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Broden EG, Boyden JY, Keller S, James R, Mooney-Doyle K. Who, What, Where, and How? The State of Family Science in Pediatric Palliative Care. J Pain Symptom Manage 2024:S0885-3924(24)00844-3. [PMID: 38992396 DOI: 10.1016/j.jpainsymman.2024.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 06/04/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
CONTEXT Families are vital providers and recipients of pediatric palliative care (PPC) services. Understanding the scope and nature of evidence at the intersection of family science and PPC research is necessary to develop family-focused interventions that enhance child and family health. OBJECTIVES Explore and describe the family-level impact of pediatric serious illness. METHODS We conducted a librarian-assisted scoping review using Arskey and O'Malley's approach. We searched PubMed, Scopus, CINAHL, and EMBASE databases for empirical publications from 2016 to 2021 that focused on families navigating serious pediatric illness published in English. Two reviewers assessed eligibility, with discrepancies resolved by a third. We used Covidence and REDCap for data management and extraction. RESULTS We screened 10,983 abstracts; 309 abstracts were included in full text screening. The final group of 52 citations was analyzed by the entire team. Most research was conducted in Western Europe and North America. The perspectives of parents of children with cancer were most frequently described; voices of seriously ill youth and their siblings were less often presented. Most of the research was descriptive qualitative, followed by descriptive quantitative. Few studies were mixed methods, inferential, or interpretive. Studies most often described parent, youth, and family experience with illness and less often explored family processes and relationships. Irrespective of the approach (i.e., qualitative, quantitative), few studies focused on families as the analytic unit or used family-level analysis techniques. Study participants were usually from local dominant populations and less often from historically marginalized communities. CONCLUSION The robust, descriptive, and individual-level evidence describing family impact of serious pediatric illness provides a solid foundation for future research priorities. Stronger integration of family techniques and diverse family voices in pediatric palliative care research can clarify family processes, illuminate structural barriers, and inform interventions that are responsive to family needs. These steps will enhance the education, policy, and clinical provision of PPC to all who would benefit, thereby advancing health equity for children living with serious illness and their families.
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Affiliation(s)
- Elizabeth G Broden
- Yale National Clinician Scholars Program (E.G.B.), Yale University, New Haven, CT; School of Public Health (E.G.B.), Yale University, New Haven, CT.
| | - Jackelyn Y Boyden
- Department of Family and Community Health (J.Y.B.), School of Nursing, University of Pennsylvania, Philadelphia, PA; Division of General Pediatrics (J.Y.B.), Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Susan Keller
- Research Library (S.K.M.), Children's National Hospital, Washington, DC
| | - Richard James
- Nemours Children's Health (R.J.M.), Wilmington, DE; Fontan Outcomes Network
| | - Kim Mooney-Doyle
- Department of Family and Community Health (K.M-D.), School of Nursing, University of Maryland, Baltimore, MD
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Zhou T, Luo Y, Xiong W, Meng Z, Zhang H, Zhang J. Problem-Solving Skills Training for Parents of Children With Chronic Health Conditions: A Systematic Review and Meta-Analysis. JAMA Pediatr 2024; 178:226-236. [PMID: 38165710 PMCID: PMC10762633 DOI: 10.1001/jamapediatrics.2023.5753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/25/2023] [Indexed: 01/04/2024]
Abstract
Importance Problem-solving skills training (PSST) has a demonstrated potential to improve psychosocial well-being for parents of children with chronic health conditions (CHCs), but such evidence has not been fully systematically synthesized. Objective To evaluate the associations of PSST with parental, pediatric, and family psychosocial outcomes. Data Sources Six English-language databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Cochrane Library), 3 Chinese-language databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang), gray literature, and references were searched from inception to April 30, 2023. Study Selection Randomized clinical trials (RCTs) that performed PSST for parents of children with CHCs and reported at least 1 parental, pediatric, or family psychosocial outcome were included. Data Extraction and Synthesis Study selection, data extraction, and quality assessment were conducted independently by 2 reviewers. Data were pooled for meta-analysis using the standardized mean difference (SMD) by the inverse variance method or a random-effects model. Subgroup analyses of children- and intervention-level characteristics were conducted. Main Outcomes and Measures The psychosocial outcomes of the parents, their children, and their families, such as problem-solving skills, negative affectivity, quality of life (QOL), and family adaptation. Results The systematic review included 23 RCTs involving 3141 parents, and 21 of these trials were eligible for meta-analysis. There was a significant association between PSST and improvements in parental outcomes, including problem-solving skills (SMD, 0.43; 95% CI, 0.27-0.58), depression (SMD, -0.45; 95% CI, -0.66 to -0.23), distress (SMD, -0.61; 95% CI, -0.81 to -0.40), posttraumatic stress (SMD -0.39; 95% CI, -0.48 to -0.31), parenting stress (SMD, -0.62; 95% CI, -1.05 to -0.19), and QOL (SMD, 0.45; 95% CI, 0.15-0.74). For children, PSST was associated with better QOL (SMD, 0.76; 95% CI, 0.04-1.47) and fewer mental problems (SMD, -0.51; 95% CI, -0.68 to -0.34), as well as with less parent-child conflict (SMD, -0.38; 95% CI, -0.60 to -0.16). Subgroup analysis showed that PSST was more efficient for parents of children aged 10 years or younger or who were newly diagnosed with a CHC. Significant improvements in most outcomes were associated with PSST delivered online. Conclusions and Relevance These findings suggest that PSST for parents of children with CHCs may improve the psychosocial well-being of the parents, their children, and their families. Further high-quality RCTs with longer follow-up times and that explore physical and clinical outcomes are encouraged to generate adequate evidence.
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Affiliation(s)
- Tianji Zhou
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yuanhui Luo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wenjin Xiong
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Zhenyu Meng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hanyi Zhang
- Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jingping Zhang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Hamama L, Levy S. Adolescent siblings of children with cancer: Resource-based profiles, normalization, and search for meaning in life. J Adolesc 2024; 96:221-234. [PMID: 37926934 DOI: 10.1002/jad.12269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 09/13/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Adolescent siblings of children with cancer jointly face the experience of having a brother or sister with cancer and being in the developmental period of adolescence themselves. Based on Hobfoll's conservation of resources theory, we aimed to identify profiles based on two distinct resources: sense of hope (personal resource) and perceived social support (social resource). Both have been found to be vital for optimal functioning during adolescence. Further, we examined differences in these profiles with regard to two distal outcomes: normalization (a coping strategy) and search for meaning in life (a commonly assumed adolescent developmental task). METHODS One hundred and eleven Israeli adolescent siblings (aged 13-17) completed self-report measures. RESULTS Two distinct resource-based profiles were identified: "high resources" and "low resources." Participants with "high resources" had a higher sense of hope and higher social support; were significantly more likely to live with married parents than with unmarried parents; had marginally fewer siblings; and scored higher on normalization and search for meaning in life than did participants with "low resources." CONCLUSIONS The study outcomes highlight the essential role of resources for this population. Such resources seem to be helpful for normalization, a coping strategy whose focus is on facilitating regular family routines, and for the siblings' search for meaning in life. Practitioners who work with families in the context of childhood cancer should aim to help these siblings obtain key resources, such as social support, and to actively pursue their goals.
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Affiliation(s)
- Liat Hamama
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Shoham Levy
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Bates CR, Staggs VS, Dean KM, August KJ, Befort CA, Covitz LM, Dreyer Gillette ML. Family Rules and Routines During the Early Phases of Pediatric Cancer Treatment: Associations With Child Emotional and Behavioral Health. J Pediatr Psychol 2024; 49:66-76. [PMID: 37990581 DOI: 10.1093/jpepsy/jsad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/19/2023] [Accepted: 10/19/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE Consistent family rules and routines promote positive adaptation to stress and may be protective to child emotional and behavioral functioning. Few studies have quantified family engagement in these behaviors during pediatric cancer treatment or examined associations with child emotional and behavioral health. METHODS In this cross-sectional observational study, 86 primary caregivers of youth ages 2-14 years (M = 7.9) with an initial diagnosis of cancer within 16 weeks reported on their frequency of engagement in family rules and routines (e.g., sleep, schoolwork, and meal routines) before their child's cancer diagnosis and their current frequency of engagement in the same routines. Caregivers also reported demographics, psychosocial distress, and child emotional and behavioral health outcomes. Analyses examined demographic and psychosocial factors associated with engagement in rules and routines during cancer treatment, and associations with child emotional and behavioral health. RESULTS Families reported a lower frequency of engagement in rules and routines during cancer treatment, compared to before treatment (mean difference 0.8 SDs [95% confidence interval 0.7-1.1 SDs]). Caregiver factors associated with lower engagement in rules and routines during treatment included being married, having lower educational attainment, and higher levels of psychosocial distress. Families who engaged in higher levels of rules and routines during treatment reported fewer child externalizing and behavioral challenges. There was limited evidence of association between family rules and routines and child internalizing outcomes. CONCLUSIONS Results found that engaging in family rules and routines during cancer treatment was associated with fewer child behavioral challenges during treatment. Future directions include longitudinal examinations of family rules, routines, and child emotional/behavioral outcomes to examine directional impact over time.
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Affiliation(s)
- Carolyn R Bates
- Department of Pediatrics, University of Kansas Medical Center, USA
- University of Kansas Cancer Center, USA
- Center for Children's Healthy Lifestyles & Nutrition, USA
| | - Vincent S Staggs
- Department of Pediatrics, Children's Mercy Kansas City, USA
- University of Missouri Kansas City School of Medicine, USA
| | - Kelsey M Dean
- Center for Children's Healthy Lifestyles & Nutrition, USA
| | - Keith J August
- University of Kansas Cancer Center, USA
- Department of Pediatrics, Children's Mercy Kansas City, USA
- University of Missouri Kansas City School of Medicine, USA
| | - Christie A Befort
- Department of Pediatrics, University of Kansas Medical Center, USA
- Department of Population Health, University of Kansas Medical Center, USA
| | - Lynne M Covitz
- Department of Pediatrics, Children's Mercy Kansas City, USA
- University of Missouri Kansas City School of Medicine, USA
| | - Meredith L Dreyer Gillette
- Center for Children's Healthy Lifestyles & Nutrition, USA
- Department of Pediatrics, Children's Mercy Kansas City, USA
- University of Missouri Kansas City School of Medicine, USA
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5
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Capurso M, Catalano G, Calvaruso A, Monticelli A, Taormina C, Battiato S, Guadagna FP, Piccione T, D’Angelo P, Russo D, Trizzino A, Raspa V. Tailored Psychoeducational Home Interventions for Children with a Chronic Illness: Families' Experiences. CONTINUITY IN EDUCATION 2024; 5:1-21. [PMID: 38774596 PMCID: PMC11104378 DOI: 10.5334/cie.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/27/2023] [Indexed: 05/24/2024]
Abstract
The quality of life for a child with a chronic illness depends on various factors, including the illness's severity, medical treatments, psychosocial and educational support, resource availability, and community involvement. These biopsychosocial factors become significant when the child receives care at home. This article presents and evaluates a highly personalized support project offered to 40 Sicilian families, consisting of educational, social, and psychological services delivered at the families homes and in their communities. Guided by the Psychosocial Assessment Tool (PAT) and the Functional Psychology framework, the project employed a family-focused approach to healthcare and was based on a continuous dialogue between all stakeholders. The project was evaluated through a qualitative interview with eight families in the Palermo area, which was analyzed using consensual qualitative research. Results revealed families' appreciation of the project and the importance of a professional who listened to their needs, provided a connection with the medical team, and tailored activities inside and outside the home. The ability of professionals to listen and adapt activities to different contexts and needs was crucial for the project's success. We conclude that creating tailored family-level interventions with an educator acting as a liaison with the medical team is a widely acceptable strategy that should be further developed and investigated.
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Affiliation(s)
- Michele Capurso
- Department of Philosophy, Human and Social Sciences and Education, University of Perugia, IT
| | | | | | | | - Calogero Taormina
- Department of Pediatric Hematology Oncology A.R.N.A.S. Civico, Palermo, IT
| | | | | | | | - Paolo D’Angelo
- Department of Pediatric Hematology Oncology A.R.N.A.S. Civico, Palermo, IT
| | - Delia Russo
- Department of Pediatric Hematology Oncology A.R.N.A.S. Civico, Palermo, IT
| | - Antonino Trizzino
- Department of Pediatric Hematology Oncology A.R.N.A.S. Civico, Palermo, IT
| | - Veronica Raspa
- Research assistant, Department of Philosophy, Human and Social Sciences and Education, University of Perugia, IT
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Holland AA, Shamji JF, Clem MA, Perez R, Palka JM, Stavinoha PL. Parent ratings of executive functioning in pediatric survivors of medulloblastoma and pilocytic astrocytoma. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:52-61. [PMID: 36111630 DOI: 10.1080/21622965.2022.2123707] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The present study compared parent-rated executive functioning in pediatric medulloblastoma (MB) and pilocytic astrocytoma (PA) survivors. Although standard care for both includes surgical resection, children with MB additionally receive chemotherapy and craniospinal irradiation. Given well-documented neurocognitive late effects associated with the latter, we anticipated poor parent-reported executive functioning in MB survivors. Parents/guardians of 36 MB survivors and 20 PA survivors completed the Behavior Rating Inventory of Executive Functioning (BRIEF). PA survivors were younger at diagnosis (t[51.97] = 3.07, p < .001, d = 0.86) and demonstrated higher IQ (t[54] = -3.51, p < .001, d = 0.95). However, relative to the MB group, the PA group was rated as having significantly more problems on all BRIEF scales (all p ≤ .05; d = 0.30 - 1.10), except the Shift scale. Additionally, all mean BRIEF scores for MB survivors were within normal limits, whereas for PA survivors, all mean BRIEF scores except for Organization of Materials were significantly discrepant from normative means. Overall, PA survivors were rated as demonstrating poorer executive function than MB survivors. Five theories are discussed as possible explanations for these surprising findings: two related to group differences, two related to potential sources of parental bias, and one related to the nature of questionnaire-based assessment. All these theories represent directions for future research. Parent questionnaires such as the BRIEF may have real-world implications for pediatric brain tumor survivors. Future research should explore factors affecting parent ratings of executive functioning in these populations, along with comparison to performance-based measures.
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Affiliation(s)
- Alice Ann Holland
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
| | - Jabeen F Shamji
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
- University of North Texas, Denton, Texas, USA
| | - Matthew A Clem
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Private practice in Dallas, Texas, USA
| | - Roger Perez
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Private practice in Mission Viejo, California, USA
| | - Jayme M Palka
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
| | - Peter L Stavinoha
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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7
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Zhang A, Zheng X, Shen Q, Zhang Q, Leng H. Family management experience of parents of children with chronic heart failure: A qualitative study. J Pediatr Nurs 2023; 73:e36-e42. [PMID: 37481387 DOI: 10.1016/j.pedn.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/09/2023] [Accepted: 07/09/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE To explore the experience of family management among parents of children with chronic heart failure. DESIGN AND METHODS Qualitative descriptive phenomenology was used as the research design. The sample included 16 parents. For data collection, semi-structured interviews were conducted. Colaizzi's seven-step analysis method was used for data analysis. Themes were encoded and created with Nvivo 12.0 Plus software. RESULTS Three themes and ten sub-themes were identified: (1) weakened family socialization (diminished parental role in social education and insufficient socialization of children), (2) experience of five psychological stages (resistance, self-blame, worry, exhaustion, acceptance), and (3) family management dilemmas (low social awareness of the disease, heavy economic burden, and limited coping style). CONCLUSION The experience of parents of children with chronic heart failure is complex. The children have low socialization and face public prejudice. Parents are stressed by social education, economics, and the five psychological stages they have experienced. Families face difficulties such as heavy economic burdens and limited coping styles. PRACTICE IMPLICATIONS To address these complexities, pediatric nursing staff should take steps to improve family management and, as a result, children's quality of life. Our study provides a resource for pediatric nursing staff when implementing family management interventions.
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Affiliation(s)
- Ai Zhang
- Department of Cardiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xianlan Zheng
- Department of Nursing Children's Hospital of Chongqing Medical University, China.
| | - Qiao Shen
- Department of Nursing Children's Hospital of Chongqing Medical University, China
| | - Qin Zhang
- Department of Cardiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hongyao Leng
- Department of Nursing Children's Hospital of Chongqing Medical University, China
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Bally JMG, Burles M, Spurr S, McGrath J. Exploring the Use of Arts-Based Interventions and Research Methods in Families of Seriously Ill Children: A Scoping Review. JOURNAL OF FAMILY NURSING 2023; 29:395-416. [PMID: 37128884 PMCID: PMC10629247 DOI: 10.1177/10748407231165119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Family care is essential to pediatric nursing practice, as the entire family is affected by childhood illness. However, little is known about art making for therapeutic purposes and how art is used to better understand families' experiences. Our purpose was to examine the nature of arts-based interventions and research methods used with, and the experiences of families of children facing life-limiting and life-threatening illnesses, and those families who are bereaved. Academic peer-reviewed sources published between January 1999 and May 2022 were retrieved via four databases using key search terms. Twenty-five articles were analyzed, resulting in three multifaceted categories including Social, Emotional, and Family Health. Critical strengths and limitations were also identified. Art making has been incorporated into interventions and research studies due to its benefits for family well-being. Understanding the potential of art making can inspire nurses to implement such activities to enhance family nursing practice and research.
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Bates CR, Pallotto IK, Moore RM, Covitz LM, Dreyer Gillette ML. Barriers and facilitators of family rules and routines during pediatric cancer treatment. J Pediatr Nurs 2023; 72:e33-e39. [PMID: 37308340 DOI: 10.1016/j.pedn.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Pediatric nurses work closely with families of children with new cancer diagnoses and can provide essential supports to promote coping and adjustment. This cross-sectional qualitative study aimed to gather caregiver perspectives on barriers and facilitators to adaptive family functioning during the early phases of cancer treatment, with a focus on family rules and routines. METHODS Caregivers (N = 44) of a child diagnosed with cancer and receiving active treatment completed a semi-structured interview about their engagement in family rules and routines. Time since diagnosis was abstracted from the medical record. A multi-pass inductive coding strategy was utilized to extract themes identifying caregiver-reported facilitators and barriers to maintaining consistent family rules and routines during the first year of pediatric treatment. RESULTS Caregivers identified three primary contexts that presented barriers and facilitators to engagement in family rules and routines: the hospital setting (n = 40), the family system (n = 36), and the broader social and community setting (n = 26). Caregivers reported barriers primarily related to the demands of their child's treatment, additional caregiving needs, and needing to prioritize basic daily tasks (e.g., food, rest, household needs). Caregivers reported that different networks of support across contexts facilitated family rules and routines by expanding caregiver capacity in distinctive ways. CONCLUSIONS Findings provided insight into the importance of having multiple networks of support to extend caregiving capacity in the context of cancer treatment demands. PRACTICE IMPLICATIONS Providing nurses with training to facilitate problem-solving skills in the context of competing demands may provide a new avenue of clinical intervention at the bedside.
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Affiliation(s)
- Carolyn R Bates
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA; Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA; University of Kansas Cancer Center, Kansas City, KS, USA.
| | | | - Rachel M Moore
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA; University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA
| | - Lynne M Covitz
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA; University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA
| | - Meredith L Dreyer Gillette
- Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA; Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA; University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA
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10
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Howard Sharp KM, Tillery Webster R, Cook J, Okado Y, Long A, Phipps S. Profiles of Resilience, Distress, and Posttraumatic Growth in Parents of Children with Cancer and the Relation to Subsequent Parenting and Family Functioning. J Pediatr Psychol 2023; 48:375-385. [PMID: 36668686 PMCID: PMC10118855 DOI: 10.1093/jpepsy/jsac097] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The aim of this study was to identify patterns of distress and growth in parents of children with cancer and examine associations with subsequent parenting, parent-child relationship, and family environment. METHODS Participants included children with cancer history (8-17 years) stratified by time since diagnosis and their parent. At enrollment, parents (n = 254) reported depression and anxiety, and post-traumatic stress symptoms, posttraumatic growth (PTG), and benefit finding in relation to their child's cancer. Three years later, children (n = 214) reported parenting behavior, parent reactions to their distress, and family environment. Parents reported their reaction to children's distress and qualities of the parent-child relationship. RESULTS Latent profile analysis empirically identified 3 cross-sectional profiles using baseline data: "Resilience, High Growth" (50%), characterized by the lowest distress and the highest PTG/benefit finding; "Moderate Distress with Growth" (33%), characterized by relatively high levels of all indicators; and "Resilience, Low Growth" (17%), characterized by relatively low distress with low PTG/benefit finding. Membership in profiles was associated with parent gender; parents' stressful life events; socioeconomic status; and child diagnosis, on versus off treatment status, and treatment intensity. Parent membership in the Moderate Distress with Growth profile was generally linked with poorer parenting behavior, parent-child relationship quality, and family functioning. CONCLUSION The majority of parents exhibited resilience and growth. However, a subset of parents displaying moderate distress may be at risk for subsequent parenting and family functioning challenges. Findings further highlight the importance of screening for even moderate parent distress and the possible impact of parent psychosocial interventions indirectly on parenting and family functioning.
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Affiliation(s)
| | | | - Jessica Cook
- Department of Psychology, St. Jude Children’s Research Hospital, USA
- Department of Psychology, The University of Memphis, USA
| | - Yuko Okado
- Department of Psychology, California State University, USA
| | - Alanna Long
- Department of Psychology, St. Jude Children’s Research Hospital, USA
| | - Sean Phipps
- Department of Psychology, St. Jude Children’s Research Hospital, USA
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Gilbert R, Bates CR, Khetawat D, Dreyer Gillette ML, Moore R. Risk and Resilient Functioning of Families of Children with Cancer during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5208. [PMID: 36982118 PMCID: PMC10048924 DOI: 10.3390/ijerph20065208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Previous literature highlights the impact of COVID-19 on family functioning. Less is known about the impact of the pandemic on families of pediatric cancer patients. In order to determine universal and unique risk and resilience factors of these families during the pandemic, a qualitative analysis was conducted on families currently receiving cancer treatment at a Midwestern hospital. Results of the data analysis depict ways in which these families have been impacted by and have adapted to COVID-19. These findings suggest that families of pediatric cancer patients have unique experiences in the context of COVID-19, in addition to universal experiences outlined in previous literature.
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Affiliation(s)
- Renee Gilbert
- Clinical Child Psychology Program, Dole Human Development Center, University of Kansas, Lawrence, KS 66044, USA
| | - Carolyn R. Bates
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 64114, USA
- University of Kansas Cancer Center, 4001 Rainbow Blvd, Kansas City, KS 64114, USA
| | - Devanshi Khetawat
- Clinical Child Psychology Program, Dole Human Development Center, University of Kansas, Lawrence, KS 66044, USA
| | | | - Rachel Moore
- Department of Pediatrics, Children’s Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO 64108, USA
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Neris RR, Bolis LO, Leite ACAB, Alvarenga WDA, Garcia-Vivar C, Nascimento LC. Functioning of structurally diverse families living with adolescents and children with chronic disease: A metasynthesis. J Nurs Scholarsh 2023; 55:413-428. [PMID: 36209360 DOI: 10.1111/jnu.12831] [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: 05/03/2022] [Revised: 08/15/2022] [Accepted: 09/27/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The diagnosis of children and adolescents with a chronic disease may affect the entire family system. When families have diverse structures, additional tensions can be present and affect the balance of family functioning. This metasynthesis aims to analyze and synthesize qualitative evidence on the functioning of structurally diverse families who live with adolescents and children with chronic disease. DESIGN Qualitative metasynthesis. METHODS Systematic searches up to 2021 were performed in PubMed, CINAHL, PsycINFO, SCOPUS, LILACS, and Web of Science and supplemented by manual search strategies. It followed guidelines from the statement in the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). A quality appraisal of each study was undertaken using the Critical Appraisal Skills Programme. Data synthesis was conducted according to the thematic synthesis approach. FINDINGS Of a total of 6538 references identified, 9 studies were included in the metasynthesis. The thematic synthesis enabled the construction of three analytical themes: "Family structural changes and weakened co-parenting"; "Family rearrangements and the challenges faced by families"; and "Committed to healthy family functioning for the child's well-being: Searching for family homeostasis". CONCLUSIONS The themes showed that the causes of the rupture in the family unit interfere in family functioning, making it ineffective. In most families, family functioning is centered on the mothers. Faced with the need to care for children and adolescents and to control chronic disease, structurally diverse families need to adjust their family functioning and search for family homeostasis. CLINICAL RELEVANCE The results of this review can support nurses to target their care toward these families and formulate effective interventions that promote, strengthen, or maintain the healthy functioning of these families.
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Affiliation(s)
- Rhyquelle Rhibna Neris
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Letícia Onelli Bolis
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Ana Carolina Andrade Biaggi Leite
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | | | - Cristina Garcia-Vivar
- Universidad Pública de Navarra, IdiSNA - Instituto de Investigación Sanitaria de Navarra, Navarra, Spain
| | - Lucila Castanheira Nascimento
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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13
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Chow WK, Hetherington K, McGill BC, Sansom-Daly UM, Daly R, Miles G, Cohn RJ, Wakefield CE. 'Like ships in the night': A qualitative investigation of the impact of childhood cancer on parents' emotional and sexual intimacy. Pediatr Blood Cancer 2022; 69:e30015. [PMID: 36200485 DOI: 10.1002/pbc.30015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/19/2022] [Accepted: 08/29/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Childhood cancer is highly distressing for families and can place strain on parents' relationships. Parental functioning and cohesiveness are important predictors of family functioning and adaptation to stress. This qualitative study investigated the perceived impact of childhood cancer on parents' relationship with their partner, with a focus on emotional and sexual intimacy. METHODS We conducted semi-structured interviews with 48 parents (42 mothers, six fathers) of children under the age of 18 who had completed curative cancer treatment. We analysed the interviews using thematic analysis. RESULTS At interview, parents were on average 40.7 years old (SD = 5.5, range: 29-55 years), and had a child who had completed cancer treatment between 3 months and 10.8 years previously (M = 22.1 months). All participants were living with their partner in a married/de facto relationship. Most parents reported that their child's cancer treatment had a negative impact on emotional and sexual intimacy with their partner, with some impacts extending to the post-treatment period. Reasons for compromised intimacy included exhaustion and physical constraints, having a shifted focus, and discord arising from different coping styles. Some parents reported that their relationship strengthened. Parents also discussed the impact of additional stressors unrelated to the child's cancer experience. CONCLUSIONS Parents reported that childhood cancer had a negative impact on aspects of emotional and sexual intimacy, although relationship strengthening was also evident. It is important to identify and offer support to couples who experience ongoing relationship stress, which may have adverse effects on family functioning and psychological wellbeing into survivorship.
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Affiliation(s)
- Wan Ka Chow
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Kate Hetherington
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Brittany C McGill
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Ursula M Sansom-Daly
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Rebecca Daly
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Gordon Miles
- Acute Services: Paediatric Consultation Liaison, Princess Margaret Hospital, Subiaco, Western Australia, Australia
| | - Richard J Cohn
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Claire E Wakefield
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
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14
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Chong ASS, Mahadir A, Hamidah A, Rizuana IH, Afifi L, Chan CMH. Exploring the beliefs of caregivers about the caregiving experiences of children with acute lymphoblastic leukemia in Malaysia. BELITUNG NURSING JOURNAL 2022; 8:204-212. [PMID: 37547110 PMCID: PMC10401385 DOI: 10.33546/bnj.2083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/11/2022] [Accepted: 05/19/2022] [Indexed: 08/08/2023] Open
Abstract
Background Cancer is one of the major leading causes of childhood death, and the most common type is acute lymphoblastic leukemia. The survival rate has increased in recent years; however, the long patient trajectory may trigger psychological distress among caregivers as they play an active role in ensuring that the child's basic needs are met. Being in a patient-focused system, the needs of caregivers may be neglected. Objective This study aimed to explore the caregivers' beliefs on children with acute lymphoblastic leukemia caregiving experiences in order to promote their well-being. Methods Caregivers from thirteen families of children with acute lymphoblastic leukemia participated in this phenomenological study. NVivo 12 was used for the thematic analysis of the data. Consolidated criteria for reporting qualitative research (COREQ) were used in this study. Results Overall, five main themes for caregivers' beliefs were identified from their responses: 1) dietary intake with emphasis on its importance in aiding recovery and its potential influence on cancer complications, 2) childcare which emphasized the need to be strong and self-sacrifice, 3) treatment which reflected the use of home or natural remedies and caregivers' negative perception towards chemotherapy, 4) causes of cancer believed to be linked to early childcare choices on food, beverage, and stress imposed on the child, and 5) source of beliefs that included doctors, online platforms, personal encounters and information on food labels. Conclusion Caregivers' beliefs are varied and nuanced, formed in a multicultural social background of Malaysia. These findings provide knowledge for future supportive cancer care for patients, their caregivers, and the treatment outcome in the Malaysian context. Nurses, who play an essential role between healthcare professionals and patients and/or their caregivers, can be empowered to provide psychological support, early detection of psychological distress, and exploration of caregiver beliefs, given that the number of clinical psychologists in Malaysia is lacking, and there is greater preference for care to be provided by doctors or nurses.
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Affiliation(s)
- Agnes Shu Sze Chong
- Universiti Kebangsaan Malaysia, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Malaysia
| | - Ahmad Mahadir
- Universiti Kebangsaan Malaysia, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Malaysia
| | - Alias Hamidah
- Faculty of Medicine, UKM Medical Centre, Kuala Lumpur, Malaysia
| | | | - Lateh Afifi
- Prince of Songkla University, Pattani Campus, Thailand
| | - Caryn Mei Hsien Chan
- Universiti Kebangsaan Malaysia, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Malaysia
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15
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Desjardins L, Solomon A, Shama W, Mills D, Chung J, Hancock K, Barrera M. The impact of caregiver anxiety/depression symptoms and family functioning on child quality of life during pediatric cancer treatment: From diagnosis to 6 months. J Psychosoc Oncol 2022; 40:790-807. [PMID: 35016592 DOI: 10.1080/07347332.2021.2015646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A pediatric cancer diagnosis can have a significant impact on the quality of life (QOL) of the child. Diagnosis and treatment impact caregiver anxiety/depression symptoms and family functioning, and these in turn may influence child QOL. However, there has been limited longitudinal examination of the impact of both caregiver anxiety/depression symptoms and family functioning on youth QOL at specific points during the early diagnosis and treatment period. Ninety-six caregivers of youth (diagnosed with leukemia/lymphoma or a solid tumor) reported on their own anxiety/depression symptoms, family functioning, demographic and medical factors, and on their child's generic and cancer-specific QOL shortly after diagnosis (T1) and 6 months later (T2). Caregiver anxiety/depression symptoms were associated with poorer cancer-specific and generic child QOL within and across time points. Family conflict was associated with youth cancer-related QOL at T1. Attendance to caregiver anxiety/depression symptoms and family functioning, beginning early in the cancer trajectory, is an important aspect of family-centered care. Routine psychosocial screening and triage may help identify and intervene to support both caregiver and child psychosocial well-being.
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Affiliation(s)
- Leandra Desjardins
- Charles-Bruneau Cancer Care Centre, Sainte-Justine University Health Centre, Montreal, Canada.,Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Aden Solomon
- Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Wendy Shama
- Department of Social Work, Division of Hematology/Oncology, BC Children's Hospital, Vancouver, Canada
| | - Denise Mills
- Department of Nursing, Division of Hematology/Oncology, BC Children's Hospital, Vancouver, Canada
| | - Joanna Chung
- Department of Psychology, Division of Hematology/Oncology, BC Children's Hospital, Vancouver, Canada
| | - Kelly Hancock
- Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Maru Barrera
- Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
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16
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Chodidjah S, Kongvattananon P, Liaw JJ. "Changed our lives": Psychosocial issues experienced by families of early adolescents with leukemia. Eur J Oncol Nurs 2021; 56:102077. [PMID: 34998215 DOI: 10.1016/j.ejon.2021.102077] [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: 10/24/2020] [Revised: 06/27/2021] [Accepted: 11/20/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE This research aimed to explore psychosocial problems experienced by families of early adolescents with leukemia. METHOD This phenomenology research was done during December 2019-August 2020 and involved eighteen families (47 family members) of early adolescents (10-14 years old) with leukemia. Participants were recruited by using purposive sampling and snowball techniques. Data were collected by using in-depth interviews and non-participatory observations until data saturation. Content analysis was used for data analysis. Member checking and triangulation methods were confirmed for trustworthiness. RESULTS The families' perception on psychosocial problem experiences included three themes and nine sub-themes. The first theme was dealing with adolescent' emotional changes with sub-themes, namely, emotional responses to the illness, compensation for the suffering, and self-showing. The second theme was parents' social isolation with sub-themes, namely, cancer-stigma, burden of care, and jealousy to non-cancer families. The last theme was emotional distress struggles with sub-themes, namely, feeling worried, guilty, and depressed. CONCLUSION Leukemia diagnosis in early adolescents causes psychosocial problems affecting the family lives. Health care providers need to concern and support the families and the adolescents so that they can pass through the difficulties with positive adjustments.
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Affiliation(s)
- Siti Chodidjah
- Faculty of Nursing, Thammasat University, Bangkok, Thailand
| | | | - Jen J Liaw
- School of Nursing, National Defense Medical Centre, Taipeh, Taiwan, ROC
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17
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Davies J, O'Connor M, Halkett GKB, Kelada L, Gottardo NG. Parents' Experiences of Childhood Cancer During the COVID-19 Pandemic: An Australian Perspective. J Pediatr Psychol 2021; 47:148-157. [PMID: 34865100 PMCID: PMC8690259 DOI: 10.1093/jpepsy/jsab125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/17/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction COVID-19 has had far-reaching impacts including changes in work, travel, social structures, education, and healthcare. Objective This study aimed to explore the experiences of parents of children receiving treatment for cancer during the COVID-19 pandemic. Methods Parents whose children were currently in treatment for childhood cancer or had completed treatment in the previous 12 months, participated in semi-structured interviews, face-to-face or via teleconferencing. Thematic analysis was used to analyze the data. Results The sample consisted of 34 participants (17 fathers and 17 mothers) from all states across Australia. Median age 37.5 years (range 29–51, years, SD = 6.3). Five main themes were identified: “Welcome to the Club”; “Remote Work and Study”; “Silver Linings”; “The Loneliest Experience” with three sub-themes “Immediate Family”; “Friends”; and “Overseas Family” and “Lack of Support” with two sub-themes: “Community Support” and “Organized Support.” Conclusion These findings revealed contrasting experiences of the impact of the COVID-19 pandemic. For parents whose children were neutropenic, the pandemic provided benefits in increased community understanding of infection control. Parents also reflected that the movement to remote work made it easier to earn an income. In contrast, some parents observed that restrictions on visitors and family intensified feelings of isolation. Parents also described how the COVID-19 reduced access to support services. These findings contribute to an understanding of the multifaceted impacts of the COVID-19 pandemic on families of children with cancer.
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Affiliation(s)
- Jenny Davies
- School of Population Health, Faculty of Health Sciences, Curtin University, Australia
| | - Moira O'Connor
- School of Population Health, Faculty of Health Sciences, Curtin University, Australia.,WA Cancer Prevention Research Unit, School of Population Health, Curtin University, Australia
| | - Georgia K B Halkett
- Faculty of Health Sciences, Curtin School of Nursing, Curtin University, Australia
| | - Lauren Kelada
- School of Women's and Children's Health, UNSW Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Australia
| | - Nicholas G Gottardo
- Brain Tumour Research Programme, Telethon Kids Institute, Australia.,Paediatrics, School of Medicine, University of Western Australia, Australia.,Department of Paediatric and Adolescent Oncology/Haematology, Perth Children's Hospital, Australia
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18
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Park M, Choi EK, Lyu CJ, Han JW, Hahn SM. Family resilience factors affecting family adaptation of children with cancer: A cross-sectional study. Eur J Oncol Nurs 2021; 56:102078. [PMID: 34847403 DOI: 10.1016/j.ejon.2021.102078] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 05/29/2021] [Accepted: 11/20/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Pediatric cancer impacts all family members, including parents and siblings, who strive to adjust to a multitude of changes brought about by the illness. Family resilience is an important factor in the successful adaptation of families of children with cancer. Therefore, we aimed to identify risk and protective factors for family resilience at the child, family, and community levels that affect the adaptation of families of children with cancer. METHOD This study employed a descriptive survey design, and data were collected from 111 parents of children undergoing treatment for cancer between April and May 2020 at a university hospital in South Korea. Based on Patterson's family resilience model, risk factors-severity of child's condition, parental depression, and stigma and discrimination-and protective factors-the child's temperament, family communication skills, and supportive health services-for family adaptation were analyzed using multiple regression analyses. RESULTS Among family resilience factors affecting the adaptation of families of children with cancer, parental depression (ß = -0.290, p = 0.004) and family communication skills (ß = 0.403, p < 0.001) were identified as risk and protective factors, respectively. These variables accounted for 29.3% of the variance in family adaptation (F = 7.503, p < 0.001). CONCLUSIONS There is a need to develop strategies such as intervention programs that focus on reducing parental depression and strengthening family communication skills to promote the adaptation of families to pediatric cancer.
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Affiliation(s)
- Mina Park
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Eun Kyoung Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
| | - Chuhl Joo Lyu
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Woo Han
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Min Hahn
- Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
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19
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Christensen SR, Carlsen LT. From well-known to changed everyday family life in families with childhood cancer: A grounded theory of disrupted family dynamic. Psychooncology 2021; 31:282-289. [PMID: 34505326 DOI: 10.1002/pon.5809] [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: 07/06/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Families affected by childhood cancer need to adapt either temporarily or permanently. This study identifies variables that influence this adaption in positive or negative ways by presenting a classic grounded theory. METHODS This inductive, qualitative study included 69 childhood cancer patients, 39 siblings, 42 parents, and 24 childhood cancer survivors from 104 families. RESULTS The families enter a social process after diagnosis characterized by either shuttling between the well-known and the new or being in a situation with both aspects. The extent depends on the stage of the treatment (initial phase, during treatment, or the end of the course of treatment) and on four variables: (1) the diagnosis and prognosis; (2) the course of the disease, including duration of treatment or hospitalizations, and separation from the remaining family; (3) the child's current state, including symptoms, hospitalizations, and current risk of death or relapse; and (4) whether previous and current needs have been met. CONCLUSIONS These variables offer a possible explanation of insufficient coping strategies, and they should be used to identify potentially vulnerable families. The dynamic of the variables imply that families should be reevaluated during each of the three phases, as the risk of changes to the family's everyday life may increase and therefore their needs may also change.
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Affiliation(s)
- Sophie Rex Christensen
- Patient Support and Community Activities, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Line Thoft Carlsen
- Patient Support and Community Activities, Danish Cancer Society Research Center, Copenhagen, Denmark.,Denmark Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark
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20
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Atout M, Alrimawi I, Daibes MA, Abusalameh E. The lived experience of family members who care for children with cancer: An interpretative phenomenological approach. Eur J Oncol Nurs 2021; 52:101978. [PMID: 34090147 DOI: 10.1016/j.ejon.2021.101978] [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: 10/16/2020] [Revised: 03/19/2021] [Accepted: 05/03/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE This study aimed to explore the lived experiences of family carers in the care of children with cancer. METHOD A phenomenological hermeneutic approach was conducted, informed by the philosophy of Martin Heidegger. Fourteen interviews were conducted with family members: mothers (n = 9), grandmothers and fathers (n = 5). Fourteen family carers were voluntarily enrolled from a public children's oncology department in Bethlehem in the Occupied Palestinian Territories. Interpretative Phenomenological Analysis (IPA) was used to analyze the data. RESULTS Three major themes emerged from the data analysis. The first theme was the caring experience, which included three subthemes: changing priorities over time, information given about children's illness, and parents suffering due to treating irritable children. The second theme was the challenges to effective care, which illustrates the most significant challenges faced during caring, including the effects of family relations and emotional support. The final theme was around the support system; family carers found several resources to support them in their children's care, including other parents' experiences with similar diseases, the hospital environment, and their religious beliefs. CONCLUSIONS This study informs parents and healthcare providers about the daily lived experiences of family carers. Healthcare providers can fulfil a significant role in giving emotional support and relief to family carers. However, they will need continuous practise to equip them with the communication skills they require to deal with the family carers in these difficult situations.
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Affiliation(s)
- Maha Atout
- Nursing School, Philadelphia University, Office 509, Jarash Road, P.O. Box 19392, Amman, Jordan.
| | - Intima Alrimawi
- School of Nursing and Health Professions, Trinity Washington University, 125 Michigan Ave, NE, Washington, DC, 20017, USA.
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21
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Van Schoors M, Sels L, Goubert L, Verhofstadt LL. Siblings Dealing with Pediatric Cancer: A Family- and Context-oriented Approach. J Pediatr Oncol Nurs 2021; 38:166-175. [PMID: 33792425 DOI: 10.1177/1043454221992303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Pediatric cancer is a severe life-threatening disease that poses significant challenges to the life of the siblings. Based on the social ecology model, the current study is aimed at exploring the association between intrafamilial (family functioning, family support) and contextual (network support) resources, and the individual adjustment of siblings facing cancer in their brother/sister. Methods: Participants were 81 siblings of children with leukemia or non-Hodgkin lymphoma. The mean siblings' age was 10.32 years. Siblings completed the Family Environment Scale, the Social Support Questionnaire for Children, the Situation-Specific Emotional Reactions Questionnaire, and the Pediatric Quality of Life Inventory. Data were analyzed using a multi-level approach. Results: Family functioning, family support, and network support proved to be related to siblings' cancer-related emotional reactions post-diagnosis. In addition, the present study suggests taking into account the gender of the ill child and the age of the siblings. Discussion: Our findings led to the conclusion that resources at both the intrafamilial level and the contextual level are important for explaining sibling adjustment post-diagnosis. Interventions targeting the sibling, the family, and the external network are warranted to enhance sibling adjustment.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, 26656Ghent University, Ghent, Belgium
| | - Laura Sels
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, 26656Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, 26656Ghent University, Ghent, Belgium
| | - Lesley L Verhofstadt
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, 26656Ghent University, Ghent, Belgium
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22
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Van Schoors M, De Paepe AL, Lemiere J, Morez A, Norga K, Lambrecht K, Goubert L, Verhofstadt LL. Family Adjustment When Facing Pediatric Cancer: The Role of Parental Psychological Flexibility, Dyadic Coping, and Network Support. Front Psychol 2019; 10:2740. [PMID: 31920799 PMCID: PMC6914864 DOI: 10.3389/fpsyg.2019.02740] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/20/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Pediatric cancer is a life-threatening disease that poses significant challenges to the life of all family members (diagnosed child, parents, and siblings) and the family as a whole. To date, limited research has investigated family adjustment when facing pediatric cancer. The aim of the current study was to explore the role of protective factors at the individual (parental psychological flexibility), intrafamilial (dyadic coping) and contextual level (network support) in explaining family adjustment as perceived by parents of children with leukemia or non-Hodgkin lymphoma. In addition, we were interested to see whether these protective factors could be predictive for family adjustment at a later time point. METHOD Participants were 70 mothers and 53 fathers (80 families) of children with leukemia or non-Hodgkin lymphoma. Mean time since diagnosis was 5.26 (T1) and 18.86 (T2) months post-diagnosis. Parents completed the Acceptance and Action Questionnaire II (to assess psychological flexibility), Dyadic Coping Inventory, a network support questionnaire, Impact on Family Scale and the Family Adjustment Scale. Both concurrent and prospective association models were tested. RESULTS Psychological flexibility, dyadic coping and network support proved to be cross-sectionally and positively related to parents' perception of family adjustment post-diagnosis; psychological flexibility and dyadic coping proved to predict better family adjustment over time. CONCLUSION Our findings led to the conclusion that protective factors at all three levels (individual, intrafamilial and contextual) are important for explaining family adjustment as perceived by parents facing a diagnosis of cancer in their child. Interventions targeting the individual, couple, as well as family level are warranted to enhance family adjustment.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Annick Lena De Paepe
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium
- KU Leuven, Leuven, Belgium
| | - Ann Morez
- Department of Pediatric Hemato-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Koenraad Norga
- Department of Pediatric Oncology, Antwerp University Hospital, Antwerp, Belgium
- University of Antwerp, Antwerp, Belgium
| | - Karolien Lambrecht
- Department of Pediatric Hemato-Oncology and Immunology, University Hospital Brussels, Brussels, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Lesley L. Verhofstadt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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23
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Van Schoors M, De Mol J, Verhofstadt LL, Goubert L, Van Parys H. The family practice of support-giving after a pediatric cancer diagnosis: A multi-family member interview analysis. Eur J Oncol Nurs 2019; 44:101712. [PMID: 31838320 DOI: 10.1016/j.ejon.2019.101712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 11/26/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Pediatric cancer presents many challenges to the life of the child diagnosed with cancer and his/her family. Among the studies investigating risk and protective factors, social support has emerged as an important construct. However, little is known on how family members support each other in this particular context. METHOD In order to further explore this process, interviews were performed separately with mothers, fathers and siblings. For the purpose of this study (as this is part of a larger project), data from four families in which both parents and at least one sibling participated, were used. Multi Family Member Interview Analysis was used as the methodological framework to analyze the individual interviews, allowing a detailed and systematic analysis of shared family experiences. RESULTS The analysis of the data revealed three themes: Being together matters: the families identified the need of being physically together; Finding support in (not) talking: the complexity of sharing emotions was explained and Working together as a team: the families described working together as a team in order to get everything organized. CONCLUSIONS This study broadens our understanding of the interpersonal process of family support-giving when facing pediatric cancer. When meeting with families, families should be invited as a unit in order to best capture family level experiences. Also, clinicians should be sensitive to the different cancer-related communication needs within the family (i.e., the need to talk or not to talk) and incorporate this knowledge into their care.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Jan De Mol
- Department of Clinical Psychology Université Catholic de Louvain, Louvain-la-Neuve, Belgium.
| | - Lesley L Verhofstadt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Hanna Van Parys
- Department of Psychiatry Ghent University Hospital, Ghent, Belgium.
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24
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Van Schoors M, De Paepe AL, Norga K, Cosyns V, Morren H, Vercruysse T, Goubert L, Verhofstadt LL. Family Members Dealing With Childhood Cancer: A Study on the Role of Family Functioning and Cancer Appraisal. Front Psychol 2019; 10:1405. [PMID: 31275213 PMCID: PMC6594216 DOI: 10.3389/fpsyg.2019.01405] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/31/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Childhood cancer is a life-threatening disease that poses significant challenges to the life of the diagnosed child and his/her family members. Based on the ABCX-model, the aim of the current study was to explore the association between family functioning, cancer appraisal and the individual adjustment of patients, parents and siblings. METHODS Participants were 60 children with leukemia or non-Hodgkin lymphoma, 172 parents and 78 siblings (115 families). Time since diagnosis varied from zero to 33 months. Patients, parents and siblings completed the Family Environment Scale (FES), Perceived Stress Scale, Situation-Specific Emotional Reactions Questionnaire and Pediatric Quality of Life Inventory/Maudsley Marital Questionnaire. RESULTS Family functioning and the appraisal of the cancer diagnosis proved to be related to patients', parents' and siblings' cancer-related emotions and quality of life post-diagnosis. In addition, family members differed in their perception of some family functioning domains, the appraisal of the cancer diagnosis, positive feelings and quality of life. DISCUSSION Our findings led to the conclusion that family functioning and the appraisal of the cancer diagnosis are important for the individual adjustment of patients, parents and siblings when facing a diagnosis of cancer in the child. Differences across members within one family and differences between families speak to the need of screening all family members and intervening at the level of individual as well as the family unit.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Annick Lena De Paepe
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Koenraad Norga
- Department of Pediatric Oncology, Antwerp University Hospital, Antwerp, Belgium
| | - Veerle Cosyns
- Department of Pediatric Oncology, University Hospital Brussels, Brussels, Belgium
| | - Hanne Morren
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Trui Vercruysse
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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25
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Gabay G. A Nonheroic Cancer Narrative: Body Deterioration, Grief, Disenfranchised Grief, and Growth. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:287-309. [PMID: 31138010 DOI: 10.1177/0030222819852836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This longitudinal nonheroic narrative study allows familiarity with personal and societal transitions in the self-identity of individuals with life-threatening cancer. The theoretical anchor is Bion's container-contained theory. Five interviews with a terminally ill hospitalized male in his 30s were conducted along intervals of between 6 and 8 weeks, up to 2 months before his death. Data were analyzed using the selection mechanisms method. Findings provide insights about the hospitalization experience, his grief, and disenfranchised grief. A rigid mode of container-contained relationships with clinicians created disenfranchised grief. Reflection and coherence among self-identities lead to inner strength and emotional growth despite the body's deterioration. Clinicians have a role in holistic identity transitions of individuals with cancer. Findings illuminate practical recommendations that clinicians may adopt to improve the experience of individuals suffering from cancer at the chronic and terminal phase of illness.
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Affiliation(s)
- Gillie Gabay
- School of Behavioral Sciences & Psychology, College of Management Academic Studies, Rishon LeZion, Israel
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26
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Van Schoors M, Loeys T, Goubert L, Berghmans G, Ooms B, Lemiere J, Norga K, Verhofstadt LL. Couples Dealing With Pediatric Blood Cancer: A Study on the Role of Dyadic Coping. Front Psychol 2019; 10:402. [PMID: 30873091 PMCID: PMC6400881 DOI: 10.3389/fpsyg.2019.00402] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 02/11/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: Pediatric cancer is a life-threatening disease that poses significant challenges to the ill child and his/her parents. Among the studies investigating risk and protective factors for the individual and relationship adjustment of parents being confronted with pediatric cancer, couple factors - such as dyadic coping - gained little research attention. Therefore, the aim of the current study was to explore the association between dyadic coping and individual/relationship outcomes of parents in the context of pediatric cancer. Methods: Participants were 59 couples of children diagnosed with leukemia or Non-Hodgkin lymphoma. Time since diagnosis varied from diagnosis to 20 months. Both parents completed the DCI-short, DASS21, PIP, and MMQ. Results: Positive dyadic coping (i.e., supportive and common dyadic coping) and negative dyadic coping proved to be related to individual and relational outcomes of parents facing cancer in their child. In addition, while men and women reported to be equally satisfied with their partner and their sexual relationship, women reported higher levels of individual maladjustment. Conclusion: Our findings led to the conclusion that dyadic coping is important for both individual as well as relationship outcomes of parents when facing a diagnosis of cancer in their child. When meeting with families, both partners should be invited as a unit in order to best capture couple level experiences. Also, clinicians should be sensitive to relational and sexual issues besides individual issues, taking into account evidence-based standards for psychosocial care in pediatric oncology.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tom Loeys
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Geertrui Berghmans
- Department of Pediatric Hemato-Oncology and Stem Cell Transplantation Ghent, Ghent University Hospital, Ghent, Belgium
| | - Britt Ooms
- Department of Pediatric Hemato-Oncology and Immunology, University Hospital Brussels, Brussels, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hemato-Oncology, University Hospital Leuven, Leuven, Belgium
- KU Leuven, Leuven, Belgium
| | - Koenraad Norga
- Department of Pediatric Oncology, Antwerp University Hospital, Antwerp, Belgium
- University of Antwerp, Antwerp, Belgium
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27
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Beecham E, Langner R, Hargrave D, Bluebond-Langner M. Children's and Parents' Conceptualization of Quality of Life in Children With Brain Tumors: A Meta-Ethnographic Exploration. QUALITATIVE HEALTH RESEARCH 2019; 29:55-68. [PMID: 30043679 PMCID: PMC6293456 DOI: 10.1177/1049732318786484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The concept of quality of life (QoL) is used in consultations to plan the care and treatment of children and young people (CYP) with brain tumors (BTs). The way in which CYP, their parents, and their health care professionals (HCP) each understand the term has not been adequately investigated. This study aimed to review the current qualitative research on CYP, parents' and clinicians' concepts of QoL for CYP with BTs using meta-ethnography. Six studies were found, which reflected on the concept of QoL in CYP with BTs; all explored the CYP's perspective and one study also touched upon parents' concept. A conceptual model is presented. Normalcy (a "new normal") was found to be the key element in the concept. This study calls for a conception of QoL, which foregrounds normalcy over the more common health-related quality of life (HRQoL) and the need to understand the concept from all perspectives and accommodate change over time.
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Affiliation(s)
- Emma Beecham
- Louis Dundas Centre for Children’s Palliative
Care, UCL-Institute of Child Health, London, UK
- Marie Curie Palliative Care Research
Department, Division of Psychiatry, University College London, London, UK
| | - Richard Langner
- Louis Dundas Centre for Children’s Palliative
Care, UCL-Institute of Child Health, London, UK
| | - Darren Hargrave
- Paediatric Oncology Unit, Great Ormond Street
Hospital, London, UK
| | - Myra Bluebond-Langner
- Louis Dundas Centre for Children’s Palliative
Care, UCL-Institute of Child Health, London, UK
- Rutgers University, The State University of
New Jersey New Brunswick, NJ 08901-8554 USA
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Van Schoors M, De Mol J, Laeremans N, Verhofstadt LL, Goubert L, Van Parys H. Siblings’ Experiences of Everyday Life in a Family Where One Child Is Diagnosed With Blood Cancer: A Qualitative Study. J Pediatr Oncol Nurs 2018; 36:131-142. [DOI: 10.1177/1043454218818067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Childhood cancer not only presents challenges to the life of the child with cancer but also to the siblings’ daily family life. The aim of the current study was to gain a better understanding of siblings’ experiences of living in a family where one child has been diagnosed with blood cancer. Method: Ten siblings of children with leukemia or non-Hodgkin lymphoma completed a semistructured interview about their everyday family life experiences postdiagnosis. The verbatim transcripts of the interviews served as the data for an interpretative phenomenological analysis. Results: The results showed that overall the siblings experienced a continuity in many aspects of their family life: they still experienced their family as an important source of support and information/communication, as warm and loving and as a safe harbor where family members aim to protect each other. However, at the same time, the participating siblings also expressed that some things felt unmistakably different postdiagnosis: They felt that their family as a whole had been ripped apart, with a greater focus on the diagnosed child and changing responsibilities for each family member. Conclusion: This study informs parents and clinicians about the daily family life experiences from the siblings’ perspective, a perspective that is often overlooked. A focus on challenges as well as continuities within family life, the wish for connection expressed by the siblings, and the uniqueness of every sibling’s experiences is what can be taken away from this study by psychosocial workers in the field.
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Affiliation(s)
| | - Jan De Mol
- Université Catholic de Louvain, Louvain-la-Neuve, Belgium
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29
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Myrin Westesson L, Wallengren C, Baghaei F, Sparud-Lundin C. Reaching Independence Through Forced Learning: Learning Processes and Illness Management in Parents of Children Affected by Hemophilia. QUALITATIVE HEALTH RESEARCH 2018; 28:2142-2154. [PMID: 30066606 DOI: 10.1177/1049732318789631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Hemophilia is a complex condition to manage, especially for parents to newly diagnosed children. This grounded theory study explores parents' learning processes and illness management in daily life during the first year after the start of their child's treatment. Using a longitudinal qualitative design, eight parents of four children were interviewed repeatedly during 12 to 14 months. The core category, reaching independence through forced learning, reflected the parents' learning process and their experiences of the challenges during the first year after start of treatment. Incentives for learning were characterized by a longing to reach independence and regain control of one's life situation. The emerging key incentive for learning was a desire to become independent of health care professionals. Early home treatment reduced the impact of the illness, and by supporting parents in different ways during the learning process, health care professionals can promote the parents' trajectory toward independency.
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Affiliation(s)
| | - Catarina Wallengren
- 2 Institute of Health and Care Sciences, the Sahlgrenska Academy at University of Gothenburg, Sweden
- 3 Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
| | | | - Carina Sparud-Lundin
- 2 Institute of Health and Care Sciences, the Sahlgrenska Academy at University of Gothenburg, Sweden
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30
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Kracht CL, Sisson SB. Sibling influence on children's objectively measured physical activity: a meta-analysis and systematic review. BMJ Open Sport Exerc Med 2018; 4:e000405. [PMID: 30364499 PMCID: PMC6196974 DOI: 10.1136/bmjsem-2018-000405] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2018] [Indexed: 12/26/2022] Open
Abstract
Abstract Children without siblings (only children) have higher rates of obesity than children with siblings. Childhood obesity may be prevented by minimising sedentary behaviour and accumulating sufficient physical activity in young children. A growing number of articles have examined the influence of siblings on physical activity and sedentary behaviour, yet these articles have not been synthesised. Objective To synthesise literature and describe the influence of siblings on objectively measured physical activity and sedentary behaviour of children (ages 2–18 years). Design Outcomes were analysed in a systematic review and meta-analysis. Data sources PubMed, EMBASE, Web of Science and Medline OVID were searched for articles related to siblings, physical activity, sedentary behaviour and obesity outcomes from 1947 to March 2018. Eligibility criteria Articles that evaluated sibling status on physical activity objectively measured by accelerometer or pedometer were included. Results Nineteen articles, representing 17 independent datasets, were included in the review. Nine were included in the quantitative analysis. Pooled data from nine articles indicated children with siblings had higher moderate-to-vigorous physical activity (MVPA) relative to only children, with a potential dose response for higher number of children in household and higher MVPA (Mean Difference=3.13, 95% CI 1.90 to 4.35, p=0.001). Findings were mixed for the influence of siblings on sedentary behaviour and light physical activity. Summary/Conclusion Children with siblings had healthier physical activity patterns, as measured by accelerometer or pedometer, than did only children. Suggested mechanisms include peer modelling, encouraging active transport and sports participation, opportunity for playmate and serving as additional caregivers. Trial registration number CRD42017055463.
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Affiliation(s)
- Chelsea L Kracht
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Susan B Sisson
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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