Practitioner Review: Effectiveness and mechanisms of change in participatory arts-based programmes for promoting youth mental health and well-being - a systematic review

BACKGROUND

Participatory arts-based (PAB) programmes refer to a diverse range of community programmes involving active engagement in the creation process that appear helpful to several aspects of children's and young people's (CYP) mental health and well-being. This mixed-methods systematic review synthesises evidence relating to the effectiveness and mechanisms of change in PAB programmes for youth.

METHOD

Studies were identified following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. Eleven electronic databases were searched for studies of PAB programmes conducted with CYP (aged 4-25 years), which reported mental health and well-being effectiveness outcomes and/or mechanisms of change. A mixed-methods appraisal tool assessed study quality. A narrative synthesis was conducted of effectiveness and challenges in capturing this. Findings relating to reported mechanisms of change were integrated via a metasummary.

RESULTS

Twenty-two studies were included. Evidence of effectiveness from quantitative studies was limited by methodological issues. The metasummary identified mechanisms of change resonant with those proposed in talking therapies. Additionally, PAB programmes appear beneficial to CYP by fostering a therapeutic space characterised by subverting restrictive social rules, communitas that is not perceived as coercive, and inviting play and embodied understanding.

CONCLUSIONS

There is good evidence that there are therapeutic processes in PAB programmes. There is a need for more transdisciplinary work to increase understanding of context-mechanism-outcome pathways, including the role played by different art stimuli and practices. Going forward, transdisciplinary teams are needed to quantify short- and long-term mental health and well-being outcomes and to investigate optimal programme durations in relation to population and need. Such teams would also be best placed to work on resolving inter-disciplinary methodological tensions.

The Place of Sick Peers in Adolescents and Young Adults with Cancer: Advantage, Disadvantage, and What Makes Barriers to the Encounter

Purpose: The appreciation of peer support can vary from one country to another due to the cultural and relational differences. This study explores what perceptions French adolescents and young adults (AYAs) in post-treatment for cancer have of the place of sick peers during their treatment and what can make barriers to meet them. Methods: A semistructured interview has been proposed 6 months after the end of cancer treatments. A thematic analysis has been conducted to highlight the major themes and subthemes identified through the participants' discourses. Results: Twelve AYAs (mean age 23 y.o., standard deviation = 2.8; min = 19; max = 26) from two French cancer centers were interviewed. Five major themes were identified, but only two were presented in this article: the place of peers and the impact of coronavirus disease 2019 (COVID-19) epidemic on AYA facilities. AYA peers with cancer major theme demonstrated that meeting sick peers has benefits (e.g., identification, understanding, support, feeling of normalcy) but also has disadvantages (e.g., negative emotional influence). The benefits of peer-to-peer meetings seem to outweigh the disadvantages. Nevertheless, AYAs can face social barriers to this kind of relationship (e.g., fatigue, need to focus on oneself, confrontation to cancer and negative events, feeling of unnatural meeting). Finally, patients' encounters and the normal functioning of AYA facilities have been hampered by the COVID-19 pandemic. Conclusion: Even if AYA services systematically suggest a meeting with other sick peers, it is important to reiterate this proposal since the needs can evolve over time. It can also be interesting to propose places of life outside the hospital to make the encounters more comfortable and natural for AYAs. Clinical Trial Registration number: NCT03964116.

Movement behaviours in paediatric cancer survivors during recovery and school weeks

Purpose

Paediatric cancer survivors (PCS) are a high-risk population, who can suffer from late effects of their treatment, such as metabolic syndrome, cardiovascular conditions, secondary tumours. Optimal movement behaviours (e.g., limited sedentary behaviour [SB] and sufficient physical activity [PA]) can reduce the side effects or avoid late effects of their treatment. The aims of this study were to analyse movement behaviours and meeting the recommendation of 60 minutes of moderate-to-vigorous physical activity (MVPA) a day in Czech PCS, and to compare their movement behaviours during recovery and school weeks in relation to gender, age, and cancer type.

Methods

Twenty-six PCS aged 7-15 years in remission stage took part in the cross-sectional study. Movement behaviours were measured with Actigraph wGT3X+ accelerometers worn 24 hour/day for 20 consecutive days covering recovery week (13 days at recovery camp) and school week (7 days). Based on cancer types, the PCS were categorized into haematological malignancy or solid tumours group.

Results

In the PCS, movement behaviours differed between recovery and school weeks. During recovery week, the PCS showed less SB (451.8 vs. 552.3 min/day, p < 0.001) and spent more time on light PA (350.3 vs. 255.1 min/day, p < 0.001), moderate PA (73.2 vs. 37.4 min/day, p < 0.001), and vigorous PA (10.3 vs. 4.0 min/day p < 0.001) than during school week. The PA recommendation was met by 77% (n = 20) PCS during recovery week, but only by 15% (n = 4) individuals during school week.

Conclusions

The PCS recorded higher levels of PA and lower levels of SB during recovery week than during school week. If provided with appropriate conditions, PCS in the remission stage are able to reach the PA level recommended for the healthy population. Recovery week can be a suitable platform for gaining experience that PCS are able to meet the recommended PA level and could be an integral part of reconditioning and resocialization programmes for PCS after the completion of their treatment.

Comment accompagner les jeunes aidants confrontés au cancer d’un proche ?

La littérature montre que de nombreux enfants et adolescents confrontés au cancer d’un proche apportent une aide significative et régulière. Ces jeunes sont nommés jeunes aidants (JA). Cette situation a des conséquences importantes sur le bien-être et la qualité de vie de ces jeunes. Pourtant, les JA sont aujourd’hui peu identifiés et reconnus en France, et il existe peu de dispositifs pour les soutenir. Cet article se propose d’exposer la place des JA dans le cancer dans notre société, leurs besoins et les dispositifs d’accompagnement pouvant y répondre.

Improvements in Psychosocial Outcomes Following a Summer Camp for Youth with Bleeding Disorders and Their Siblings

PURPOSE

Complications from bleeding episodes from hemophilia can interfere with children's lives and lead to negative psychosocial outcomes. The purpose of this study is to evaluate whether attitude toward illness, hope, perception of illness benefit and/or burden, and/or illness knowledge change for youth with bleeding disorders and their siblings following a five-day education and activity focused summer camp. We hypothesized that youth with bleeding disorders' attitude toward illness, hope, perception of illness benefit, and illness knowledge would improve after camp attendance, and perception of illness burden would decease after camp attendance. We hypothesized that siblings' hope and illness knowledge would improve after camp attendance.

DESIGN AND METHODS

A total of 98 youth (M = 10.9, SD = 3.33, 61.2% male) who attended a bleeding disorder summer camp participated in this study. Fifty percent of participants were diagnosed with either Hemophilia A, Hemophilia B (5%), Von Willebrand Disease (VWD) (28.3%), or platelet deficiency (1.7%), with 38 campers consisting of healthy siblings. The camp hosted "Learning about Hemophilia" breakout sessions for campers. Participants completed self-report questionnaires on the first day and last day of camp.

RESULTS

Of participants with bleeding disorders, illness knowledge, perception of illness benefit, and attitude toward their illness significantly improved from pre-camp to post-camp. Hope did not significantly improve among youth with bleeding disorders. Healthy siblings' total hope significantly improved while illness knowledge remained constant.

CONCLUSIONS

Summer camps are a promising intervention to improve psychosocial outcomes in youth with hemophilia and WVD.

CONCLUSIONS

Summer camps are a promising intervention to improve psychosocial outcomes in youth with hemophilia and WVD.

The Impact of Volunteering at a Family Camp for Children and Adolescents With Cancer: The Experience of Pediatric Intensive Care Nurses

OBJECTIVE

This study explored the experience of pediatric ICU (PICU) nurses who volunteered at a camp for families of children and adolescents with cancer.

BACKGROUND

PICU nurses are at risk of developing symptoms of posttraumatic stress disorder, compassion fatigue, depression, and burnout due to exposure(s) to traumatic events. Spending time with patients, families, and nurse colleagues at camp may reduce the effects of this exposure.

METHODS

A qualitative descriptive study was conducted using content analysis. Fifteen nurse participants completed a precamp questionnaire and semistructured focus groups immediately following camp. Individual interviews were conducted 6 months after camp.

RESULTS

Three categories emerged: 1) personal factors, changes in the nurses themselves; 2) patient and family factors, changes in how nurses perceived patients and families; and 3) work-related factors, relationships with colleagues.

CONCLUSIONS

Supporting PICU nurses to participate with patients, families, and colleagues outside of the hospital may reduce burnout and support nurses' well-being.

Feeling excluded and not having anyone to talk to: Qualitative study of interpersonal relationships following a cancer diagnosis in a sibling

PURPOSE

To explore experiences related to interpersonal relationships following a cancer diagnosis in a sibling.

METHODS

Respondents (n = 7 females) were recruited by means of convenience sampling during a camp for children affected by childhood cancer and their siblings. Data from children and adolescents with a sibling diagnosed with cancer was collected through individual face-to-face interviews and analyzed using systematic text condensation.

RESULTS

Two categories portrayed the experiences related to interpersonal relationships following a cancer diagnosis in a sibling. Feeling excluded while wanting to maintain a relationship with their ill sibling and be involved in the care portrayed that trying to be involved in the care of their ill sibling was a stressful and difficult experience, since they were simultaneously expected to also manage household chores and attend school. Feeling stigmatized and exposed in social contexts while needing an allowing space to talk about their experiences portrayed the emotional difficulties evoked by social situations and behaviors of others, which left respondents feeling exposed and mistreated. Having the possibility to talk about their experiences and receiving social support was described as essential in order to cope with the situation.

CONCLUSIONS

Health professionals need to take into consideration the emotional difficulties and vulnerable situation that children and adolescents who have a sibling diagnosed with cancer are at risk of experiencing. Stigmatization and social exposure present a risk of psychological distress. Having an allowing space to communicate feelings and experiences is desired. Interventions may be necessary to help these individuals psychologically cope.

Improvements in Hope and Beliefs about Illness Following a Summer Camp for Youth with Chronic Illnesses

This study evaluated changes in hope, attitude toward illness, and perceptions of illness benefit and burden following participation in a summer camp designed for youth with a variety of chronic illnesses. Participants were 62 youth campers (Age M = 13.45 years, SD = 2.41) with a variety of chronic illnesses. For youth who began camp low in hope about future goal attainment, participation in optional camp activities negatively predicted post-camp hope about future goal attainment. This relation was nonsignificant for campers who began camp high in hope. We found no significant changes in attitude toward illness or perceptions of illness benefit or burden. This study provides an important contribution to burgeoning research on summer camps designed for children with varying chronic illnesses. Findings were inconsistent with previous studies on chronic illness summer camp outcomes. Further work is needed to identify camp components that are related to desirable psychosocial outcomes for youth with chronic illnesses.

How and Why School Is Important to Teenagers with Cancer: Outcomes from a Photo-Elicitation Study

BACKGROUND

Being diagnosed with cancer during the teenage years can be significant given that young people are at a key developmental, educational, and future-planning stage. Little is known about young people's attitude toward and engagement with school postdiagnosis, nor how this changes over time. We adopted a novel qualitative approach to examine accounts over time of young people recently diagnosed with cancer.

METHODS

Twelve teenagers (13-16 years), recently diagnosed with cancer, participated in photo-elicitation interviews at three time points (∼2, 6, and 9 months postdiagnosis), generating 30 interviews in total. Photo-elicitation interviews center around images that participants bring to represent key experiences and issues that matter to them. Transcripts were analyzed using interpretative phenomenological analysis.

RESULTS

Seven themes were generated, representing experiences over time. Themes convey how significant school was to the young people postdiagnosis, principally because it mattered to them to maintain a normative educational pathway. Young people felt tension between wanting to be the same as their peers but feeling distinctly changed. Keeping ownership and control of their cancer story within school was challenging. Survivorship brought, for some, a legacy of missed schooling.

CONCLUSION

Support for young people and reintegration plans for school need to be tailored to the young person's emerging way of understanding their cancer and recovery, and their orientation to coping. Young people need help to understand that schoolwork exemptions/extensions do not implicate academic deficiency, and how they could accept a "same but different" position as they continue to develop personally and educationally with their peers.

Cancer Survivors' Social Context in the Return to Work Process: Narrative Accounts of Social Support and Social Comparison Information

Purpose Returning to work is a process that is intertwined with the social aspects of one's life, which can influence the way in which that person manages their return to work and also determines the support available to them. This study aimed to explore cancer patients' perceptions of the role of their social context in relation to returning to work following treatment. Methods Twenty-three patients who had received a diagnosis of either urological, breast, gynaecological, or bowel cancer participated in semi-structured interviews examining general perceptions of cancer, work values and perceptions of the potential impact of their cancer diagnosis and treatment on work. Interviews were analysed using the iterative process of Framework Analysis. Results Two superordinate themes emerged as influential in the return to work process: Social support as a facilitator of return to work (e.g. co-workers' support and support outside of the workplace) and Social comparison as an appraisal of readiness to return to work (e.g. comparisons with other cancer patients, colleagues, and employees in other organisations or professions). Conclusions Two functions of the social context of returning to work after cancer were apparent in the participants' narrative: the importance of social support as a facilitator of returning to work and the utilisation of social comparison information in order to appraise one's readiness to return to work. The role of social context in returning to work has largely been absent from the research literature to date. The findings of this study suggest that social support and social comparison mechanisms may have a significant impact on an individual's successful return to the workplace.

Psychosocial interventions for rehabilitation and reintegration into daily life of pediatric cancer survivors and their families: A systematic review

Background

The survival rate of childhood cancer patients increased over the past decades. However, even after successful treatment the transition back to normalcy is often a major challenge for the whole family. Therefore, this study aims to provide an overview of psychosocial interventions for childhood cancer survivors and their families in the first years after the end of cancer treatment.

Methods

We conducted a systematic review following the PRISMA Checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PROSPERO registration number: CRD42017059782). In November 2016 and September 2017, we searched the databases CINAHL, MEDLINE, PSYNDEX, and Web of Science. We included studies investigating psychosocial interventions for childhood cancer survivors diagnosed under the age of 21, their family members or the family as a whole. Further, we summarized the study characteristics and conducted a narrative synthesis of the results. Finally, we assessed the study quality with the Effective Public Health Practice Project Quality Assessment Tool.

Results

We identified a total of 8215 records based on our database searches and 17 additional records through hand searches. We included 33 articles in the qualitative synthesis. Most of the studies described interventions for the cancer survivor (n = 15). Nine studies investigated interventions for the whole family, and two studies interventions for siblings. The interventions mainly take place in an outpatient group setting (n = 15). Overall, most of the studies reported a significant psychosocial benefit of the interventions. However, the quality of the included studies was limited.

Conclusion

In summary, we identified a broad range of different interventions and thus could give a comprehensive overview of existing interventions for childhood cancer survivors and their families. However, there is a necessity for high quality studies. The results may help to optimize health care services that support families with the re-entry into daily life.

Am I a 6 or a 10? Mate Value Among Young Adult Survivors of Childhood Cancer and Healthy Peers

PURPOSE

This study focused on self-perceived mate value of young adult survivors of childhood cancer relative to healthy peers. Qualitative studies indicate potential problems surrounding romantic relationships among survivors, but systematic studies are missing.

METHODS

One-hundred forty-nine childhood cancer survivors and 149 matched controls completed online questionnaires about their mate value, social comparison strategies (i.e., upward/downward identifying/contrasting strategies), and marital status. Survivors and controls were aged 20-40 (M = 27.8), 55% were female, and survivors had been treated for brain tumors (n = 52; 35%), leukemia (n = 42; 28%), lymphoma (n = 31; 21%), or other solid tumors (n = 24; 16%) at 5-33 years before study participation.

RESULTS

Survivors and controls did not differ on overall mate value, but on individual characteristics: Survivors thought they had a better sense of humor (d = 0.36), were more loyal (d = 0.32), had higher social status (d = 0.26), and were more ambitious (d = 0.19), while also considering themselves less sexually adventurous (d = 0.31), less healthy (d = 0.26), having less desire to have children (d = 0.21), and a less attractive face (d = 0.20). Higher mate value was related to being partnered, more upward-identifying, less upward-contrasting, and less downward-identifying strategies. Moreover, less downward-identifying was associated with higher mate value in survivors, but not controls; whereas greater downward-contrasting was associated with higher mate value among controls only (R² = 30.8%).

CONCLUSIONS

Survivors do not generally view themselves as less valuable (potential) romantic partners, but they evaluate different characteristics either more positively or more negatively. Social comparison strategies offer targetable points of interventions to intervene on negative self-evaluations, potentially enhancing well-being.

'I have cystic fibrosis': an analysis of web-based disclosures of a chronic illness

AIM

This study examined instances where individuals with cystic fibrosis disclosed their illness on the World Wide Web, better understand their experiences and needs across stages of the lifespan.

BACKGROUND

Disclosing one's chronic illness is typically done purposefully, so examining those disclosures allows a naturalistic window into individuals' experiences and needs. This study is unique to Internet-based studies of chronic illness in that data are not limited to interactions at health-related websites, but include disclosure instances gathered across a variety of Internet contexts.

DESIGN

Qualitative content analysis with a summative component was used.

METHOD

A web-based search engine was used to identify all web pages containing the phrases 'I have cystic fibrosis' and 'I have cf' (n = 277). Constant comparative analysis methods were used to identify thematic categories of context. Quantitative methods were used to examine age-related differences in the distribution of those disclosure statements. Findings were interpreted within a framework of Erikson's lifespan psychosocial theory.

RESULTS

Adolescents (13-18 years) most frequently expressed psychosocial concerns and enlisted social support. Emerging adults (19-25 years) tended to present cystic fibrosis as just one of many self-characteristics. Adults (>25 years) tended to reach out to support others with cystic fibrosis.

CONCLUSIONS

The study identified age-related differences in the types of illness disclosures found among individuals with cystic fibrosis. It also demonstrated that web-based research into chronic illness need not be limited to analysis of illness-specific online communities.

RELEVANCE TO CLINICAL PRACTICE

Findings suggest that psychosocial interventions for individuals with cystic fibrosis across the lifespan might focus on (a) facilitating social support and incorporating illness into one's emerging identity among adolescents, (b) supporting emerging adults in presenting and incorporating themselves into larger social networks and (c) partnering with adults who wish to mentor others living with cystic fibrosis.

Providing Children and Adolescents Opportunities for Social Interaction as a Standard of Care in Pediatric Oncology

Experiences with peers constitute an important aspect of socialization, and children and adolescents with cancer may experience reduced social interaction due to treatment. A literature review was conducted to investigate the evidence to support a standard of care evaluating these experiences. Sixty-four articles were reviewed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Moderate quality of evidence suggest that social interaction can be beneficial to increase knowledge, decrease isolation, and improve adjustment and constitute an important, unmet need. The evidence supports a strong recommendation for youth with cancer to be provided opportunities for social interaction following a careful assessment of their unique characteristics and preferences.

Psychosocial outcomes of a summer overnight recreational experience for children with heart disease

Children with chronic heart disease (CHD) are often turned away from recreational summer overnight experiences because of complicated medical histories and medication regimens. The purpose of this qualitative study was to evaluate the psychosocial impact of a five-day overnight recreational experience for children with CHD and their parents. Thirty-six children with CHD between the age of 8 and 15 years and their parents participated in the study. Data were collected from the children using photovoice interviews. Parent data were collected using a post camp survey. Results included the following external outcome themes: inclusion in a peer group and the importance of friendship, fun, and safety. Internal or personal outcome themes included counselor as a role model, increased self-confidence, and the realization of life's possibilities. Parent themes included increased child independence, increased child confidence, and child feelings of normalcy related to belonging to a peer group. Findings from this study can be used to encourage families of children with CHD to allow participation in a well-supervised overnight recreational experience. Such an experience can foster the child's overall development, provide peer group support, and reduce parent anxiety about overnight separation from the child.

Changes in Socio-Emotional and Behavioral Functioning After Attending a Camp for Children with Tourette Syndrome: A Preliminary Investigation

Children and adolescents with Tourette syndrome are at risk for social, emotional, and behavioral difficulties that may negatively influence feelings of self-competence and attitudes toward having this diagnosis. Attending a camp for children with Tourette syndrome may facilitate improvements in overall socio-emotional and behavioral functioning and self-perception. The current study obtained data from 37 campers (76 % male, 24 % female) and 47 caregivers of campers to investigate changes in children's emotional and behavioral functioning, self-perception (i.e., social and general), attitudes towards having Tourette syndrome, and how different they felt from peers after attending a 1-week summer camp for youth with Tourette syndrome using a pre-post design. Results indicated that campers endorsed a significantly improved sense of social self-competence and more favorable attitudes toward having Tourette syndrome post-camp. Campers also tended to endorse feeling less different than peers at camp versus peers in general. Caregivers endorsed significantly less severe symptoms associated with Tourette syndrome for campers after attending camp. No pre-to-post-camp changes were observed for campers' levels of anxiety or obsessive-compulsive symptoms. These preliminary findings suggest that attending camp or having other opportunities to interact with similar peers may promote better perceptions of social self-competence, more favorable attitudes toward having Tourette syndrome, and a stronger sense of affiliation with peers for children with Tourette syndrome.

Nursing care for adolescents and young adults with cancer: literature review

Cancer patients belonging to the adolescent and young adult (AYA) age group have unique and very specific needs, which require special attention from the caring staff. The difficulty in maintaining the personal and professional development at this age is both natural and normal. Adding to this, coping with a life-threatening disease turns this stage in life into a period with many dilemmas and challenges of quite a complex nature. AYA patients have to deal with issues above and beyond the disease itself, which create a very complex coping picture. On top of that, prognosis for this age group has not improved in recent years, unlike the situation in other age groups like children and adults. The literature on this subject is extensive and comprehensive. However, most of the papers on this subject are very specific and narrow in their approach, each dealing with a specific topic. In this article, we bring together many different papers which make a wide and comprehensive picture of the subject of AYAs coping with cancer, coupled with recommendations for the caring staff. In this review we focus on the various aspects of the disease and treatments in AYAs, based on the conceptual model of quality of life proposed by Ferrell and colleagues [Cancer Nurs 1992;15:153-160; Cancer Nurs 1992;15:247-253], including physical, social, emotional and spiritual aspects. From the psychological standpoint, most of the papers discuss the negative aspects; however, in this article we try to include some articles from the positive psychology school of thought. From our findings it is apparent that there is an opportunity and need to further explore research in this regard. It is apparent that taking a unique approach to AYA cancer patients is needed in order to deal with the unique needs of this age group. This article aims at putting a framework around this issue, with actionable recommendations for the caring staff.

Peer and romantic relationships among adolescent and young adult survivors of childhood hematological cancer: a review of challenges and positive outcomes

This review focuses on peer and romantic relationship experiences of adolescent and young adult (AYA) survivors of childhood cancer, highlighting those surviving leukemia or lymphoma. While most AYA survivors adjust well to life following a hematological cancer diagnosis and treatment, many unique experiences, both positive and challenging, have been documented with respect to successfully navigating developmentally normative social goals. Therefore, the social implications of surviving childhood leukemia or lymphoma are explored. Specifically, the development of peer and romantic relationships, perceptions of social acceptance, parental influences and attachment, perceived vulnerabilities and body image, and risks to fertility are discussed.

The psychological and social impact of camp for children with chronic illnesses: a systematic review update

Advances in medicine have reduced mortality among children with complex medical conditions, resulting in a growing number of young patients living with chronic illnesses. Despite an improved prognosis, these children experience significant psychosocial morbidity, such as depression and anxiety. Therapeutic summer recreation camps have been proposed as an intervention to enhance quality of life among these children. The purpose of this systematic review was to assess the psychosocial impact of camp for children with chronic illnesses. A systematic review of central databases was undertaken using key words, and a rating tool – the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies – was employed to rate methodological quality. 21 studies were included in this systematic review. Although overall methodological quality was weak, camp participation appeared to offer short-term psychosocial benefits on some parameters in children with a variety of chronic illnesses. There was some consistency in improved social outcomes, such as social interaction and acceptance. Based on the available evidence, it is premature to make robust claims regarding the psychosocial impact of camp as a therapeutic intervention. Theoretically informed camp programs, long-term follow-up, and incorporating camp-based messaging into routine hospital care,may enhance the utility of camp as a potential psychosocial intervention in paediatrics.

Perceived self-competence, psychosocial adjustment, and quality of life in pediatric patients with pacemakers

OBJECTIVES

To compare participants' self-competence levels to normative data and examine self-competence as a potential protective factor against poorer health-related quality of life (HRQOL) and psychosocial adjustment in children with pacemakers.

METHODS

Twenty-seven children between the ages of 8 and 18 years and their caregivers were recruited from a pediatric pacemaker clinic. Participants completed self-report and parent-proxy measures of children's health-related quality of life (HRQOL), self-competence, and psychosocial functioning, which included externalizing and internalizing symptoms, adaptive skills, and behavioral symptoms.

RESULTS

Participants reported significantly lower levels of self-competence compared to healthy norms. Self-competence was significantly and positively correlated with most HRQOL domains. Few significant correlations emerged between self-competence and various domains of psychosocial functioning.

CONCLUSION

Self-competence may function as a protective factor against lower HRQOL in children with pacemakers. There was less evidence that self-competence may play a protective role against lower adaptive skills and higher externalizing, internalizing, and behavioral symptoms. Clinical implications of these findings, limitations of the study, and areas for future research are discussed.

Benefits of attending a summer camp for children with inflammatory bowel disease

OBJECTIVES

The aim of the present study was to investigate knowledge of pediatric patients with inflammatory bowel disease (IBD) and perceptions of Camp Gut Busters, an IBD summer camp.

METHODS

The present ethnographic study uses traditional anthropological methods to investigate participants' knowledge and perceptions of Camp Gut Busters. Data were gathered using in-depth qualitative interviews, participant observation during 4 Camp Gut Busters summer sessions, and attendance records for the summer camp. Participants either attended Camp Gut Busters (campers) or did not attend (noncampers). Campers' knowledge and perceptions were based on their actual experience at Camp Gut Busters, whereas those of noncampers were based on their expectations of camp.

RESULTS

Participant responses reference their illness experience with IBD, their struggles of learning to live with a chronic condition, and the benefits of attending a disease-specific camp. Campers addressed notions of identity, the isolation associated with having a potentially stigmatizing chronic condition, therapeutic routines, and awareness of IBD. Noncampers focused on discomfort with IBD and their identity as an individual and child with the disease.

CONCLUSIONS

Pediatric patients with IBD who attended a disease-specific summer camp benefited from the experience. Exposure to peers with similar therapeutic routines and to the range of IBD helped campers build an empathetic social network and introduced a new perspective on their disease. Attending a disease-specific camp helps pediatric patients with IBD in psychosocial adjustment and acquisition of knowledge about their disease. Ultimately, it helps them learn to live with their chronic condition.

Designing and evaluating the acceptability of Realshare: An online support community for teenagers and young adults with cancer

A participatory action approach was used to design and evaluate the acceptability of the Realshare online community. Pre and post-intervention focus groups were conducted and participants were asked to test out Realshare during two intervention periods: when a facilitator was present and when one was not. Focus group data and forum messages were thematically analysed. The themes identified related to participants’ website design requirements, how they used the community and the evaluation of Realshare after having used it. Amendments were made to Realshare throughout the project. Realshare is available to young oncology patients in the South West of England.

Social Theory Applied to Body Image and Chronic Illness in Youth

Changes in appearance and functional limitations of youth with chronic illness place them at greater risk for negative body image and poor psychosocial and medical outcomes compared with their healthy peers. Sociocultural pressures from the media, family, and peers, as well as social comparison processes to some extent explain the development of negative or positive body image in young people. This article discusses social theories applied to body image in young people with chronic illness, an overlooked population. A review of risk and protective factors of body dissatisfaction in this population and suggested treatment strategies/interventions in the prevention of body dissatisfaction are also considered. Reported findings may help health care providers become more aware of body image issues their young patients with chronic illness face, and posit the importance of regularly monitoring their psychosocial well-being in the efforts to curtail development of body dissatisfaction and consequential poor health outcomes.

Evaluation of child and parent outcomes after a pediatric cardiac camp experience

PURPOSE

This study evaluated the effects of a cardiac camp experience on children with heart disease and their parents.

DESIGN AND METHODS

A repeated measures design was used with 49 parent-child dyads. Repeated measures evaluated the effects of camp on anxiety, attitude toward illness, and psychosocial functioning of the children. Parental anxiety was also evaluated.

RESULTS

Results demonstrated decreases in parent anxiety, decreases in child trait anxiety, and positive psychosocial outcomes in the areas of self-esteem, social, physical, and emotional functioning.

PRACTICE IMPLICATIONS

Findings can be used to support decisions for those contemplating a camping experience for the child with heart disease.

Body image of children and adolescents with chronic illness: a meta-analytic comparison with healthy peers

This meta-analysis integrates results from 330 studies on differences between body image of children and adolescents with and without chronic physical illness. Young people with a chronic illness had a less positive body image than their healthy peers although the average size of differences was small (g=-.30 standard deviation units). A comparison of diseases showed that young people with obesity (g=-.79), cystic fibrosis (g=-.50), scoliosis (g=-.41), asthma (g=-.37), growth hormone deficits (g=-.35), spina bifida (g=-.23), cancer (g=-.20), and diabetes (g=-.17) evaluated their body less positively than their healthy peers. Furthermore, levels of body dissatisfaction varied by age at onset of the disease, method for assessing body image, ethnicity, year of publication, and comparison group. Recommendations are stated for reducing effects of chronic illness on the body image of people with chronic illness.

Unique children in unique places: innovative pediatric community clinical

Pediatric nursing is a specialization that requires a particular set of skills and abilities. Most nurses seldom get the chance to interact with families who have children living with exceptionalities unless they choose to work in tertiary settings dealing exclusively with children. This article explores how one school of nursing in Canada offers its students two unique learning opportunities where they get the chance to work with children who have special needs in an interdisciplinary community-based setting. Shared statements from parents and students highlight the benefits to all those involved.

Outcomes and processes at a camp for youth with HIV/AIDS

The impact of HIV/AIDS on the lives of youth with this chronic illness suggests the need for additional support as youth develop. Summer camp can serve as a therapeutic intervention for youth with HIV/AIDS. Using a case study employing observations, focus groups, and interviews, we examined outcomes associated with participation in a camp for youth with HIV/AIDS, and program processes that influenced outcomes. Findings showed that camp played a major developmental role for youth. Three outcomes of camp emerged: (a) forming caring connections (awareness of commonalities, lack of isolation); (b) feeling reprieve and recreation (fun activities, anticipation of and reflection on camp, sense of freedom); and (c) increasing knowledge, attitudes, and skills (conflict management, disclosure, skill learning and education, medication adherence). Processes included formal and informal education, staff-camper interactions, long-term relationships, outside-of-camp support, activities, planning for camper needs, accessibility, and freedom from worry. We discuss implications for youth programs.

Exploring the needs and resources of children in a haematology-oncology unit

Too often a child’s body is restored to health in the hospital, but the child is sent home with emotional wounds. This study explored the needs of children in a haematology-oncology unit as well as the resources that could be mobilised in order to address these needs by firstly carrying out a literature review. A field study was then conducted in order to prioritise the resources according to their importance for children in a haematology-oncology unit. A definite trend could be found in the way that the children responded to the request to prioritise the resources. The first three resources, as chosen by the children, all concerned the external social environment of the child. It could therefore be concluded that support from parents and other people of significance are most important to the child and should be taken into account when facilitating support for children in a haematology-oncology unit. It could also be concluded that these children do not experience sufficient control in their situation and it could therefore be suggested that children in a haematology-oncology unit should experience more control and power in their situation.OpsommingSo dikwels word ‘n kind se liggaam genees in die hospitaal, maar hierdie selfde kind gaan huis toe met emosionele wonde. Die behoeftes van kinders in ‘n hematologie-onkologie eenheid is ondersoek asook die hulpbronne wat gemobiliseer kan word om hierdie behoeftes aan te spreek deur gebruik te maak van ‘n literatuurstudie. Daarna is ‘n veldstudie gedoen om hierdie hulpbronne te prioritiseer volgens die belangrikheid daarvan vir kinders in ‘n hematologieonkologie eenheid. Die manier waarop die kinders die hulpbronne geprioritiseer het, het ‘n definitiewe tendens getoon. Die eerste drie hulpbronne wat deur die kinders gekies is, is al drie hulpbronne wat die eksterne sosiale omgewing van die kind behels. Die gevolgtrekking kan dus gemaak word dat die ondersteuning van ouers en ander persone wat belangrik is vir die kind, van uiterste belang is en in aanmerking geneem behoort te word in die fasilitering van ondersteuning van kinders in ‘n hematologie-onkologie eenheid. Die gevolgtrekking wat gemaak kan word is dat hierdie kinders nie genoeg beheer ervaar in hulle situasie nie en daarom word voorgestel dat kinders in ‘n hematologie-onkologie eenheid meer bemagtig behoort te word gegewe hulle omstandighede.

Follow-up effects of social comparison information on the quality of life of cancer patients: the moderating role of social comparison orientation

OBJECTIVE

To examine how social comparison orientation (SCO) moderates the effects of three types of social comparison information on the global quality of life of cancer patients 2 weeks and 3 months later.

DESIGN

Cancer patients (n=226) were provided with social comparison information just prior to undergoing radiation therapy, using audiotapes. Each participant was confronted with one of three tapes: (1) focusing on procedural aspects, (2) focusing on emotional reactions and (3) focusing on coping strategies.

MAIN OUTCOME MEASURES

Quality of life as measured with the Cantril self-anchoring scale [Cantril, H. (1965). The pattern of human concerns. New Brunswick, NJ: Rutgers University Press].

RESULTS

With increasing SCO, a lower quality of life was reported after listening to the emotion tape, while a higher quality of life was reported after listening to the coping tape. These effects were found 2 weeks as well as 3 months after the radiation therapy had ended.

CONCLUSION

Social comparison information may have longitudinal effects on quality of life, but these effects are to an important extent dependent on the nature of the information and individual differences in SCO.

Been There, Done That, Wrote the Blog: The Choices and Challenges of Supporting Adolescents and Young Adults With Cancer

The purpose of this article is to review the current literature on the provision of support groups for adolescent and young adult (AYA) patients with cancer with a focus on the challenges that are faced by these initiatives. The value of group support to patients with cancer and particularly to this age group has been well documented. However, with the advent and increase in popularity of online support options, it is an opportune time to examine the options available to the AYA group and highlight areas that would benefit from further investigation. This article will review the literature on the need to provide support groups to this age group, the available options, and the challenges they face.

Brain Tumor Survivors Speak Out

Although progress has been made in the treatment of childhood brain tumors,work remains to understand the complexities of disease, treatment, and contextual factors that underlie individual differences in outcome. A combination of both an idiographic approach (incorporating observations made by adult survivors of childhood brain tumors) and a nomothetic approach (reviewing the literature for brain tumor survivors as well as childhood cancer survivors) is presented. Six areas of concern are reviewed from both an idiographic and nomothetic perspective, including social/emotional adjustment, insurance, neurocognitive late effects, sexuality and relationships, employment, and where survivors accessed information about their disease and treatment and possible late effects. Guidelines to assist health care professionals working with childhood brain tumor survivors are offered with the goal of improving psychosocial and neurocognitive outcomes in this population.

Talking With Others Who “Just Know”: Perceptions of Adolescents With Cancer Who Participate in a Teen Group

Adolescents with cancer have social support needs that are challenging to meet. A qualitative descriptive study was done using in-person interviews with 11 participants between the ages of 14 and 20. The purpose of the study was to explore and describe adolescent's perceptions of a teen support group. Two main themes emerged: Satisfying Elements and Challenges in the teen group. The subthemes under Satisfying Elements include participants being able to talk to others who “just know,” sharing experiences while having fun as a normal teenager, and giving or receiving inspiration. Subthemes under Challenges as identified by participants include ensuring that activities during teen events meet the needs of all participants and dealing with the death of a group member. Study findings suggest that adolescent's feel supported when they are among others in similar circumstances while engaging in normal activity. Offering this type of group for adolescents with cancer provides them with the ongoing opportunities for connection with their peers that is often needed throughout the treatment journey.

Decreases in anxiety associated with participation in a camp for children with cardiac defects

The aim of our study was to examine psychosocial changes associated with participation in a camp for children with cardiac defects. We enrolled 29 children with cardiac defects aged from 8 to 18 years, along with their parents. Both the parents and the children completed measures of expectations for the camp and anxiety. Analyses of repeated measures indicated that levels of anxiety amongst the children decreased significantly at the end of camp when compared to its beginning. Levels of anxiety amongst the children were not statistically different at follow-up. Anxiety amongst the parents concerning the separation from their children also decreased at follow-up when compared to before the camp. Higher levels of anxiety reported by the children prior to the camp were associated with greater anxiety amongst the parents concerning the anticipated separation, more negative parental expectations of the camp, fewer experiences of separation from their children, and lower expectations by the children for the camping experience. Reductions in anxiety amongst the children following the camp were associated with negative parental expectations about the camping experience. The camping environment can provide a naturalistic exposure to new experiences for the child, and a successful separation for the parent, thereby promoting confidence amongst the parents in the ability of their children to function independently.

Overview of camp research

Organized camp experiences for children have been a part of American culture for almost 150 years. Millions of young people and adults have had positive developmental experiences in outdoor camp environments. Research about the outcomes of camp as well as about camp operations has documented the role that camps play in enhancing human development. This article summarizes some of the trends that have occurred in camp research and offers suggestions for future directions to assure that camp experiences continue to "enrich lives and build tomorrows."

Camp experiences and developmental outcomes for youth

Most children view camp as an enjoyable experience. In addition to the essential fun aspect of camp, researchers are discovering several positive developmental outcomes. This article describes some of the developmental outcomes that occur at camp based on developmental theories that underlie camp programs and the research that has been conducted. The primary developmental outcomes examined relate to the broad areas of self-constructs, social relationships, skill building, and spirituality. The recent national data collected by the American Camp Association to document developmental outcomes are highlighted to better understand how "camp gives kids a world of good."

A STUDY OF THE SELF-CONCEPTS OF 9–14 YEAR-OLD CHILDREN WITH ACUTE AND CHRONIC DISEASES

This study identified the level of self-concept in children with acute and chronic illnesses and determined the factors that may influence their self-concepts. The study sample includes 154 children (77 children with chronic illness, 77 children with acute illness). The data were collected via the General Information Form and the Piers-Harris Self-Concept Scale for Children (Piers & Harris, 1969). The data were analyzed via MANOVA, ANOVA and the Duncan Test. The findings indicate that self-concept scores vary, depending on the age of the child (p < .01) and the age of the mother (p < .05). Furthermore, for children with chronic illnesses, the medical department (p < .05), diagnosis (p < .05), treatment period (p < .05), and length of hospitalization (p < .01) all affected self-concept scores.