Integrative Literature Review on Psychological Distress and Coping Strategies Among Survivors of Adolescent Cancer

Facilitators and Barriers to Multidisciplinary Teamwork in Adolescent and Young Adult Oncology Care: A Descriptive Qualitative Study

Purpose

This descriptive qualitative study aims to deepen the understanding of the teamwork processes employed by multidisciplinary healthcare professionals caring for adolescent and young adult cancer patients and identify the facilitators and barriers influencing these teamwork activities.

Patients and Methods

Semi-structured interviews were conducted with 13 healthcare professionals working with adolescent and young adult patients with cancer in a major hospital in South Korea. The data were thematically analyzed using NVivo software (14.0), with two researchers independently coding the interview transcripts.

Results

The oncology multidisciplinary team process was identified as comprising three phases: (1) establishing teamwork during admission; (2) strengthening teamwork during active treatment; and (3) concluding teamwork and sustaining connections during care transitions. Key facilitators of teamwork included a positive team atmosphere, enhanced interdisciplinary communication, and a strong workforce. Barriers to effective teamwork were identified at the interpersonal, institutional, and national levels, including inadequate information sharing, role ambiguity, hierarchical communication structures, and limited resources.

Conclusion

Effective care for adolescents and young adults with cancer requires addressing their psychosocial needs through a well-resourced multidisciplinary team. Future research should focus on applying identified facilitators and overcoming barriers to enhance teamwork. This study emphasizes the critical role of nurses in achieving high-quality, patient-centered care.

Differences in Psychological Coping with Illness During the Treatment and Survivorship Phases in Adolescents According to Age and Sex

INTRODUCTION

Despite the importance of addressing different stages of cancer, there is a lack of data on how these stages relate to coping strategies. This study aims to analyze coping strategies among adolescents with cancer by comparing two distinct time points, the treatment phase and the post-treatment phase, with a particular focus on age and gender.

METHODOLOGY

A total of 201 cancer patients aged 12 to 17 years from Alicante, Valencia, and Madrid participated in the study. They completed a Demographic and Clinical Data Form questionnaire capturing age, gender, and illness phase, along with the ACS to assess coping strategies.

RESULTS

During the treatment phase, strategies such as "worrying", "stress reduction", "ignoring the problem", and "self-blame" were used more frequently than during the follow-up phase, revealing notable changes in emotional management between the two stages. Gender differences were observed in the first three strategies.

CONCLUSIONS

The coping strategies of adolescents with cancer vary significantly between the treatment and follow-up phases, with greater use of certain strategies during treatment and a decline in their use post-treatment. These findings highlight the evolving emotional demands of each stage and emphasize the need for targeted interventions that address the specific coping needs unique to each phase. Such targeted interventions in clinical settings could support emotional management by adapting strategies to the distinct challenges faced by adolescents during treatment and post-treatment phases.

The 'Young Adult Taking Action' programme for young adult cancer survivors: A study protocol for a feasibility study

BACKGROUND

Young adult cancer survivors (YACS) aged 18-39 report age-specific multifactorial challenges with self-care, leisure, work and education requiring multicomponent rehabilitation intervention. Therefore, the 'Young Adult Taking Action' (YATAC) programme was developed.

AIMS/OBJECTIVES

To present a protocol for a feasibility study evaluating the acceptability of the YATAC programme and exploring implementation, mechanisms of impact and outcomes.

MATERIAL AND METHODS

A mixed-method feasibility study with a convergent research design will be conducted. The programme is an age-specific, multicomponent, goal-oriented, and peer-based rehabilitation programme delivered by an interdisciplinary staff consisting of nine components: 1) Goal setting, 2) Everyday life, 3) Physical activity, 4) Psychological issues, 5) Work and study, 6) Sexuality and relationship, 7) Rights and finance, 8) Peer-to-peer support and 9) Individual consultation. Quantitative and qualitative data about acceptability, implementation, mechanisms of impact and outcomes will be collected.

RESULTS

The results will provide essential knowledge about the programme's acceptability, implementation, mechanisms of impact and outcomes.

CONCLUSION AND SIGNIFICANCE

The study will inform adjustment of the programme and will provide knowledge of whether and how to deliver age-specific rehabilitation to YACS.

Effects of Person-Centered Information for Parents of Children With Cancer (the PIFBO Study): A Randomized Controlled Trial

Background: Conveying information to parents is a core part of pediatric oncology nursing; however, most published interventions do not tailor information to individual parental needs. Objective: To evaluate the effect on parental illness-related stress of person-centered information provided to parents of children with cancer. Methods: A multicenter, unblinded randomized controlled trial with two parallel arms recruiting parents of children diagnosed within the past two months from two tertiary children's cancer centers in Sweden. Parents were randomized using sealed envelopes prepared and opened by an independent person. Parents in the intervention arm met four times with experienced nurses trained in the intervention, whereas controls received standard care. The effect of the intervention was measured five times regarding parents' illness-related stress. Secondary outcomes were psychosocial states, experiences with healthcare providers, and received information. Further, we collected process data on the intervention's content and fidelity. Results: Of the 32 parents included and analyzed in the study, 16 were randomized to the intervention, which addressed a broad variety of topics. The intervention increased parents' knowledge about the biophysiological and functional aspects of their child's illness, but it had no measurable effect on their distress. Discussion: Although fidelity to the intervention protocol was sufficient, the study was flawed by recruitment difficulties, primarily due to organizational factors, which may have prevented us from observing any possible effects on psychosocial distress. Having a person-centered perspective could be promising for future studies aimed at parents of children with cancer. (Registered at Clinicaltrials.gov, number NCT02332226.).

Perceived family impact and coping mechanisms of caregivers of children with nephrotic syndrome

BACKGROUND

Pediatric chronic disease impacts the affected child and their family structure. There is limited literature investigating the psychosocial impact of nephrotic syndrome on families.

METHODS

Caregivers of children with nephrotic syndrome completed two validated surveys: (1) Impact on Family (IOF) that evaluates the family impact (degree to which family is affected by a pediatric chronic illness) and (2) Coping Health Inventory for Parents (CHIP) that examines the coping patterns used by caregivers. Linear regression models were utilized to determine predictors of perceived family impact and coping patterns.

RESULTS

Seventy-five caregivers of a child with nephrotic syndrome completed the surveys. On a scale from low impact to significant impact to very serious impact, results indicated that nephrotic syndrome had a significant impact on families (mean revised IOF total score 33.04 ± 9.38). Families in the steroid-resistant nephrotic syndrome (SRNS) group reported a higher financial impact compared to the steroid-sensitive nephrotic syndrome (SSNS) group (p = 0.03). Families in the frequently relapsing group (FRNS) reported a higher impact on the caregiver's ability to cope with the child's condition compared to the SRNS group (p = 0.02). Tacrolimus use was associated with increasing the perceived family impact (β = 4.76, p = 0.046). CHIP scores indicated that caregivers did not cope well with family integration (component I) but coped well with social support (component II) and communication (component III).

CONCLUSIONS

Childhood nephrotic syndrome has a significant overall perceived impact on the family, and caregivers did not cope well regarding strengthening their family life. These findings can be used as outcome measures for future intervention studies to find solutions that would decrease the perceived family burden. A higher resolution version of the Graphical abstract is available as Supplementary information.