI: 10.1002/pbc.30490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Completing therapy for childhood cancer is an exciting milestone. However, this adjustment can be extremely stressful for patients and their families as they transition from cancer patient to survivor. A better understanding of the patient and family experience and their needs during this transition is crucial for developing guidelines and leveraging support for future patients and families. PROCEDURE Participants were recruited from across the United States using a maximum variation sampling strategy. Families were eligible if they had a child diagnosed with cancer before age 15 and had completed treatment at least 1 year prior to their interview. Participants completed a 90-180-minute semi-structured interview either in person or virtually. Interviews focused on the experiences of getting a diagnosis, experiences with treatment, information seeking, impact of cancer on the family, social support, and transitions to survivorship. Inductive thematic analysis revealed a wide variety of themes. This paper examines the transition from active cancer therapy into survivorship. RESULTS Identified primary themes included (i) feelings about transitioning off therapy; (ii) coping with lingering effects; and (iii) experiences of transitioning off therapy and survivorship care. Subthemes highlighted the need for more support for both patients and families during this transition. CONCLUSION Patients and families desire more support during the transition off therapy. Suggestions included access to additional resources, earlier transition to receiving survivorship care, and more holistic survivorship care. Further research is needed to determine best models and feasibility of delivering this desired support to all patients and families.
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Affiliation(s)
- Kellee Parker
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Vivian Christensen
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, Oregon
| | - Susan Lindemulder
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon
| | - Lai Hin Kimi Chan
- Department of Family Medicine, University of California Davis, Sacramento, California, USA
| | - Lauren Saxton
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, Oregon
| | - Erika Cottrell
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, Oregon
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5
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Bingen K, Karst J, Anderson L, Chan S, Jordan A, Morin J, Nichols J, Palou-Torres A, Phelan R, Schmidt D, Yan K, Hoag JA. Evaluation of a transition to survivorship program for pediatric, adolescent, and young adult cancer patients and caregivers. Pediatr Blood Cancer 2023; 70:e30277. [PMID: 36880713 DOI: 10.1002/pbc.30277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/17/2023] [Accepted: 02/05/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Survivorship education and anticipatory guidance represent an unmet need for pediatric, adolescent, and young adult (AYA) cancer survivors and their caregivers when treatment ends. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of a structured transition program, bridging treatment to survivorship, to reduce distress and anxiety and increase perceived preparedness for survivors and caregivers. PROCEDURE Bridge to Next Steps is a two-visit program, within 8 weeks prior to treatment completion and 7 months post treatment, which provides survivorship education, psychosocial screening, and resources. Fifty survivors (age range 1-23 years) and 46 caregivers participated. Participants completed pre- and post-intervention measures: Distress Thermometer and Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety/emotional distress (ages ≥8 years), and perceived preparedness survey (ages ≥14 years). AYA survivors and caregivers completed a post-intervention acceptability survey. RESULTS Most participants (77.8%) completed both visits, and most AYA survivors (57.1%) and caregivers (76.5%) endorsed the program as helpful. Caregivers' distress and anxiety scores decreased from pre to post intervention (p < .01). Survivors' scores remained the same, which were low at baseline. Survivors and caregivers felt more prepared for survivorship from pre to post intervention (p = .02, <.01, respectively). CONCLUSIONS Bridge to Next Steps was feasible and acceptable for most participants. AYA survivors and caregivers felt more prepared for survivorship care after participation. Caregivers reported decreased anxiety and distress from pre to post Bridge, whereas survivors remained at a low level for both. Effective transition programs that better prepare and support pediatric and AYA cancer survivors and families from active treatment to survivorship care can contribute to healthy adjustment.
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Affiliation(s)
- Kristin Bingen
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jeffrey Karst
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lynnette Anderson
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sherilynn Chan
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Seattle Children's Hospital, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Anna Jordan
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | | | - Akasha Palou-Torres
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Rachel Phelan
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Ke Yan
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jennifer A Hoag
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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6
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Jones AM, Browne EK, Adams K, Potter BS, McLaughlin Crabtree V, Jurbergs N, Heidelberg RE, Webster RT. The Toll of Transition: Caregiver Perceptions of Family Adjustment During the Transition off Pediatric Cancer Therapy. Psychooncology 2022; 31:985-994. [PMID: 35083824 DOI: 10.1002/pon.5888] [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: 07/29/2021] [Revised: 12/28/2021] [Accepted: 01/07/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The role of transition-focused psychology appointments in managing the transition off therapy is unclear. The objective of this research was to explore caregiver perceived familial distress and the role of psychology in preparing families for transition. METHODS Fifty-seven caregivers of youth, who finished treatment, completed an online questionnaire through a quality improvement project on experiences of families at transition. Twenty-two percent of caregivers had children who completed a transition-focused psychology consult and 63% completed a cognitive assessment at transition. Retrospective analyses were conducted assessing the association of psychology visits on caregiver perceptions of being informed of and prepared to manage transition-related challenges. RESULTS Most caregivers reported experiencing adjustment concerns for family members. Caregivers of children completing a transition-focused psychology consult or cognitive assessment reported feeling more informed and greater preparedness to manage difficulties. Although decreased distress was not associated with the visit, those who felt more informed and prepared reported lower distress. CONCLUSIONS Caregivers perceive transitioning off therapy as stressful for their family, though they experience decreased familial distress when informed of and prepared to manage transition-related challenges. These findings highlight the importance of psychosocial support at transition. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anna M Jones
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN
| | - Emily K Browne
- Transition Program, St. Jude Children's Research Hospital, Memphis, TN
| | - Kristen Adams
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Brian S Potter
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN
| | - Valerie McLaughlin Crabtree
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN.,St. Jude Graduate School of Biomedical Sciences, Memphis, TN
| | - Niki Jurbergs
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN
| | - R Elyse Heidelberg
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN
| | - Rachel Tillery Webster
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN.,Comprehensive Cancer Center, St. Jude Children's Research Hospital, Memphis, TN
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7
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Leibring I, Anderzén‐Carlsson A. Young children's experiences of support when fearful during treatment for acute lymphoblastic leukaemia-A longitudinal interview study. Nurs Open 2022; 9:527-540. [PMID: 34651461 PMCID: PMC8685861 DOI: 10.1002/nop2.1092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/31/2021] [Accepted: 09/29/2021] [Indexed: 11/11/2022] Open
Abstract
AIM AND OBJECTIVES To describe young children's experiences of valuable support in managing their fears about treatment for acute lymphoblastic leukaemia. The focus was specifically on support from parents and healthcare professionals. DESIGN The study had a qualitative descriptive longitudinal design. METHODS The study analysed 35 interviews with 13 children at three different times during their treatment period. Data were analysed using a matrix-based method. The Consolidated criteria for reporting qualitative research (COREQ) guidelines have been followed. RESULTS Parents and healthcare professionals provide important support to children undergoing treatment for acute lymphoblastic leukaemia, although their roles differ. Children valued their parents' closeness and advocacy, being able to participate in their own care, and being given pain relief during procedures known to create pain. Valued support from healthcare professionals changed over time, from providing information and showing the tools that would be used in procedures, to paying attention to the child's needs and desires. It was more important for children to be able to choose between different alternatives in medical procedures than deciding on major treatment issues.
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Affiliation(s)
- Ingela Leibring
- Institution for HealthFaculty of Health, Science and TechnologyKarlstad UniversityKarlstadSweden
| | - Agneta Anderzén‐Carlsson
- University Health Care Research CenterFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
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8
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McCarthy MC, Marks IR, Mulraney M, Downie P, Matson A, De Luca CR. Parental adjustment following their child's completion of acute lymphoblastic leukemia treatment. Pediatr Blood Cancer 2021; 68:e29302. [PMID: 34411413 DOI: 10.1002/pbc.29302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Few studies haveexamined parent and family adaptation in the early period following the end of childhood cancer treatment. We examined parent adjustment at the end of their child's treatment for acute lymphoblastic leukemia (ALL). METHODS Parents of childhood cancer survivors (CCS), who were 3 months post-ALL treatment, and parents of typically developing children completed measures of psychological and family functioning. Parents of CCS also completed distress and posttraumatic stress symptom (PTSS) questionnaires related to their child's cancer experience. RESULTS One hundred twenty-nine parents were recruited: 77 parents of CCS and 52 comparison parents. Overall mean psychological symptoms of depression, anxiety and stress, and family functioning were within normal limits for both groups. Parents of CCS endorsed higher scores for stress, depression, and family problems; however, mean scores for emotional distress were low for both groups, in particular the comparison group. Parents of CCS endorsed low rates of PTSS. Fifty-one percent of parents of CCS scored above the distress thermometer (DT-P) clinical cutoff (>4), with items elevated across all six DT-P domains. However, most parents did not indicate a wish to speak to a health professional about their symptoms. CONCLUSION Specialist psychosocial intervention may be indicated for only a subset of parents at the end of treatment. As per psychosocial standards of care, effective screening at this timepoint is warranted. Further examination of appropriate timing of psychosocial information and support services that are tailored to parents' circumstances is needed. eHealth approaches may be appropriate.
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Affiliation(s)
- Maria C McCarthy
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - India R Marks
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Melissa Mulraney
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Downie
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Children's Cancer Centre, Monash Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Alice Matson
- School of Psychological Science, University of Melbourne, Melbourne, Victoria, Australia
| | - Cinzia R De Luca
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Peikert ML, Inhestern L, Krauth KA, Escherich G, Rutkowski S, Kandels D, Schiekiera LJ, Bergelt C. Fear of progression in parents of childhood cancer survivors: prevalence and associated factors. J Cancer Surviv 2021; 16:823-833. [PMID: 34302272 PMCID: PMC9300493 DOI: 10.1007/s11764-021-01076-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/14/2021] [Indexed: 10/29/2022]
Abstract
PURPOSE Recent research demonstrated that fear of progression (FoP) is a major burden for adult cancer survivors. However, knowledge on FoP in parents of childhood cancer survivors is scarce. This study aimed to determine the proportion of parents who show dysfunctional levels of FoP, to investigate gender differences, and to examine factors associated with FoP in mothers and fathers. METHODS Five hundred sixteen parents of pediatric cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system (CNS) tumor) were consecutively recruited after the end of intensive cancer treatment. We conducted hierarchical multiple regression analyses for mothers and fathers and integrated parent-, patient-, and family-related factors in the models. RESULTS Significantly more mothers (54%) than fathers (41%) suffered from dysfunctional levels of FoP. Maternal FoP was significantly associated with depression, a medical coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and lower family functioning (adjusted R2 = .30, p < .001). Paternal FoP was significantly associated with a lower level of education, depression, a family coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and fewer siblings (adjusted R2 = .48, p < .001). CONCLUSIONS FoP represents a great burden for parents of pediatric cancer survivors. We identified associated factors of parental FoP. Some of these factors can be targeted by health care professionals within psychosocial interventions and others can provide an indication for an increased risk for higher levels of FoP. IMPLICATIONS FOR CANCER SURVIVORS Psychosocial support targeting FoP in parents of childhood cancer survivors is highly indicated.
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Affiliation(s)
- Mona L Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology and Oncology, Klinik Bad Oexen, Oexen 27, 32549, Bad Oeynhausen, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Louis J Schiekiera
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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10
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Krisnana I, Kurnia ID, Pujiati P, Ugrasena IDG, Arief YS. Psycho-Education on Knowledge of Oral Hygiene and Psychological Distress to the Parents with Leukemia Children. Asian Pac J Cancer Prev 2021; 22:485-490. [PMID: 33639664 PMCID: PMC8190351 DOI: 10.31557/apjcp.2021.22.2.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Indexed: 11/25/2022] Open
Abstract
Objective: To analyze the effect of psycho-educational intervention on knowledge of oral hygiene and psychological distress to the parents of children suffering from leukemia. Methods: Design of this study was a quasi-experimental pre-posttest control group design. The sample were 70 mothers who had children with leukemia (intervention group = 35 mothers; control group = 35 mothers). The independent variable was psycho-educational, while the dependent variables were oral hygiene knowledge and psychological distress. The instruments used were the knowledge questionnaire and the Depression-Anxiety-Stress Scale (DASS-21). Data were analyzed using the Wilcoxon signed rank test and the Mann Whitney U-test with the significance α =0.05. Results: The knowledge most widely known by parents was about how to perform of oral care (37.3%). All parameters of knowledge about oral hygiene have increased after being given a psycho-educational intervention. Psycho-educational interventions had an effect on reducing psychological distress; depression (p=0.000), anxiety (p=0.001) and stress (p=0.000). Conclusion: Most parents whose children suffer from cancer experience psychological distress in the form of depression, anxiety and stress with a range of symptoms ranging from mild to moderate. Psycho-educational interventions can increase knowledge about oral hygiene and decrease psychological distress in parents.
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Affiliation(s)
- Ilya Krisnana
- Faculty of Nursing Universitas Airlangga, Surabaya Indonesia
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11
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Clever K, Schepper F, Maier S, Christiansen H, Martini J. Individual and Dyadic Coping and Fear of Progression in Mothers and Fathers of Children with Hematologic Cancer. FAMILY PROCESS 2020; 59:1225-1242. [PMID: 31408204 DOI: 10.1111/famp.12480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study investigated the association of individual and dyadic coping strategies with fear of progression (FoP) in mothers and fathers of children with hematologic cancer. Parental couples (N = 44) whose children had been diagnosed with hematologic cancer were recruited at a university hospital and a rehabilitation clinic in Germany between 03/2017 and 08/2017. Data included parents' self-report on FoP (Fear of Progression Questionnaire-parent version, FoP-Q-SF/PR), individual coping (Coping Health Inventory for Parents, CHIP-D), and dyadic coping (Dyadic Coping Inventory, DCI). Statistical analyses were carried out for mothers and fathers individually as well as for parental couples using dyadic data analyses (e.g., actor-partner interdependence model, APIM). Individual and dyadic coping strategies were significantly correlated with FoP in mothers, but not in fathers. Fathers' evaluation of the couple's dyadic coping significantly predicted mothers' FoP. The more frequent use of familial integration (CHIP-D FAM) and maintaining social support (CHIP-D SUP) as well as a better evaluation of their partners' dyadic coping was significantly associated with lower FoP in mothers. Differences in individual and dyadic coping in parental couples were not associated with FoP. Individual and dyadic coping strategies should be addressed in the psychosocial care of mothers and fathers of children with hematologic cancer. Study results support the benefits of involving fathers in psychosocial interventions, for example, in couple-based interventions that acknowledge interpersonal effects of coping on FoP. Future research should further explore coping strategies applied by fathers of children with hematologic cancer for the regulation of FoP.
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Affiliation(s)
- Katharina Clever
- Department of Pediatric Oncology, Hematology and Hemostaseology, Leipzig University, Leipzig, Germany
| | - Florian Schepper
- Department of Pediatric Oncology, Hematology and Hemostaseology, Leipzig University, Leipzig, Germany
| | - Stephan Maier
- Rehabilitation Clinic Katharinenhöhe, Schönwald, Germany
| | - Holger Christiansen
- Department of Pediatric Oncology, Hematology and Hemostaseology, Leipzig University, Leipzig, Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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12
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Peikert ML, Inhestern L, Krauth KA, Escherich G, Rutkowski S, Kandels D, Bergelt C. Fear of progression in parents of childhood cancer survivors: A dyadic data analysis. Psychooncology 2020; 29:1678-1685. [PMID: 32779255 DOI: 10.1002/pon.5508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Fear of progression (FoP), also referred to as fear of cancer recurrence, is gaining increasing interest in survivorship research as it constitutes a great burden for patients and relatives. However, only little is known about FoP in parents of childhood cancer survivors. The objective of this study was to investigate the impact of FoP on quality of life (QoL) in parental couples. METHODS We analyzed dyadic data of 197 couples parenting childhood cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system tumor) after the end of intensive cancer treatment. The actor-partner interdependence model calculated by structural equation modelling was used to examine actor effects (effect of one's own FoP on one's own QoL) and partner effects (effect of one's own FoP on the partner's QoL). RESULTS Eighty-one percentage of the parents reported moderate or high FoP levels. Mothers reported higher FoP levels (p < .01) and lower overall QoL levels than fathers (p < .01). The results revealed a significantly positive intra-dyadic correlation between FoP of mothers and fathers of the same dyad (r = .431, p < .001). We found significantly negative actor effects for both mothers and fathers for the overall QoL (p < .001) as well as for several QoL subscales. No significant partner effects were found. CONCLUSIONS Most parents reported elevated levels of FoP. Our results show that FoP in parents of childhood cancer survivors is strongly negatively associated with QoL. Parental FoP should therefore be explored in future research and needs to be targeted by health care providers.
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Affiliation(s)
- Mona L Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology & Oncology, Klinik Bad Oexen, Bad Oeynhausen, Germany
| | - Gabriele Escherich
- Clinic of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Rutkowski
- Clinic of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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13
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Conway Keller M, King C, Hart L, Engelke K, Needham A, Holden E, Foy K, Lucas R. The end of cancer treatment experience for children, adolescents, and their parents: A systematic review of the literature. J Psychosoc Oncol 2020; 38:573-591. [DOI: 10.1080/07347332.2020.1769795] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Mary Conway Keller
- Division of Hematology-Oncology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Courtney King
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Leigh Hart
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Karina Engelke
- Division of Hematology-Oncology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Andrew Needham
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Elizabeth Holden
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Kelly Foy
- Division of Hematology-Oncology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Ruth Lucas
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
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14
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Walker AJ, Lewis FM, Rosenberg AR. Walking on Eggshells: Parents' First Year After Their Adolescent Completes Their Cancer Treatment [Formula: see text]. J Pediatr Oncol Nurs 2020; 37:233-243. [PMID: 32141370 PMCID: PMC7312346 DOI: 10.1177/1043454220909788] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Despite an awareness that parents experience distress and heightened uncertainty at the end of their adolescent's treatment for cancer, little is known about the specific challenges and concerns parents hold for their adolescent survivors or how they manage these challenges. This study described challenges parents experience in the first year after their adolescent's cancer treatment and what parents did to manage those challenges. Method: Single occasion semistructured interviews were conducted with parents and were transcribed verbatim. Data were coded using inductive content analysis methods adapted from grounded theory. Results: Participants were 30 parents of adolescent survivors (13-18 years) who were in the first year following treatment completion. The core construct, "Walking on Eggshells," explained the processes and experiences parents faced once treatment was complete. Two additional domains captured how parents managed posttreatment challenges ("Doing What We Can") and the ways parents helped their adolescents adjust ("Balancing"). Conclusion: Study results suggest that services and materials are needed to help parents know common struggles that arise after treatment and ways to mitigate the severity of distress parents experience.
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Affiliation(s)
| | | | - Abby R. Rosenberg
- University of Washington, Seattle, WA,
USA
- Seattle Children’s Hospital, Seattle,
WA, USA
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15
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CE: Hematologic Childhood Cancers: An Evidence-Based Review. Am J Nurs 2019; 119:34-44. [PMID: 31764050 DOI: 10.1097/01.naj.0000615784.09785.ab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Every year in the United States, thousands of children and adolescents are diagnosed with a hematologic cancer. That diagnosis and the prescribed course of treatment profoundly affect both the child and the family. This article provides a brief overview of the therapies used to treat such cancers, describes the presentations and diagnoses of the various hematologic cancers, and explains the treatments specific to each. Nursing care of the child and family is discussed, with an emphasis on education and supportive care.
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16
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Conway Keller M, Ruiz T, Needham A, King C, Hart L, Holden E, Lucas R. Development and Content Validation of End of Treatment Questionnaires for Children With Cancer. J Pediatr Oncol Nurs 2019; 37:128-135. [PMID: 31596172 DOI: 10.1177/1043454219878392] [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] [Indexed: 12/24/2022] Open
Abstract
Purpose: To describe the development and content validation of measures to assess the psychoeducational needs of children, adolescents/young adults (AYAs), and their parents at the end of successful treatment for cancer. Method: Professional experts, which included pediatric oncology nurses and advanced practice registered nurses, conducted a systematic review of the literature to determine specific end of treatment (EOT) needs of children and AYAs with cancer and their parents and evaluate available tools to measure these needs. From this review, two EOT questionnaires were initially developed. Oncology Family Advisory Board (FAB) members served as experiential experts in refining and validating these questionnaires. FAB members participated in a content validation process, rating questionnaires online, and subsequently participating in a focus group to establish content validity (n = 6). Results: Three EOT questionnaires were ultimately developed. The Child/AYA questionnaire was divided into two separate measures for developmental and literacy considerations. The Parent/Caregiver and the AYA questionnaires each contain 38 items with a content validity index score of 100%. The Child questionnaire contains 37 items with a content validity index score of 100%. Conclusion: Content validity was established for three EOT questionnaires, each of which has the potential to elicit information regarding needs and potential gaps in services perceived by childhood cancer survivors and their parents. Further psychometric testing is needed to determine stability (test-retest reliability) and construct validity of the questionnaires.
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Affiliation(s)
| | - Tiffany Ruiz
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Andrew Needham
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Courtney King
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Leigh Hart
- Connecticut Children's Medical Center, Hartford, CT, USA
| | | | - Ruth Lucas
- University of Connecticut, Storrs, CT, USA
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17
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Greenblatt A, Saini M. Experiences of adolescents with cancer from diagnosis to post-treatment: a scoping review. SOCIAL WORK IN HEALTH CARE 2019; 58:776-795. [PMID: 31311459 DOI: 10.1080/00981389.2019.1640338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 05/19/2019] [Accepted: 06/27/2019] [Indexed: 06/10/2023]
Abstract
Adolescence is a turbulent time of transition. Facing a serious health issue such as cancer during this time can be challenging and confusing. This study presents a scoping review of 33 research articles including quantitative, qualitative, mixed method, and reviews focused on the experiences of adolescents throughout the cancer journey. Extracted themes across studies identified individual, interpersonal, and environmental aspects of adolescents' experiences in each stage of this trajectory. Implications for these findings are discussed including a need for early diagnosis and treatment of adolescent cancers and developmentally appropriate clinical supports.
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Affiliation(s)
- Andrea Greenblatt
- Factor-Inwentash School of Social Work, University of Toronto , Toronto , Ontario , Canada
| | - Michael Saini
- Factor-Inwentash School of Social Work, University of Toronto , Toronto , Ontario , Canada
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18
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Perceived Family Impact During Children’s Hospitalization for Treatment of Acute Lymphoblastic Leukemia. Cancer Nurs 2019; 43:489-497. [DOI: 10.1097/ncc.0000000000000720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Health-related quality of life in paediatric patients up to five years post-treatment completion for acute lymphoblastic leukaemia: a systematic review. Support Care Cancer 2019; 27:4341-4351. [PMID: 30900055 DOI: 10.1007/s00520-019-04747-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 03/12/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Despite survival rates greater than 90%, treatment for paediatric acute lymphoblastic leukaemia (ALL) remains challenging for families. The early post-treatment phase is an especially unique time of adjustment. The primary aim of this review was to identify and synthesise research on health-related quality of life (HRQoL) for patients up to five years post-treatment. The secondary aim was to identify if theorised risk/resistance model factors could explain any variance in reported HRQoL. METHODS We conducted a systematic review using the PRISMA guidelines across five databases: Embase, Medline, Psychinfo, Pubmed, and Cochrane. Only studies examining HRQoL up to five years post-treatment were included. Studies were excluded if they covered periods greater than five years post-treatment or did not differentiate between patients with ALL and other cancers. After assessing the quality of each study sample size, patient characteristics, HRQoL outcomes and HRQoL correlates were extracted and summarised. RESULTS A total of 14 studies representing 1254 paediatric patients, aged 2-18 years, were found. HRQoL findings were mixed, dependent on time since completion and comparison group. Patient HRQoL was mostly lower compared to normative data, whilst higher compared to healthy control groups, patients on treatment, and patients with other types of cancers. Lower HRQoL was also found to be associated with demographic (age and sex), family dysfunction, and treatment-related factors. CONCLUSIONS Completing treatment signalled a significant improvement in HRQoL for patients compared to being on treatment. Overall, however, HRQoL was still significantly lower than the population during the early post-treatment period.
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20
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Wilford JG, Hopfer S, Wenzel L. Perceptions of changes in clinical, informational, and supportive relationships after end of treatment among parents of young childhood cancer survivors. Psychooncology 2019; 28:913-919. [PMID: 30812064 DOI: 10.1002/pon.5042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/21/2019] [Accepted: 02/23/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Parents of childhood cancer patients experience changes in relationships with their health-care team as the child transitions from treatment to long-term survivorship (LTS). These changes may affect parent receptivity of survivorship-health-related programs, yet little is known about the experience of changing clinical relationships for parents as treatment ends and children transition into LTS. METHODS In-depth, semistructured interviews were conducted with 20 English-speaking parents of childhood cancer survivors less than 13 years old who were greater than 1-year posttreatment. Audiotaped, transcribed interview content was analyzed using emergent themes grouped and refined in a process of multistaged constant comparison. RESULTS There was a consensus among parents regarding the emotional stressors of the period immediately after the end of treatment. Regardless of positive or negative recollection of treatment, parents commonly viewed their health-care team with affection and this period as one of stability and security. Transitioning off treatment was viewed as a severe disruption of the security of weekly, treatment-related contact with nurses, nurse practitioners, physician's assistants, and physicians. LTS was generally viewed as presenting lower levels, but new types of stress as new, psychosocial late effects were seen to emerge. Clinical needs shifted to prevention and late-effect management. CONCLUSION Parents of young childhood cancer survivors experience a similar emotional trajectory from treatment to transitioning off treatment and into LTS. This period is seen by parents as uniquely distressing because it represents a disruption of the hard-won safety represented by regular clinical relationships.
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Affiliation(s)
- Justin G Wilford
- Department of Population Health & Disease Prevention, University of California Irvine, Irvine, California
| | - Suellen Hopfer
- Department of Population Health & Disease Prevention, University of California Irvine, Irvine, California.,Chao Family Comprehensive Cancer Center, University of California, Irvine, California
| | - Lari Wenzel
- Department of Population Health & Disease Prevention, University of California Irvine, Irvine, California.,Chao Family Comprehensive Cancer Center, University of California, Irvine, California.,School of Medicine, University of California, Irvine, California
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21
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Greenblatt A, Lee E. Cancer survivorship and identity: what about the role of oncology social workers? SOCIAL WORK IN HEALTH CARE 2018; 57:811-833. [PMID: 30222064 DOI: 10.1080/00981389.2018.1521893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
With cancer survival rates rapidly increasing over time, more people are living into the survivorship stage of their cancer experience. Furthermore, the experience of cancer may impact individuals long after treatment has ceased. This paper presents the results of a mapping review implemented to explore key themes in the literature related to issues with identity following the completion of cancer treatment. The review included 22 studies including quantitative, qualitative, mixed method, and review studies as well as conceptual papers. Findings revealed key descriptions post-cancer treatment identities, literature focused on dominant discourses and counter-discourses around cancer survivorship, and key themes focused on identity management and the roles of Oncology Social Workers in supporting identity issues in postcancer treatment. This review presents a 'map' of current research on identity and cancer survivorship, helping to identify major gaps in the literature, direct future research, and inform practice.
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Affiliation(s)
- Andrea Greenblatt
- a Factor-Inwentash School of Social Work , University of Toronto , Toronto , Ontario , Canada
| | - Eunjung Lee
- a Factor-Inwentash School of Social Work , University of Toronto , Toronto , Ontario , Canada
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22
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Burns W, Péloquin K, Rondeau É, Drouin S, Bertout L, Lacoste-Julien A, Krajinovic M, Laverdière C, Sinnett D, Sultan S. Cancer-related effects on relationships, long-term psychological status and relationship satisfaction in couples whose child was treated for leukemia: A PETALE study. PLoS One 2018; 13:e0203435. [PMID: 30192798 PMCID: PMC6128557 DOI: 10.1371/journal.pone.0203435] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/21/2018] [Indexed: 01/21/2023] Open
Abstract
Objectives Follow-up studies suggest that the psychosocial impact of pediatric cancer on parents often extends beyond the end of their child’s cancer treatments, and parents can continue to experience both individual and relationship effects. In a long-term study of parents of children who were treated for acute lymphoblastic leukemia (ALL), we aimed to: 1) describe parents’ adjustment (psychological distress, relationship satisfaction; 2) describe the perceived impact of cancer on couples’ relationship, and; 3) identify to what extent the perceived impact of cancer on the couple is related to both parents’ long-term adjustment. Methods Parents of childhood ALL survivors (n = 103 couples) were surveyed as part of a cohort recall (PETALE cohort). Both parents completed questionnaires exploring adjustment (Brief Symptom Inventory-18, Dyadic Adjustment Scale) and perceived impact of cancer on the relationship (Impact of Cancer on the Couple). Mothers’ and fathers’ scores were compared using MANOVAs. We also examined the degree to which a parent’s perceived changes in relationship dynamics following their child’s cancer were associated with their own current adjustment (actor effects), and their partner’s current adjustment (partner effects) using the Actor-Partner Interdependence Model (APIM). Results Frequencies of current distress were normative in parents (mothers/fathers): general distress (6.8/7.8%), anxiety (5.8/6.8%), depression (2.9/6.8%), somatization (13.6/9.7%), and relationship distress (21.4/20.4%). Mothers and fathers typically agreed on their reported relationship satisfaction, and the perceived nature of relationship changes following the illness. Dyadic analyses indicated that whereas mothers’ adjustment was related to their own perceived relationship changes, fathers’ adjustment was primarily related to their partner’s perceptions. Conclusion In long-term stable couples, mothers may act as an influential bridge connecting the illness experiences of survivors and fathers. This could explain why mothers’ perceptions of relationship changes were related to their partners’ long-term adjustment, which was not the case for fathers.
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Affiliation(s)
- Willow Burns
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Katherine Péloquin
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Laurence Bertout
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | | | - Maja Krajinovic
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
- * E-mail:
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