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Fisher AP, Patronick J, Moscato EL, Gerhardt CA, Treble-Barna A, Radonovich K, Wade SL. Barriers to Care and Perceived Need for Mental Health Services Among Adolescent and Emerging Adult Survivors of Pediatric Brain Tumors. J Adolesc Young Adult Oncol 2024; 13:469-480. [PMID: 38100322 PMCID: PMC11296316 DOI: 10.1089/jayao.2023.0119] [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] [Indexed: 12/17/2023] Open
Abstract
Purpose: Pediatric brain tumor survivors (PBTS) commonly experience mental health challenges, which can be exacerbated during adolescence and emerging adulthood (AEA). We examined survivors and caregivers' perceived need for mental health services and barriers to receiving mental health care. Methods: Families completed surveys to assess perceived need for mental health services, socioemotional impairment, and barriers to mental health services. Survivors were between 13 and 25 years of age and were at least 5 years from diagnosis. Results: Sixty-nine caregiver-PBTS dyads participated, as well as 18 survivors and 20 caregivers who participated individually. Approximately half of survivors were male (n = 57, 52.3%), 85% (n = 93) were White, and their average age was 19.31. Most caregivers (n = 63, 70.8%) and survivors (n = 55, 63.2%) endorsed need for services for the survivors. Adolescents endorsed more barriers related to perceived helpfulness, t(18) = 2.3, p = 0.03, d = 0.54, and effects of services, t(18) = 3.8, p < 0.001, d = 0.88, than their caregivers. Emerging adults, t(34) = 2.4, p = 0.02, d = 0.41, endorsed more content barriers than their caregivers.. Discussion: Both survivors and their caregivers reported obstacles to accessing mental health services such as perceived lack of need, concerns regarding the effectiveness and usefulness of services, and limited knowledge about the content of services. Psychoeducation and psychosocial screening can support families in understanding survivors' need for mental health services.
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Affiliation(s)
- Allison P. Fisher
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jamie Patronick
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Emily L. Moscato
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Cynthia A. Gerhardt
- Department of Pediatrics and Psychology, The Abigail Wexner Research Institute, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Amery Treble-Barna
- Neurodevelopmental Center, WVU Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA
| | - Krestin Radonovich
- Physical Medicine and Rehabilitation and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shari L. Wade
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
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Deatrick JA. Adapting Psychosocial Interventions Using Participatory Methods: Lessons Learned for Family Nursing. JOURNAL OF FAMILY NURSING 2024; 30:87-93. [PMID: 38682440 DOI: 10.1177/10748407241232091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
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3
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Miyagishima K, Ichie K, Sakaguchi K, Kato Y. The parental involvement process regarding childhood cancer survivors becoming independent: Focus on balancing health management and social lives from adolescence to adulthood. Jpn J Nurs Sci 2024; 21:e12572. [PMID: 37937387 DOI: 10.1111/jjns.12572] [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: 06/28/2023] [Revised: 09/15/2023] [Accepted: 10/07/2023] [Indexed: 11/09/2023]
Abstract
AIM This study aimed to elucidate the parental involvement process regarding childhood cancer survivors' (CCSs') independence while balancing their health management and social lives from adolescence to adulthood to obtain suggestions for long-term support for CCSs and their parents. METHODS Semi-structured interviews were conducted with 19 parents of Japanese CCSs aged 16-25 years. The data were then qualitatively analyzed using the modified grounded theory approach. RESULTS Three "categories" and 20 "concepts" were generated. The connections among these categories and concepts revealed the parental involvement process regarding CCSs' independence while balancing their health management and social lives. The first phase in this process is to "support careful behaviors," mainly during CCSs' treatment in the outpatient clinic or shortly after discharge. As CCSs recover after cancer treatment, parents "watch over, but feel conflicted," with "conflicts between protecting their sons/daughters and giving them independence." Then, parents reach a phase in which they "acknowledge and entrust," which includes "acknowledgment of development and efforts" of their sons/daughters, and develop an "attitude to entrust medical checkups to their sons/daughters, along with their preparation." The influencing factors of the three phases include "ongoing anxieties about the late effects of therapy and recurrence" and an "expectation for their sons/daughters to acquire abilities for living independently." CONCLUSIONS These findings suggest that nurses need to accept parents' feelings and thoughts regarding conflicts with CCSs, recognition of CCSs' development, and values. These processes may help nurses and health-care professionals support parents from a comprehensive perspective.
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Affiliation(s)
- Kyoko Miyagishima
- Faculty of Nursing, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kazuko Ichie
- Faculty of Nursing, Seirei Christopher University, Hamamatsu, Japan
| | | | - Yuka Kato
- Department of Nursing, Shizuoka Children's Hospital, Shizuoka, Japan
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Perez MN, Deatrick JA, Barakat LP. Caregiver condition management and family functioning after pediatric cancer treatment: Moderation by race and ethnicity. Psychooncology 2024; 33:e6263. [PMID: 38040486 DOI: 10.1002/pon.6263] [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: 08/16/2023] [Revised: 11/03/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE End of pediatric cancer treatment requires family adjustment. Caregivers who struggle to incorporate the child's condition into family life have poorer family outcomes. To better understand factors that contribute to successful transition off active childhood cancer treatment, we sought to examine caregiver perceived management ability of the youth's condition and family functioning as predictors of caregiver distress, evaluate family functioning as a mediator between perceived ability and distress, and explore race and ethnicity as a moderator between perceived ability and family functioning. METHODS Caregivers (N = 141) completed measures assessing family management (condition management ability; CMA), family functioning, and distress as part of a clinical education and screening program within 1 year of the end of treatment. Bias-corrected bootstrap regression analyses examined mediation and moderated mediation models with patient race and ethnicity as the moderator. RESULTS The overall mediation model was statistically significant for CMA→family functioning→distress. Race and ethnicity moderated the relationship between CMA and family functioning, but the full model was not significant. CMA was related to family functioning for caregivers of non-Hispanic white youth, but not caregivers of Hispanic youth. Family functioning was related to distress for all caregivers. CONCLUSIONS Family functioning serves as an initial intervention target to reduce caregiver distress. Caregiver perceived management ability of their child's condition is a meaningful predictor of family functioning and distress for caregivers of non-Hispanic white youth, yet CMA may be limited as a screener of family management patterns for diverse populations, and other family management dimension may be more applicable.
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Affiliation(s)
- Megan N Perez
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Janet A Deatrick
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lamia P Barakat
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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5
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Bonanno M, Bourque CJ, Robichaud LA, Levesque A, Lacoste-Julien A, Rondeau É, Dubé É, Leblanc M, Bertrand MC, Provost C, Desjardins L, Sultan S. Prioritizing Solutions and Improving Resources among Young Pediatric Brain Tumor Survivors: Results of an Online Survey. Curr Oncol 2023; 30:8586-8601. [PMID: 37754538 PMCID: PMC10527929 DOI: 10.3390/curroncol30090623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
Pediatric Brain Tumor Survivors (PBTS) often experience social, academic and employment difficulties during aftercare. Despite their needs, they often do not use the services available to them. Following a previous qualitative study, we formulated solutions to help support PBTS return to daily activities after treatment completion. The present study aims to confirm and prioritize these solutions with a larger sample. We used a mixed-methods survey with 68 participants (43 survivors, 25 parents, PBTS' age: 15-39 years). Firstly, we collected information about health condition, and school/work experience in aftercare. Then, we asked participants to prioritize the previously identified solutions using Likert scales and open-ended questions. We used descriptive and inferential statistics to analyze data, and qualitative information to support participants' responses. Participants prioritized the need for evaluation, counseling, and follow-up by health professionals to better understand their post-treatment needs, obtain help to access adapted services, and receive information about resources at school/work. Responses to open-ended questions highlighted major challenges regarding the implementation of professionals' recommendations at school/work and the need for timely interventions. These results will help refine solutions for PBTS and provide key elements for future implementation. Translating these priorities into action will need further work involving professionals and decision makers.
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Affiliation(s)
- Marco Bonanno
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, QC H3T 1C5, Canada
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | | | - Lye-Ann Robichaud
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
| | - Ariane Levesque
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
| | - Ariane Lacoste-Julien
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Émélie Rondeau
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Émilie Dubé
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Michelle Leblanc
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Marie-Claude Bertrand
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, QC H3T 1C5, Canada
| | - Carole Provost
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, QC H3T 1C5, Canada
| | - Leandra Desjardins
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- CHU Sainte-Justine Research Centre, Montreal, QC H3T 1C5, Canada
| | - Serge Sultan
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
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6
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Bates CR, Fairclough D, Noll RB, Barrera ME, Kupst MJ, Egan AM, Gartstein MA, Ach EL, Gerhardt CA, Vannatta KA. Psychosocial functioning of caregivers of pediatric brain tumor survivors. Pediatr Blood Cancer 2022; 69:e29565. [PMID: 35044078 PMCID: PMC8860870 DOI: 10.1002/pbc.29565] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/06/2021] [Accepted: 12/23/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Assessment of caregiver needs is a recommended standard of care in pediatric oncology. Caregivers of pediatric brain tumor survivors (PBTS) are a subgroup that may be at highest psychosocial risk. This study examined psychosocial functioning of caregivers of PBTS in comparison to caregivers of youth without cancer history. We hypothesized that caregivers of PBTS would exhibit more psychological symptoms, higher caregiver burden, and lower perceptions of social support than caregivers of comparison youth. PROCEDURE As part of a five-site study, we utilized a matched sample design to evaluate psychosocial functioning of 301 caregivers of 189 PBTS (ages 8-15) who were 1-5 years post treatment, and 286 caregivers of 187 comparison youth matched for sex, race, and age. Caregivers completed measures of psychological symptoms, caregiver burden, and perceptions of social support. Repeated measures mixed models compared outcomes between groups and examined differences based on caregiver sex. Socioeconomic status (SES) was examined as a moderator of significant main effects. RESULTS Caregivers of PBTS reported similar levels of psychological symptoms to caregivers of comparison youth. Mothers of PBTS mothers reported higher caregiver burden and lower perceptions of social support than mothers of comparison youth. Low SES exacerbated group differences in caregiver burden. CONCLUSIONS Mothers of PBTS may have more caregiving responsibilities and perceive less social support, but reported similar levels of psychological symptoms to comparison mothers; fathers of PBTS were similar to comparison fathers. The mechanisms involved in this complex psychosocial dynamic require further investigation.
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Affiliation(s)
- Carolyn R. Bates
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS
| | - Diane Fairclough
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Robert B. Noll
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Maru E. Barrera
- Division of Hematology/Oncology, Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mary Jo Kupst
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Anna M. Egan
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO,University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA
| | | | - Emily L. Ach
- Department of Psychiatry, Stanford University School of Medicine, Stanford, California, USA
| | - Cynthia A. Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Kathryn A. Vannatta
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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7
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Beyond Colloquial Use: A Concept Analysis of Family Care Management in A Chronic-Conditions Context. Res Theory Nurs Pract 2022; 36:66-100. [PMID: 35173028 DOI: 10.1891/rtnp-2021-0012] [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: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Family care management is a colloquial concept that is widely applied to health and social care worldwide. Despite that the concept has been in use in a variety of contexts for decades, a substantial number of scientific papers apply it with seemingly little consistency. In this study, we therefore report a concept analysis of family care management within a chronic-conditions context from the nursing perspective. METHODS A review of recent nursing and health-related literature covering the years 2000-2020 was performed on the concepts of family care, family nursing, family management, and care management. Nineteen studies were extracted for this analysis. Utilizing the Walker and Avant concept-analysis strategy, we defined attributes and analyzed the antecedents and their consequences. RESULTS The concept is defined from the perspective of health professionals. Five key attributes of family care management were identified: supervising situations, providing guidance, creating partnerships, a philosophical foundation, and a management style. Antecedents to the conductance of family care management included chronic health status, demographic and socioeconomic factors, and shortage of resources. The outcome of family care management was then described with respect to both positive and negative aspects. IMPLICATION FOR PRACTICE Family care management is a highly abstract concept. We described two sub-concepts in need of clarification, including dynamic management behavior and a static management frame. Without a clear understanding of family care management, the concept is at risk of being relegated to a vague colloquial expression. Developing a theory of family care management might position the concept in a theoretical context, and could provide health providers with a point of reference for meaningful family care management strategies within their practices.
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8
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Development of Training in Problem Solving for Caregivers of Childhood Brain Tumor Survivors. Cancer Nurs 2021; 45:E746-E757. [DOI: 10.1097/ncc.0000000000001041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Bonanno M, Bourque CJ, Aramideh J, Cloutier N, Dumont É, Gomez-Tyo M, Julien-Lacoste A, Košir U, Provost C, Laverdière C, Sultan S. Articulating viewpoints to better define and respond to the needs of adolescents and young adult survivors of pediatric brain tumors. J Psychosoc Oncol 2021; 40:347-365. [PMID: 34859737 DOI: 10.1080/07347332.2021.2004291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Adolescents and young adult survivors of pediatric brain tumors (AYA-PBTS) often experience difficulties with social skills, pursuit of studies and employment. This study explored pediatric long-term survivors' perspective on their post-treatment needs and ways to improve resources and interventions. METHODS We used an original method of three sequential focus group interviews by adding the perspectives of survivors (15-22 years), parents and health professionals (total N = 22). Participants were recruited using purposive sampling from the long-term follow-up clinic at a Canadian tertiary hospital. We used computer-assisted analysis to draw themes from each group and compare thematic content across groups. RESULTS Categorization of participants' responses resulted in three domains: personal life, education and work. Participants mentioned the improvement of communication tools to facilitate access to timely information, the organization of counseling to improve employment integration, and tailoring interventions to optimize the return to daily activities in aftercare. Subsequent inductive analysis revealed three overarching trends among groups: multipurpose social networking, AYA-PBTS-specific information websites and transition tools and procedures. CONCLUSION AND IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS This study identified solutions for AYA-PBTS' specific needs in aftercare. This population needs up-to-date post-treatment information and refined outreach procedures. Future research should define and prioritize these suggested solutions.
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Affiliation(s)
- Marco Bonanno
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, Canada.,Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada
| | - Claude Julie Bourque
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Jennifer Aramideh
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada.,Department of Psychology, Université de Montréal, Montreal, Canada
| | - Nancy Cloutier
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, Canada
| | - Émilie Dumont
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada
| | | | - Ariane Julien-Lacoste
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada
| | - Urška Košir
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Carole Provost
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, Canada
| | - Caroline Laverdière
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Serge Sultan
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, Canada.,Department of Psychology, Université de Montréal, Montreal, Canada
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Bashore L, Hobbie W. Emerging and Ongoing Survivorship Challenges Among Childhood Cancer Survivors and Providing Risk-Based Focused Follow-Up Care. Semin Oncol Nurs 2021; 37:151163. [PMID: 34144848 DOI: 10.1016/j.soncn.2021.151163] [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] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To provide a summary of the emerging and ongoing survivorship challenges facing childhood, adolescent, and young adult cancer survivors and their families. DATA SOURCES Research and review articles, websites, and clinical guidelines specific to childhood cancer survivorship were used. CONCLUSION Many challenges exist in assuring quality long-term follow-up and risk-based screening for childhood cancer survivors. Although many childhood cancer survivors survive well into adulthood, they are at risk for a vast number of later complications of their cancer treatment necessitating annual cancer surveillance. In addition, many childhood cancer survivors are not engaging in long-term follow-up recommendations for clinic attendance, risk-based surveillance, and screening for potentially life-ending events. Pediatric oncology nurses and advanced practice nurses have played an enormous role in the design of childhood cancer survivorship programs and are an integral member of the multidisciplinary health care team who care for this population. Nurses have an obligation to continue to advance the survivorship care of childhood cancer survivors and lead interventional opportunities to improve the lifelong health-related quality of life and overall physical health. IMPLICATIONS FOR NURSING PRACTICE Pediatric oncology nurses and advanced practice registered nurses must have a working knowledge of the many late effects that childhood cancer treatment has on the long-term health of childhood cancer survivors. Nurses are well-placed in positions to continue the efforts begun more than 2 decades prior by pediatric oncology nurses who saw the value and necessity of designated survivorship programs.
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Affiliation(s)
| | - Wendy Hobbie
- Children's Hospital of Philadelphia, Philadelphia, PA
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11
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Young K, Bowers A, Bradford N. Families' experiences of child and adolescent brain tumor: A systematic review and synthesis of qualitative research. Psychooncology 2021; 30:1643-1662. [PMID: 34124814 DOI: 10.1002/pon.5745] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/18/2021] [Accepted: 05/23/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Brain tumors are the most common and fatal of all solid tumors for children and adolescents; those who survive live with long-term physical and emotional consequences, as do their families. We aimed to synthesize relevant qualitative evidence on families' experiences and psychosocial service needs across the lifespan to identify gaps in care delivery and research. METHODS Searches were conducted in Medline, CINAHL, PsycInfo, Embase, and Web of Science. Identified papers were assessed with the Joanna Briggs Institute Critical Appraisal Tool. Data were extracted into NVivo12 and analyzed by qualitative description and, where appropriate, thematic analysis. RESULTS The search yielded 628 papers, of which 40 (33 studies) were eligible (6%). Although the methodological quality of the papers was low, we identified concerns that were consistently reported over time and from different perspectives. Individual family members had varying psychosocial needs to be addressed within healthcare, schooling, and public policy. These include for survivor's mental health (particularly for body image), and to the disproportionate biopsychosocial burden faced by mother-caregivers. CONCLUSIONS Addressing the biological aspects of brain tumor cannot be our only focus. We have an obligation to provide services that meet the needs of families across diagnosis, treatment, survivorship, palliative care, and bereavement.
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Affiliation(s)
- Kate Young
- Cancer and Palliative Care Outcomes Center, Center for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Alison Bowers
- Cancer and Palliative Care Outcomes Center, Center for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia.,Center for Children's Health Research, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Center, Center for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia.,Center for Children's Health Research, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
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12
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Knafl KA, Deatrick JA, Gallo AM, Skelton B. Tracing the Use of the Family Management Framework and Measure: A Scoping Review. JOURNAL OF FAMILY NURSING 2021; 27:87-106. [PMID: 33749353 PMCID: PMC8044632 DOI: 10.1177/1074840721994331] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This article reports the results of a scoping review of research applications of the Family Management Style Framework (FMSF) and the Family Management Measure (FaMM). We identified 32 studies based on the FMSF and 41 studies in which the FaMM was used, 17 of which were based on the FMSF. Both the framework and measure have been used by investigators in multiple countries, with most applications of the FaMM outside the United States. Although the FMSF and FaMM were originally developed for use with families in which there was a child with a chronic physical condition, both have been applied to a broader range of health conditions and to studies focusing on families with an adult member facing a health challenge. Based on our findings, we make recommendations for how researchers can more fully address all aspects of the FMSF.
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Affiliation(s)
| | | | | | - Beth Skelton
- The University of North Carolina at Chapel Hill, USA
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13
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Deatrick JA, Knafl GJ, Knafl K, Hardie TL, Bressler S, Hobbie W, Bratton K, Dominguez M, Guzman CD, Rees Papinsick A, Rees AL, Voisine S, Barakat LP. Mothers' and fathers' views of family management and health-related quality of life for young adult survivors of childhood brain tumors. J Psychosoc Oncol 2020; 39:629-645. [PMID: 33191861 DOI: 10.1080/07347332.2020.1844845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To examine associations between fathers' and mothers' appraisals of family management and physical and emotional health-related quality of life (QOL) for young adult survivors of childhood brain tumors. DESIGN Cross-sectional. SAMPLE 47 mothers and 39 fathers (39-67 years old); 47 survivors (18-33 years old). METHODS Analyses evaluated relationships among family management (Survivor's Daily Life, Condition Management Ability, Condition Management Effort, Family Life Difficulty, View of Condition Impact, Parental Mutuality), quality of life, and parental role. FINDINGS Except for Parental Mutuality, family management ratings were not significantly different for mothers and fathers, and parental views of survivors' physical and emotional QOL improved with better family management. Parental role moderated associations between physical and emotional QOL and Survivors' Daily Life and between emotional QOL and Condition Management Ability, Condition Management Effort, and View of Condition Impact. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Assess and address survivor QOL through family management from multiple perspectives.
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Affiliation(s)
- Janet A Deatrick
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - George J Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathleen Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas L Hardie
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Shannon Bressler
- Department of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Wendy Hobbie
- Department of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kelly Bratton
- Department of Nursing, Children's Healthcare of Atlanta - Scottish Rite Hospital, Sandy Springs, GA, USA
| | | | - Caitlyn De Guzman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Allison L Rees
- Department of Nursing, Children's Mercy Hospital, Kansas City, MO, USA
| | - Sarah Voisine
- Department of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lamia P Barakat
- Department of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Family Management in Childhood Attention Deficit Hyperactivity Disorder: A Qualitative Inquiry. J Pediatr Nurs 2020; 52:82-90. [PMID: 32005539 DOI: 10.1016/j.pedn.2019.09.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/02/2019] [Accepted: 09/21/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this study was to better understand how caregivers and families manage childhood Attention Deficit Hyperactivity Disorder (ADHD) in their everyday lives and explore family management factors most relevant to child outcomes, including the child's daily life, condition management effort, condition management ability, and view of condition impact. DESIGN AND METHODS Cross-sectional data from caregivers (N = 50) of children with ADHD (ages 5-12 years) within a large northeastern city were collected, analyzed, and interpreted using directed content analysis and qualitative methods. This inquiry was part of a larger mixed method study which examined the impact of family management on childhood ADHD and how family management factors were related to children's level of impairment across a spectrum of child functioning. RESULTS Thematic summaries based on qualitative descriptive methods highlighted four aspects of family management including: 1) how caregivers contextualized their child's condition in everyday family life, 2) the significant effort required by caregivers to manage their child's ADHD, 3) how caregivers perceived their ability to manage their child's condition, and 4) the impact of ADHD on their child and family's future. CONCLUSIONS Family management is an important concept within pediatric literature and may be extended to further research and practice changes for children with ADHD and their caregivers. PRACTICE IMPLICATIONS Pediatric nurses are at the forefront of working with children and families. Understanding caregiver perspectives in regard to family management is important for strengthening collaborative partnerships with families and improving the care of children with ADHD.
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