The effects of group therapy on adolescents with cancer

"They Did Not Understand": Exploring Adult Survivors of Childhood Cancer's Memories of Their Experiences With Peers

Background: Peer relationships are impacted by the diagnosis of childhood cancer. Children with cancer can feel isolation, such as bullying and lack of engagement, from their peers. As the rates of survival increase, one way to further learn about the experiences of childhood cancer is to reflect on the memories of adult survivors. This study examines adult survivors of childhood cancer's memories of their experiences with peers during their cancer. Method: Twenty-seven adult survivors (15 male, 12 female) of childhood cancer were recruited from Amazon Mechanical Turk, a crowdsourcing marketplace for survey distribution, and surveyed about their experiences with peers during childhood cancer. Using inductive thematic analysis, open-ended survey questions were analyzed. Results: Five main themes emerged, including age, perceptions of cancer, acts of kindness, peer responses, and limited peer engagement. Participants' memories included peers' lack of understanding about their diagnosis, prognosis, and treatment, positive and negative responses to their cancer diagnosis, acts of services and gifts from peers, and feelings of isolation during the cancer experience. Discussion: In the current study, adult survivors of childhood cancer had specific memories about how cancer impacted peer relationships. Such findings contribute to the evidence that children with cancer could benefit from psychosocial interventions, including education to peers about the diagnosis and the impact of diagnosis on peer relationships, peer engagement activities, and peer support groups.

Psychosocial Interventions for Adolescents and Young Adults Diagnosed with Cancer During Adolescence: A Critical Review

Adolescents and young adults (AYA) face individual and social challenges different to other age groups that shape their experience of cancer and the associated psychological distress. This critical review examined the availability of AYA-specific psychosocial interventions to assess the impact they have and identify elements that make them successful. Five literature databases were searched for psychosocial intervention studies involving AYAs with cancer, on and off treatment, aged 10-30 years, published between 1980 and 2016. Eleven out of 42 identified studies were included in the final review after quality assessment. All but two interventions showed positive results on at least one measure of psychosocial well-being. A distinctive difference between the supportive needs of those on and off treatment was noted, and differences in intervention design and delivery formats were identified between the two subgroups. Analysis of specific intervention characteristics that achieved the successful outcomes was more challenging due to the large variation in outcome measures used. This review demonstrates that psychosocial intervention research for AYA with cancer is increasing and the results show a potential benefit of intervention participation. Further work is needed to validate whether the benefits achieved by intervention participation remain over time.

Participant evaluation of teleconference support for African American women with breast cancer

BACKGROUND

African American women with breast cancer face obstacles such as transportation and family obligations when attending standard support groups. Teleconference support circumvents barriers such as transportation to participation, but few evaluations have been reported about teleconference support.

OBJECTIVE

The purpose of this article was to describe the format of a teleconference group and to provide a descriptive account of the participants' feedback about a teleconference group intervention.

METHODS

A descriptive design was used. Participants completed the Overall Support Group Evaluation tool at the end of the 10th group session.

RESULTS

Teleconference group participants' feedback indicated that they perceived they had gained knowledge about breast cancer and coping. The participants expressed that the group helped them to reach out and ask for support and improved family and work relationships. Also, participants rated the group highly for the presence of therapeutic factors. On a scale of 1 to 4, with 4 being the highest, mean scores ranged from 3.97 to 3.56.

CONCLUSIONS

The participants gave high ratings of satisfaction in terms of knowledge gained, leadership style, and benefits. The participants perceived that the group increased their knowledge about cancer, improved family connections, and increased their ability to deal with their cancer.

IMPLICATIONS FOR PRACTICE

Using teleconferencing technology to deliver a support group to African American breast cancer patients is a beneficial method to reach a disadvantaged population that may be unable to attend face-to-face groups.

Interventions for improving communication with children and adolescents about their cancer

BACKGROUND

Communication with children and adolescents with cancer about their disease and treatment and the implications of these is an important aspect of good quality care. It is often poorly performed in practice. Various interventions have been developed that aim to enhance communication involving children or adolescents with cancer.

OBJECTIVES

To assess the effects of interventions for improving communication with children and/or adolescents about their cancer, its treatment and their implications, updating the 2003 version of this review.

SEARCH STRATEGY

In April 2006 we updated searches of the following sources: CENTRAL (The Cochrane Library, issue 1 2006); MEDLINE (Ovid), (2003 to March week 5 2006); EMBASE (Ovid) (2003 to 2006 week 13); PsycINFO (Ovid) (2003 to March week 5 2006); CINAHL (Ovid) (2003 to March week 5 2006); ERIC (CSA) (earliest to 2006); Sociological Abstracts (CSA) (earliest to 2006); Dissertation Abstracts: (2002 to 6 April 2006).In 2003 we conducted searches of CENTRAL; MEDLINE, EMBASE, PsycINFO, CINAHL, ERIC, Sociological Abstracts and Dissertation Abstracts.For the initial (2001) publication of this review we also searched the following databases: PsycLIT; Cancerlit; Sociofile; Health Management Information Consortium; ASSIA; LISA; PAIS; Information Science Abstracts; JICST; Pascal; Linguistics and Language Behavior Abstracts; Mental Health Abstracts; AMED; MANTIS.We also searched the bibliographies of studies assessed for inclusion, and contacted experts in the field.

SELECTION CRITERIA

Randomised and non-randomised controlled trials, and before and after studies, evaluating the effects of interventions for improving communication with children and/or adolescents about their cancer, treatment and related issues.

DATA COLLECTION AND ANALYSIS

Data relating to the interventions, populations and outcomes studied and the design and methodological quality of included studies were extracted by one review author and checked by another review author. We present a narrative summary of the results.

MAIN RESULTS

One new study met the criteria for inclusion; in total we have included ten studies involving 438 participants. Studies were diverse in terms of the interventions evaluated, study designs used, types of people who participated and the outcomes measured.One study of a computer-assisted education programme reported improvements in knowledge and understanding about blood counts and cancer symptoms. One study of a CD-ROM about leukaemia reported an improvement in children's feelings of control over their health. One study of art therapy as support for children during painful procedures reported an increase in positive, collaborative behaviour. Two out of two studies of school reintegration programs reported improvements in some aspects of psychosocial wellbeing (one in anxiety and one in depression), social wellbeing (two in social competence and one in social support) and behavioural problems; and one reported improvements in physical competence. One newly-identified study of a multifaceted interactive intervention reported a reduction in distress (as measured by heart rate) related to radiation therapy.Two studies of group therapy, one of planned play and story telling, and one of a self-care coping intervention, found no significant effects on the psychological or clinical outcomes measured.

AUTHORS' CONCLUSIONS

Interventions to enhance communication involving children and adolescents with cancer have not been widely or rigorously assessed. The weak evidence that exists suggests that some children and adolescents with cancer may derive some benefit from specific information-giving programs, from support before and during particular procedures, and from interventions that aim to facilitate their reintegration into school and social activities. More research is needed to investigate the effects of these and other related interventions.

Support and intervention groups for adolescents with cancer in two Ontario communities

Adolescents who are treated for cancer must learn to negotiate challenging developmental tasks in the context of their treatment and adverse effects. Adverse affects of disease and treatment may prevent some of these adolescents from achieving full psychosocial development. Two programs developed independently to address the psychosocial and unique contextual needs of adolescents and young adults from different geographic regions in Ontario, Central urban and Northeastern rural, are described. The program in the urban area consists of eight 2-h sessions that combined structured creative activities and informal discussions of issues generated by adolescents; it includes a pre- post- intervention evaluation with standardized questionnaires. The Northeastern rural program consists of a monthly support open group that encourages sharing personal experiences and an annual expressive art retreat; both components include informal evaluation. Formal evaluation of these programs is in progress. Informal feedback from participants and parents suggest positive effects. These distinct and unique programs continue to evolve, as they address the unique psychosocial needs of adolescents and young adults in urban and rural areas.

Efficacy of Therapeutic Group by Telephone for Women With Breast Cancer

A pilot study was conducted to test the efficacy of a therapeutic group by telephone conference call for women with breast cancer. Sixty-six women with stage I or stage II breast cancer consented to participate in the study. Participants were randomly assigned to a usual psychosocial care or intervention group, using a permuted block method. Only 2 of 68 patients dropped out of the study, which included 27% African Americans. Assessments at 3 time periods (pretest, immediately after the intervention, and 3 months after the group ended) included evaluation of quality of life (QOL), mood, and immune function. ttests were performed to determine if differences on important variables existed at pretest. The intervention group had worse QOL and mood scores than did the control group on the pretests. A mixed-model repeated-measures procedure controlling for pretest differences was used to analyze data. A significant Group by Time interaction was found for spiritual well-being and mood. These differences were not in the expected direction. The intervention group showed improvement in QOL and mood during the intervention, but showed decompensation following the intervention. Conversely, the control group demonstrated stable or declining scores. This intervention is feasible and practical for women with breast cancer, especially African American participants. The puzzling results suggest several areas for future research, including a better conceptual fit with outcome measures, increasing dosage, and exploration of the value of emotional expression.

Interventions for improving communication with children and adolescents about their cancer

BACKGROUND

Communication with children and adolescents with cancer about their disease and treatment and the implications of these is an important aspect of good quality care. It is often poorly performed in practice. Various interventions have been developed that aim to enhance communication involving children or adolescents with cancer.

OBJECTIVES

To examine the effects of interventions to enhance communication with children and/or adolescents about their cancer, its treatment and their implications.

SEARCH STRATEGY

We searched the following sources: Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library, Issue 1 2003; MEDLINE (1966 to January week 2 2003); EMBASE (1985 to 2003 week 4); CINAHL (1982 to December week 4 2002); Dissertation Abstracts (1861 to January 2003); ERIC (1966 to January 2003); PsycINFO (1985 to January week 4 2003); Sociological Abstracts (1963 to January 2003).For the initial (2001) publication of this review we also searched the following databases: PsycLIT; Cancerlit;; Sociofile; Health Management Information Consortium; ASSIA; LISA; PAIS; Information Science Abstracts; JICST; Pascal; Linguistics and Language Behavior Abstracts; Mental Health Abstracts; AMED; MANTIS. We also searched the bibliographies of studies assessed for inclusion, and contacted experts in the field.

SELECTION CRITERIA

Randomised and non-randomised controlled trials and before and after studies that evaluated the effects of interventions to enhance communication with children and/or adolescents about their cancer, treatment and related issues.

DATA COLLECTION AND ANALYSIS

Data relating to the interventions, populations and outcomes studied and the design and methodological quality of included studies were extracted by one reviewer and checked by another reviewer. A narrative summary of the results is presented.

MAIN RESULTS

Nine studies met the criteria for inclusion. They were diverse in terms of the interventions evaluated, study designs used, types of people who participated and the outcomes measured. One study of a computer-assisted education programme reported improvements in knowledge and understanding about blood counts and cancer symptoms. One study of a CD-ROM about leukemia reported an improvement in children's feelings of control over their health. One study of art therapy as support for children during painful procedures reported an increase in positive, collaborative behaviour. Two out of two studies of school reintegration programs reported improvements in some aspects of psychosocial wellbeing (one in anxiety and one in depression), social wellbeing (two in social competence and one in social support) and behavioural problems; and one reported improvements in physical competence.

REVIEWER'S CONCLUSIONS

Interventions to enhance communication involving children and adolescents with cancer have not been widely or rigorously assessed. The weak evidence that exists suggests that some children and adolescents with cancer may derive some benefit from specific information-giving programs and from interventions that aim to facilitate their reintegration into school and social activities. More research is needed to investigate the effects of these and other related interventions.

The needs of children and adolescents with cancer for information and social support

Research has indicated that information and social support may have helped children and adolescents with cancer to cope with their illness and lead normal lives. However, recent researchers have reported that youths with cancer express a clear interest in receiving more information and social support. This study reviewed research on information and social support for children and adolescents with cancer to understand their needs. Young patients with cancer showed high uncertainty about cancer. Besides, adolescents with cancer were more in conflict with their parents than healthy youths. Discussions on future plans or death are difficult for young people with cancer. They also are frequently absent from school over time. Moreover, they want to make healthy friends. To fulfill the needs of these youths, nurses should be aware not only of individualized information and social support, but also of these factors from an ecologic perspective. Further qualitative research is required to identify the needs of youths with cancer and resolve these issues.

The effects of a support group on selected psychosocial outcomes of bereaved parents whose child died from cancer

Group support for bereaved parents whose child died from cancer has been suggested as a means of helping parents express emotions about their loss and improve their coping. Using a quasi-experimental design, we sought to determine the selected psychosocial effects of participation in a support group for bereaved parents whose child died from cancer. Five bereaved parents completed the Emotions Profile Index, the Family Adaptability and Cohesion Evaluation Scales, and the Social Adjustment Scale Self-Report before and after the seven group sessions. No statistically significant differences were found. Descriptive data were analyzed from the co-therapists' process log and the participants' evaluation forms. The group process log revealed intense pain and grief over the loss of the child and the parents' conscious struggle to adapt to the present and prepare for the future. The discussions poignantly indicated the great extent to which the child's death had changed their lives. Using the group evaluation form parents reported high satisfaction with the group sessions. Tentative conclusions support the value of such a group in providing a forum for some bereaved parents to ventilate feelings and thoughts and validate the normalcy of their reactions.

Cancer in adolescents and young adults. Psychosocial concerns, coping strategies, and interventions

Adolescent cancer patients present a unique challenge to health care professionals because of the impact of the disease and its treatment on the successful acquisition of age-appropriate developmental milestones, as well as the psychosocial concerns raised by the illness itself. Understanding normal adolescent development provides a framework for identifying psychosocial concerns, predicting problems, and developing appropriate interventional strategies for adolescents with cancer. A comprehensive support program with specific goals of promoting adjustment to the illness and providing a basis for community reentry by strengthening recognized coping strategies based on identified psychosocial concerns is described as a model.

"Lasting Impressions: adolescents with cancer share how to cope"--a videotape program

This article discusses the production of a videotape program for newly diagnosed adolescent cancer patients and their parents. The video was developed as a goal of the members of Lasting Impressions, a support program for adolescent cancer patients and their parents. The patients wanted to help other patients realistically understand the stresses they would encounter and learn ways to cope with them. The project is unique in that the patients developed the content, wrote the script, and starred in the production. This article details the various components of the project and describes the therapeutic goals achieved.