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Schepers SA, Phipps S, Devine KA, Noll RB, Fairclough DL, Dolgin MJ, Ingman KA, Schneider NM, Voll ME, Askins MA, Sahler OJ. Psychometric properties of the 52-, 25-, and 10-item English and Spanish versions of the Social Problem-Solving Inventory-Revised. Front Psychol 2023; 14:1213784. [PMID: 37809313 PMCID: PMC10551167 DOI: 10.3389/fpsyg.2023.1213784] [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: 04/28/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Objective The Social Problem-Solving Inventory-Revised (SPSI-R) is a widely used instrument to assess problem-solving ability. This study examined the factor structure of the 52-, 25-, and 10-item versions of the SPSI-R and assessed factorial invariance across English- and Spanish-speaking participants. In addition, the internal consistency, test-retest reliability and sensitivity to detect change in problem-solving skills over time were assessed across the three different versions of the SPSI-R. Methods Data from three randomized controlled trials, in which caregivers of children with cancer (N = 1,069) were assigned to either a problem-solving skills intervention (N = 728) or a control condition (N = 341), were combined. The SPSI-R was administered at baseline (T1) and immediately post intervention (T2). Reliability and multigroup analyses were performed with confirmatory factor analysis (CFA). Sensitivity to change analyses were performed using repeated measures ANOVA. Results Confirmatory factor analysis at T1 showed good fit statistics and internal consistency for the 52- and the 25-item versions, but not for the 10-item version. Factorial invariance was demonstrated across time (T1-T2) and language (Spanish-English) for both the 52- and 25-item versions. Adequate sensitivity to change over time was shown. Conclusion The 52- and 25-item versions of the SPSI-R appear reliable and valid for assessment of problem-solving skills in English- and Spanish-speaking caregivers of children with newly diagnosed cancer. The 25-item SPSI-R can be used as a short version measuring problem-solving ability; the 10-item version cannot be considered a reliable measure for this population.
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Affiliation(s)
| | - Sean Phipps
- St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Katie A. Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Robert B. Noll
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | | | | | | | | | - Megan E. Voll
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Martha A. Askins
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Olle Jane Sahler
- University of Rochester Medical Center, Rochester, NY, United States
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2
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Levesque A, Béliveau J, Ogez D, Marcil V, Curnier D, Laverdière C, Sinnett D, Péloquin K, Sultan S. Do problem-solving skills help mitigate emotional distress through perceived control and self-efficacy in parents of children with cancer? Psychooncology 2023; 32:247-255. [PMID: 36434711 DOI: 10.1002/pon.6075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Parents of children with cancer face psychological challenges that can result in significant distress. It has been found that problem-solving (PS) could mitigate emotional distress (ED) in this population, but mechanisms of this relation are poorly understood. This study aimed to assess whether there is a link between PS and ED through perceived control and self-efficacy. METHODS We included 119 parents (67 mothers, 52 fathers, including 50 couples) whose child was diagnosed with cancer. We evaluated whether PS was associated with ED through perceived control and self-efficacy in couples of parents. RESULTS We found no direct association between PS and ED (β = -0.01, p = 0.92). Our results indicated a significant indirect effect between ED and PS with perceived control as the intermediary variable (β = -0.24, p < 0.001, 95% CI [-0.41, -0.11]). However, there was no indirect association between ED and PS with self-efficacy as the intermediary variable (β = -0.04, p = 0.26, 95% CI [-0.11, 0.09]). The effect size was large in magnitude (R2 = 0.59 for ED). CONCLUSION The mitigating role of PS on ED is better explained by an enhanced experience of control than by improved self-efficacy. Future interventions should directly target the action mechanism behind PS and ED in both mothers and fathers by targeting their perceived control.
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Affiliation(s)
- Ariane Levesque
- Department of Psychology, Université de Montreal, Montreal, Québec, Canada.,Research Center, Sainte-Justine University Health Center, Montreal, Québec, Canada
| | - Julianne Béliveau
- Department of Psychology, Université de Montreal, Montreal, Québec, Canada.,Research Center, Sainte-Justine University Health Center, Montreal, Québec, Canada
| | - David Ogez
- Department of Psychology, Université de Montreal, Montreal, Québec, Canada.,Department of Anesthesiology, Université de Montreal, Montreal, Québec, Canada
| | - Valérie Marcil
- Research Center, Sainte-Justine University Health Center, Montreal, Québec, Canada.,Department of Nutrition, Université de Montreal, Montreal, Québec, Canada
| | - Daniel Curnier
- Research Center, Sainte-Justine University Health Center, Montreal, Québec, Canada.,School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montreal, Montreal, Québec, Canada
| | - Caroline Laverdière
- Research Center, Sainte-Justine University Health Center, Montreal, Québec, Canada.,Department of Pediatrics, Université de Montreal, Montreal, Québec, Canada
| | - Daniel Sinnett
- Research Center, Sainte-Justine University Health Center, Montreal, Québec, Canada.,Department of Pediatrics, Université de Montreal, Montreal, Québec, Canada
| | - Katherine Péloquin
- Department of Psychology, Université de Montreal, Montreal, Québec, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montreal, Montreal, Québec, Canada.,Research Center, Sainte-Justine University Health Center, Montreal, Québec, Canada.,Department of Pediatrics, Université de Montreal, Montreal, Québec, Canada
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3
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McNeal DM, Sahler OJZ, Noll RB, Fairclough DL, Voll ME, Bhat S, Morrato EH. Core functions and forms of Bright IDEAS: A multi-methods evaluation of the adoption of an evidence-based psychosocial training program through iterative adaptation. FRONTIERS IN HEALTH SERVICES 2022; 2:928580. [PMID: 36925829 PMCID: PMC10012676 DOI: 10.3389/frhs.2022.928580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
Background Despite efforts to widely disseminate interventions designed to increase access to quality supportive care to pediatric cancer patients and their families, many of these interventions fail to meet expectations once deployed in real-life clinical settings. This study identifies the functions and forms of Bright IDEAS: Problem-Solving Skills Training, an evidence based psychosocial intervention for caregivers of children recently diagnosed with cancer, to identify pragmatic program adaptations in its real-world clinical implementation. We compare intervention adoption before and after adaptations to the Bright IDEAS training program as part of a national training program designed to disseminate the intervention. Methods 209 pediatric psychosocial oncology practitioners representing 134 unique institutions were trained during 10 in-person 8-hour workshops (2015-2019). Functions and forms of Bright IDEAS were identified, and adaptations made to the training agenda and curriculum based on practitioner feedback following implementation in local institutions. Mixed method evaluation included longitudinal surveys at 6- and 12-months post training; and qualitative interviews among a subgroup of practitioners (N = 47) to understand and compare perspectives on intervention adoption and barriers to implementation before and after adaptations to the Bright IDEAS training program. The RE-AIM framework was used to guide dissemination evaluation. Results A total of four adaptations were tailored to the identified forms of the intervention: case studies; pre-training reading materials; training videos; and letters of institutional support from primary supervisor. Pre- and post-training adaptations to the Bright IDEAS training program were mapped to RE-AIM constructs. Quantitative findings demonstrate that adaptations appeared to improve adoption and usage overall. Conclusion This study provides insight into how contextual factors influence psychosocial practitioners' capacity to adopt, implement, and maintain Bright IDEAS in the clinical setting. This study demonstrates the use of real-time stakeholder feedback to guide intervention translation from research to practice settings.
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Affiliation(s)
- Demetria M. McNeal
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Olle Jane Z. Sahler
- Division of Pediatric Hematology/Oncology, University of Rochester School of Medicine and Dentistry, Golisano Children's Hospital, Rochester, NY, United States
| | - Robert B. Noll
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Diane L. Fairclough
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Megan E. Voll
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shubha Bhat
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Elaine H. Morrato
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, United States
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4
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Psychosocial Intervention Programs for Parents of Children with Cancer: A Systematic Review and Critical Comparison of Programs’ Models and Development. J Clin Psychol Med Settings 2019; 26:550-574. [DOI: 10.1007/s10880-019-09612-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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5
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Ogez D, Bourque CJ, Péloquin K, Ribeiro R, Bertout L, Curnier D, Drouin S, Laverdière C, Marcil V, Rondeau É, Sinnett D, Sultan S. Definition and improvement of the concept and tools of a psychosocial intervention program for parents in pediatric oncology: a mixed-methods feasibility study conducted with parents and healthcare professionals. Pilot Feasibility Stud 2019; 5:20. [PMID: 30774970 PMCID: PMC6366012 DOI: 10.1186/s40814-019-0407-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 01/24/2019] [Indexed: 12/17/2022] Open
Abstract
Background Studies have shown that supporting parents in pediatric oncology reduces family distress following a cancer diagnosis. Manualized programs for parents have therefore been developed to reduce family distress. However, these programs have limitations that need to be improved, such as better defining programs’ procedures, developing interventions focusing on parents’ conjugal relationship, conducting rigorous evaluations of implementation, and proposing adaptations to various cultural dimensions. According to the Obesity-Related Behavioral Intervention Trials (ORBIT) model for the development of behavioral intervention, we improved these limitations and developed TAKING BACK CONTROL TOGETHER, a six in-person intervention sessions to support parents of children with cancer by taking the active components of two programs: Bright IDEAS and SCCIP. Referring to the redesign phase of the ORBIT model, this study aims to refine the definition of this program’s design by interviewing parents and healthcare professionals. Methods In order to refine the program, we used a sequential mixed-methods study. Parents and healthcare professionals first completed questionnaires assessing the program, and then discussed its limitations, benefits, and areas for improvement in group and/or individual interviews. We performed a descriptive thematic content analysis of the qualitative data from the open-ended questions (questionnaires and interviews) with NVivo 11 to categorize recommendations for the program refinement. Results The results showed that components seemed pertinent to final users. The main areas needing improvement were the level of complexity and understandability of the parent manual, the possibility to choose the place and time of the intervention, and the lack of ethnic/cultural diversity. Changes to the program were made accordingly. Conclusions It is necessary to include end-users when developing complex intervention programs designed for vulnerable populations and sensitive clinical contexts. Following the present refinement, we now have a treatment package, which is safe and acceptable for the target population and has a better chance of yielding a clinically significant benefit for users in a future pilot study.
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Affiliation(s)
- David Ogez
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,2Department of Psychology, Université de Montréal, Québec, Canada
| | - Claude-Julie Bourque
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,3Department of Pediatrics, Université de Montréal, Québec, Canada
| | | | - Rebeca Ribeiro
- 2Department of Psychology, Université de Montréal, Québec, Canada
| | - Laurence Bertout
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada
| | - Daniel Curnier
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,4Department of Kinesiology, Université de Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,3Department of Pediatrics, Université de Montréal, Québec, Canada
| | - Valérie Marcil
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,5Department of Nutrition, Université de Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,3Department of Pediatrics, Université de Montréal, Québec, Canada
| | - Serge Sultan
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,2Department of Psychology, Université de Montréal, Québec, Canada.,3Department of Pediatrics, Université de Montréal, Québec, Canada
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6
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Shin JY, Kang TI, Noll RB, Choi SW. Supporting Caregivers of Patients With Cancer: A Summary of Technology-Mediated Interventions and Future Directions. Am Soc Clin Oncol Educ Book 2018; 38:838-849. [PMID: 30231412 DOI: 10.1200/edbk_201397] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This paper aims to review literature published on the support of cancer caregivers with health technology. Eighteen articles were reviewed to better understand cancer caregiving and categorized into four different themes: (1) design guidelines, (2) information facilitation, (3) social support, and (4) multicomponent interventions. Analysis of the current articles revealed that there are substantial gaps in knowledge regarding a range of health technologies that facilitate family caregiver support and its distribution to health institutions. Further research is needed in this area, as family caregivers are primary providers of essential elements of care to patients. Future studies should unpack existing barriers that interfere with the development of health technology interventions in cancer care.
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Affiliation(s)
- Ji Youn Shin
- From the University of Michigan, Ann Arbor, MI; Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Tammy I Kang
- From the University of Michigan, Ann Arbor, MI; Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Robert B Noll
- From the University of Michigan, Ann Arbor, MI; Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Sung Won Choi
- From the University of Michigan, Ann Arbor, MI; Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Children's Hospital of Pittsburgh, Pittsburgh, PA
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7
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Kichler JC, Seid M, Crandell J, Maahs DM, Bishop FK, Driscoll KA, Standiford D, Hunter CM, Mayer-Davis E. The Flexible Lifestyle Empowering Change (FLEX) intervention for self-management in adolescents with type 1 diabetes: Trial design and baseline characteristics. Contemp Clin Trials 2018; 66:64-73. [PMID: 29277316 PMCID: PMC5828911 DOI: 10.1016/j.cct.2017.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/15/2017] [Accepted: 12/20/2017] [Indexed: 11/24/2022]
Abstract
The Flexible Lifestyle Empowering Change (FLEX) Intervention Study is a multi-site randomized controlled trial to test the efficacy of an adaptive behavioral intervention to promote self-management for youth with type 1 diabetes mellitus (T1D). This paper details FLEX design, demographic characteristics of the sample, and outcome variables at baseline. Participants were randomized to either an intervention or control arm after their baseline standardized measurement visit. Baseline data for the primary (glycemic levels) and secondary outcome variables (e.g., motivation and problem-solving, health-related quality of life, risk factors associated with T1D complications) as well as the potential mediator variables (e.g., self-management behavior, family conflict and responsibility) suggest that the study sample was representative of the general population of adolescents with T1D and their parents. The FLEX adaptive intervention is an innovative application of a tailored treatment intervention designed to be readily adopted in real-world practice to meet each adolescent's individualized T1D self-management goals.
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Affiliation(s)
- Jessica C Kichler
- Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical School, United States.
| | - Michael Seid
- Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical School, United States
| | - Jamie Crandell
- Department of Nutrition, University of North Carolina, United States
| | - David M Maahs
- Department of Pediatrics, School of Medicine, Stanford University, United States
| | - Franziska K Bishop
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, United States
| | - Kimberly A Driscoll
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, United States
| | - Debra Standiford
- Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical School, United States
| | - Christine M Hunter
- National Institute of Diabetes and Digestive and Kidney Diseases, United States
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8
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Lamanna J, Bitsko M, Stern M. Effects of a brief problem-solving intervention for parents of children with cancer. CHILDRENS HEALTH CARE 2017. [DOI: 10.1080/02739615.2016.1275638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jennifer Lamanna
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Matthew Bitsko
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
- Division of Pediatric Hematology/Oncology, Children’s Hospital of Richmond, Richmond, VA
| | - Marilyn Stern
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
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9
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Molzon ES, Mullins LL, Cushing CC, Chaney JM, McNall R, Mayes S. The relationship between barriers to care, caregiver distress, and child health-related quality of life in caregivers of children with cancer: A structural equation modeling approach. CHILDRENS HEALTH CARE 2017. [DOI: 10.1080/02739615.2016.1275639] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Larry L. Mullins
- Department of Psychology, Oklahoma State University, Stillwater, OK
| | | | - John M. Chaney
- Department of Psychology, Oklahoma State University, Stillwater, OK
| | - Rene McNall
- Department of Hematology/Oncology, University of Oklahoma Health Sciences Center, Jimmy Everest Center for Cancer and Blood Disorders in Children, Oklahoma City, OK
| | - Sunnye Mayes
- Department of Hematology/Oncology, University of Oklahoma Health Sciences Center, Jimmy Everest Center for Cancer and Blood Disorders in Children, Oklahoma City, OK
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10
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Mayer-Davis EJ, Seid M, Crandell J, Dolan L, Lagarde WH, Letourneau L, Maahs DM, Marcovina S, Nachreiner J, Standiford D, Thomas J, Wysocki T. Flexible Lifestyles for Youth (FL3X) behavioural intervention for at-risk adolescents with Type 1 diabetes: a randomized pilot and feasibility trial. Diabet Med 2015; 32:829-33. [PMID: 25424501 PMCID: PMC4437823 DOI: 10.1111/dme.12641] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2014] [Indexed: 12/20/2022]
Abstract
AIM To determine the potential effect sizes for the Flexible Lifestyle for Youth (FL3X) behavioural intervention to improve glycaemic control (HbA(1c)) and quality of life for at-risk adolescents with Type 1 diabetes. METHODS Participants [n = 61; age 12-16 years, HbA(1c) 64-119 mmol/mol (8-13%)] were randomized to FL3X (minimum three sessions) or usual care. Effect sizes (Cohen's d), comparing the mean difference between the groups, were calculated. RESULTS Study retention (95%), attendance at intervention sessions (87% attended all three sessions) and acceptability were high (100% of the adolescents and 91% of parents would recommend the programme to others). Overall, 41% of participants in the intervention group and 24% of participants in the control group were 'responders' [HbA(1c) decreased by > 6 mmol/mol (0.5%); d = 0.37]. HbA(1c) levels decreased (d = -0.18), diabetes-specific quality of life increased (d = 0.29), but generic quality of life decreased (d = -0.23) in the intervention compared with the control group. CONCLUSIONS The FL3X programme merits further study for improving HbA(1c) and diabetes-specific quality of life in adolescents with Type 1 diabetes. (Clinical trials registry no.: NCT01286350).
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Affiliation(s)
- E J Mayer-Davis
- Department of Nutrition and Department of Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - M Seid
- Division of Pulmonary Medicine and Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J Crandell
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - L Dolan
- Division of Pediatric Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - W H Lagarde
- Children's Endocrinology and Diabetes, WakeMed Children's Hospital, Raleigh, NC, USA
| | - L Letourneau
- Department of Nutrition, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - D M Maahs
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO, USA
| | - S Marcovina
- Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, WA, USA
| | - J Nachreiner
- Department of Nutrition, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - D Standiford
- Division of Pediatric Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J Thomas
- Department of Nutrition, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - T Wysocki
- Department of Research, Nemours Children's Clinic, Jacksonville, FL, USA
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11
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Fedele DA, Hullmann SE, Chaffin M, Kenner C, Fisher MJ, Kirk K, Eddington AR, Phipps S, McNall-Knapp RY, Mullins LL. Impact of a parent-based interdisciplinary intervention for mothers on adjustment in children newly diagnosed with cancer. J Pediatr Psychol 2013; 38:531-40. [PMID: 23471362 DOI: 10.1093/jpepsy/jst010] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To determine if maternal distress predicts child adjustment outcomes or if child adjustment outcomes predict maternal distress among children newly diagnosed with cancer, and if a parent-focused intervention has downstream effects on child adjustment. METHODS Mothers (n = 52) were randomly assigned to a clinic-based, interdisciplinary intervention for parents of children newly diagnosed with cancer. Measures of maternal distress and child adjustment were collected at baseline, posttreatment, and follow-up. RESULTS A lagged relationship was identified between maternal distress and child internalizing symptoms, but not externalizing symptoms. The parent intervention reduced child internalizing and externalizing symptoms at follow-up. Only the child internalizing symptoms effect was mediated by reduced maternal distress. The child externalizing symptoms effect was mediated by unobserved parent factors. CONCLUSIONS This study provides support for illness adjustment and coping models that emphasize the role of parent factors in driving child adjustment outcomes and is encouraging for future parent-focused intervention research.
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Affiliation(s)
- David A Fedele
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
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12
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Sahler OJZ, Dolgin MJ, Phipps S, Fairclough DL, Askins MA, Katz ER, Noll RB, Butler RW. Specificity of problem-solving skills training in mothers of children newly diagnosed with cancer: results of a multisite randomized clinical trial. J Clin Oncol 2013; 31:1329-35. [PMID: 23358975 DOI: 10.1200/jco.2011.39.1870] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Diagnosis of cancer in a child can be extremely stressful for parents. Bright IDEAS, a problem-solving skills training (PSST) intervention, has been shown to decrease negative affectivity (anxiety, depression, post-traumatic stress symptoms) in mothers of newly diagnosed patients. This study was designed to determine the specificity of PSST by examining its direct and indirect (eg, social support) effects compared with a nondirective support (NDS) intervention. PATIENTS AND METHODS This randomized clinical trial included 309 English- or Spanish-speaking mothers of children diagnosed 2 to 16 weeks before recruitment. Participants completed assessments prerandomization (T1), immediately postintervention (T2), and at 3-month follow-up (T3). Both PSST and NDS consisted of eight weekly 1-hour individual sessions. Outcomes included measures of problem-solving skill and negative affectivity. RESULTS There were no significant between-group differences at baseline (T1). Except for level of problem-solving skill, which was directly taught in the PSST arm, outcome measures improved equally in both groups immediately postintervention (T2). However, at the 3-month follow-up (T3), mothers in the PSST group continued to show significant improvements in mood, anxiety, and post-traumatic stress; mothers in the NDS group showed no further significant gains. CONCLUSION PSST is an effective and specific intervention whose beneficial effects continue to grow after the intervention ends. In contrast, NDS is an effective intervention while it is being administered, but its benefits plateau when active support is removed. Therefore, teaching coping skills at diagnosis has the potential to facilitate family resilience over the entire course of treatment.
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13
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Abstract
BACKGROUND While guidelines recommend that children with asthma should receive asthma education, it is not known if education delivered in the home is superior to usual care or the same education delivered elsewhere. The home setting allows educators to reach populations (such as the economically disadvantaged) that may experience barriers to care (such as lack of transportation) within a familiar environment. OBJECTIVES To perform a systematic review on educational interventions for asthma delivered in the home to children, caregivers or both, and to determine the effects of such interventions on asthma-related health outcomes. We also planned to make the education interventions accessible to readers by summarising the content and components. SEARCH STRATEGY We searched the Cochrane Airways Group Specialised Register of trials, which includes the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED and PsycINFO, and handsearched respiratory journals and meeting abstracts. We also searched the Education Resources Information Center database (ERIC), reference lists of trials and review articles (last search January 2011). SELECTION CRITERIA We included randomised controlled trials of asthma education delivered in the home to children, their caregivers or both. In the first comparison, eligible control groups were provided usual care or the same education delivered outside of the home. For the second comparison, control groups received a less intensive educational intervention delivered in the home. DATA COLLECTION AND ANALYSIS Two authors independently selected the trials, assessed trial quality and extracted the data. We contacted study authors for additional information. We pooled dichotomous data with fixed-effect odds ratio and continuous data with mean difference (MD) using a fixed-effect where possible. MAIN RESULTS A total of 12 studies involving 2342 children were included. Eleven out of 12 trials were conducted in North America, within urban or suburban settings involving vulnerable populations. The studies were overall of good methodological quality. They differed markedly in terms of age, severity of asthma, context and content of the educational intervention leading to substantial clinical heterogeneity. Due to this clinical heterogeneity, we did not pool results for our primary outcome, the number of patients with exacerbations requiring emergency department (ED) visit. The mean number of exacerbations requiring ED visits per person at six months was not significantly different between the home-based intervention and control groups (N = 2 studies; MD 0.04; 95% confidence interval (CI) -0.20 to 0.27). Only one trial contributed to our other primary outcome, exacerbations requiring a course of oral corticosteroids. Hospital admissions also demonstrated wide variation between trials with significant changes in some trials in both directions. Quality of life improved in both education and control groups over time.A table summarising some of the key components of the education programmes is included in the review. AUTHORS' CONCLUSIONS We found inconsistent evidence for home-based asthma educational interventions compared to standard care, education delivered outside of the home or a less intensive educational intervention delivered at home. Although education remains a key component of managing asthma in children, advocated in numerous guidelines, this review does not contribute further information on the fundamental content and optimum setting for such educational interventions.
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Affiliation(s)
- Emma J Welsh
- St George's, University of LondonPopulation Health Research InstituteCranmer TerraceLondonUKSW17 0RE
| | | | - Patricia Li
- Montreal Children's Hospital, McGill University Health CentreDepartment of PediatricsMontrealQCCanada
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Othman A, Mohamad N, Hussin ZA, Blunden S. Psychological Distress and Associated Factors in Parents of Children with Cancer. ACTA ACUST UNITED AC 2011. [DOI: 10.7763/ijssh.2011.v1.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Seid M, Varni JW, Gidwani P, Gelhard LR, Slymen DJ. Problem-solving skills training for vulnerable families of children with persistent asthma: report of a randomized trial on health-related quality of life outcomes. J Pediatr Psychol 2010; 35:1133-43. [PMID: 20061311 DOI: 10.1093/jpepsy/jsp133] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To test the efficacy of problem-solving skill training (PST) in improving health-related quality of life (HRQOL) of children with persistent asthma from predominantly lower socioeconomic status (SES) Spanish-speaking Hispanic families. METHODS Randomized controlled trial comparing standard care waitlist (SC) control, home-visiting asthma education/care coordination (CC), and combined intervention (CC + PST) at baseline, after intervention, and 6-month follow-up. The primary outcome was parent proxy-report child HRQOL (PedsQL). RESULTS Participants (n = 252) were 83.3% Hispanic and 56.3% monolingual Spanish speakers, and 72.6% of mothers had not graduated high school. We found a significant (P = 0.05) intervention effect for parent proxy-reported child generic (but not asthma-specific) HRQOL, with CC + PST superior to SC [83.8 vs 79.8; adjusted mean difference of 4.05 points (95% confidence interval 0.63-7.4], but no difference between the CC and SC groups. CONCLUSIONS In this sample of vulnerable families of children with persistent asthma, a CC + PST intervention was efficacious in improving children's generic HRQOL.
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Affiliation(s)
- Michael Seid
- Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, USA.
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Gannoni AF, Shute RH. Parental and child perspectives on adaptation to childhood chronic illness: a qualitative study. Clin Child Psychol Psychiatry 2010; 15:39-53. [PMID: 19914942 DOI: 10.1177/1359104509338432] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This qualitative study aimed to gain an in-depth understanding of the adaptation of children and families to childhood chronic illness. Considering ecological theories and child empowerment, we departed from the usual practice of relying solely on parental report by also soliciting children's views. Eighteen children aged 7-14 with cancer, chronic renal failure or type 1 diabetes, and 21 of their parents, participated. The inclusion of several conditions enabled the examination of data from a categorical versus non-categorical perspective. Focus groups supplemented by individual interviews explored participants' views about challenges and the processes they considered important in enhancing adaptation to a chronic illness. Children, as well as parents, provided rich material. Thematic analysis revealed 11 main themes. Six concerned the impact of the illness on various aspects of life. The other main themes were the meaning of disease, stress-processing, social support, future concerns and psychosocial interventions. There were many similarities and some differences between parent and child reports. Many issues were common across illness groups, consistent with a non-categorical approach, though there were some illness-specific issues, especially for those with cancer. Positive as well as negative material emerged. Implications for clinical services are discussed.
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Affiliation(s)
- Anne F Gannoni
- Children, Youth and Women's Health Service, Adelaide, South Australia.
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Askins MA, Sahler OJZ, Sherman SA, Fairclough DL, Butler RW, Katz ER, Dolgin MJ, Varni JW, Noll RB, Phipps S. Report from a multi-institutional randomized clinical trial examining computer-assisted problem-solving skills training for English- and Spanish-speaking mothers of children with newly diagnosed cancer. J Pediatr Psychol 2008; 34:551-63. [PMID: 19091804 DOI: 10.1093/jpepsy/jsn124] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To evaluate the feasibility and efficacy of a handheld personal digital assistant (PDA)-based supplement for maternal Problem-Solving Skills Training (PSST) and to explore Spanish-speaking mothers' experiences with it. METHODS Mothers (n = 197) of children with newly diagnosed cancer were randomized to traditional PSST or PSST + PDA 8-week programs. Participants completed the Social Problem-Solving Inventory-Revised, Beck Depression Inventory-II, Profile of Mood States, and Impact of Event Scale-Revised pre-, post-treatment, and 3 months after completion of the intervention. Mothers also rated optimism, logic, and confidence in the intervention and technology. RESULTS Both groups demonstrated significant positive change over time on all psychosocial measures. No between-group differences emerged. Despite technological "glitches," mothers expressed moderately high optimism, appreciation for logic, and confidence in both interventions and rated the PDA-based program favorably. Technology appealed to all Spanish-speaking mothers, with younger mothers showing greater proficiency. CONCLUSIONS Well-designed, supported technology holds promise for enhancing psychological interventions.
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Affiliation(s)
- Martha A Askins
- Department of Pediatrics, Unit 87, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030-4009, USA.
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Kars MC, Duijnstee MSH, Pool A, van Delden JJM, Grypdonck MHF. Being there: parenting the child with acute lymphoblastic leukaemia. J Clin Nurs 2008; 17:1553-62. [PMID: 18482117 DOI: 10.1111/j.1365-2702.2007.02235.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To gain insight into the lived experience of parenting a child with leukaemia during treatment. BACKGROUND Diagnosis of leukaemia in children leads to an existential shock for parents and a reversal of normal family life. Today, in the Netherlands, after diagnosis, children stay at home most of the time. Therefore, their parents face considerable responsibilities for administering home-based treatment and for the support of their child during illness and treatment. METHODS A grounded theory study was undertaken at a Dutch University Hospital and involved one-time individual in-depth interviews with 12 mothers and 11 fathers (n = 23) of 12 children. FINDINGS 'Being there', was identified as the core concept. It means: 'I'll be there for you; I will never let you down'. 'Being there' is described as a parental response to the perceived vulnerability of the child and the parental need to give meaning to parenthood. It serves two purposes: protection and preservation. Protection means guarding the child against the negative aspects of illness and treatment. Preservation refers to the way parents influence the child's perception of his/her life, thus contributing to his/her coping and willingness to undergo treatment, to maximise the chances for survival. Six aspects were identified: a trusting relationship, presence, emotional support, advocacy, routines and rituals and effacing oneself. CONCLUSIONS The concept provides a theoretical frame for parenting the child with cancer. It clarifies the actions and reactions of parents and increases insight into the underlying force that enables parents to provide continuing care despite their personal burden. RELEVANCE TO CLINICAL PRACTICE The concept offers an essential insight into parenting the child with acute lymphoblastic leukaemia and has relevance for nursing practice and education. Understanding of the concept would improve the ability to understand, communicate and work pro-actively in partnership with parents.
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Affiliation(s)
- Marijke C Kars
- University Medical Centre Utrecht, Julius Centre for Health Sciences and Primary Care, Department Nursing Science, Utrecht, The Netherlands.
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Abstract
Psychosocial research examining the impact of cancer on adolescents and young adults has focused mostly on domains relating to family, psychological/emotional impact and social effects. An overview of the evidence-based literature available in each of these domains is presented to highlight the trends and provide a basis for clinical application. A review of the research literature was conducted to summarize what is known regarding the psychosocial dimensions of cancer in adolescents and young adults. Key elements critical to the psychosocial adaptation of the adolescents and young adults with cancer, as well as later effects of the cancer experience, are discussed in terms of clinical implications. A case example is utilized to demonstrate the application of what has been investigated empirically in regard to psychosocial dimensions of cancer in young adults and adolescents. Studies have identified various psychosocial challenges that adolescents and young adults experience when faced with cancer. Further research, incorporating the effects of treatment stage and developmental level of the patient on specific psychosocial dimensions of the cancer experience, is needed. Evidence-based information regarding the influence and interaction of family, psychological and emotional state, and social status of adolescents and young adults with cancer can aid clinicians when developing psychosocial assessment and treatment approaches for these patients.
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Affiliation(s)
- Elana E Evan
- Department of Pediatrics, David Geffen School of Medicine at the University of California, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California, USA.
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Hawes S, Malcarne V, Ko C, Sadler G, Banthuia R, Sherman S, Varni J, Schmidt J. Identifying problems faced by spouses and partners of patients with prostate cancer. Oncol Nurs Forum 2006; 33:807-14. [PMID: 16858462 DOI: 10.1188/06.onf.807-814] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe problems chosen as targets of problem-solving therapy by spouses and partners of patients with prostate cancer. DESIGN Descriptive, cross-sectional. SETTING Spouses' and partners' homes. SAMPLE Spouses and partners (N = 66) aged 32-79 years (mean = 60 years). The sample was predominantly Caucasian (82%) and African American (8%). METHODS As part of a randomized clinical trial, women received problem-solving therapy to help manage issues related to their husbands' or partners' prostate cancer. The issues they chose to address during therapy and the categorization of the issues fell into four groups: treatment and side-effect issues, patient issues, family issues, and spouse issues. Scores on the Social Problem-Solving Inventory-Revised, which measures everyday problem-solving skills, and the Profile of Mood States, which measures mood disturbance, were contrasted with the problems women chose to address. MAIN RESEARCH VARIABLES Problems faced by spouses and partners of patients with prostate cancer. FINDINGS The most frequently reported categories were spouse issues (e.g., women's emotional wellness, balancing their medical concerns with their husbands' condition) and patient issues (e.g., men's lack of communication, fear, or depression). CONCLUSIONS Findings of this study alert nurses to a variety of key problem areas for spouses and partners of patients with prostate cancer. IMPLICATIONS FOR NURSING Spouses and partners play a critical role when their loved ones have cancer. Understanding the problems spouses and partners face can help nurses design optimal supportive care interventions.
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Affiliation(s)
- Starlyn Hawes
- Rebecca and John Moores University of California, San Diego (UCSD), Cancer Center, USA
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Sahler OJZ, Fairclough DL, Phipps S, Mulhern RK, Dolgin MJ, Noll RB, Katz ER, Varni JW, Copeland DR, Butler RW. Using problem-solving skills training to reduce negative affectivity in mothers of children with newly diagnosed cancer: report of a multisite randomized trial. J Consult Clin Psychol 2005; 73:272-83. [PMID: 15796635 DOI: 10.1037/0022-006x.73.2.272] [Citation(s) in RCA: 173] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mothers of children with cancer experience significant distress associated with their children's diagnosis and treatment. The efficacy of problem-solving skills training (PSST), a cognitive-behavioral intervention based on problem-solving therapy, was assessed among 430 English- and Spanish-speaking mothers of recently diagnosed patients. Participants were randomized to usual psychosocial care (UPC; n=213) or UPC plus 8 sessions of PSST (PSST; n=217). Compared with UPC mothers, PSST mothers reported significantly enhanced problem-solving skills and significantly decreased negative affectivity. Although effects were largest immediately after PSST, several differences in problem-solving skills and distress levels persisted to the 3-month follow-up. In general, efficacy for Spanish-speaking mothers exceeded that for English-speaking mothers. Findings also suggest young, single mothers profit most from PSST.
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Affiliation(s)
- Olle Jane Z Sahler
- Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, NY 14642, USA.
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Affiliation(s)
- D Caprino
- Department of Pediatric Hematology and Oncology, G. Gaslini Scientific Children's Hospital, Genoa, Italy.
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Sahler OJZ, Varni JW, Fairclough DL, Butler RW, Noll RB, Dolgin MJ, Phipps S, Copeland DR, Katz ER, Mulhern RK. Problem-solving skills training for mothers of children with newly diagnosed cancer: a randomized trial. J Dev Behav Pediatr 2002; 23:77-86. [PMID: 11943969 DOI: 10.1097/00004703-200204000-00003] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mothers of children with serious illnesses have lower levels of well-being than mothers in the general population. Problem-solving therapy (PST), a cognitive-behavioral intervention, has been shown to be effective in treating negative affectivity (depression, anxiety) and other manifestations of reduced well-being. This report describes a problem-solving skills training (PSST) intervention, based on problem-solving therapy, for mothers of newly diagnosed pediatric cancer patients. Ninety-two mothers were randomly assigned to receive PSST or to receive standard psychosocial care (Control Group). After the 8-week intervention, mothers in the PSST Group had significantly enhanced problem-solving skills and significantly decreased negative affectivity compared with controls. Analysis revealed that changes in self-reports of problem-solving behaviors accounted for 40% of the difference in mood scores between the two groups. Interestingly, PSST had the greatest impact on improving constructive problem solving, whereas improvement in mood was most influenced by decreases in dysfunctional problem solving. The implications of these findings for refinement of the PSST intervention and for extension to other groups of children with serious illnesses are discussed.
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Affiliation(s)
- Olle Jane Z Sahler
- Division of Hematology/Oncology, Strong Children's Hospital/University of Rochester Medical Center, New York 14642, USA.
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Bucher JA, Loscalzo M, Zabora J, Houts PS, Hooker C, BrintzenhofeSzoc K. Problem-solving cancer care education for patients and caregivers. CANCER PRACTICE 2001; 9:66-70. [PMID: 11879281 DOI: 10.1046/j.1523-5394.2001.009002066.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE A program evaluation was conducted to explore the potential effects of a 90-minute problem-solving education session for persons with advanced cancer and their families. DESCRIPTION OF PROGRAM Patients with advanced cancer and their families, who were visiting a tertiary-care outpatient setting, were invited to attend a 90-minute individualized educational session that taught basic problem-solving principles using a cognitive-behavioral framework. Pre-education and posteducation data were collected about the confidence of participants in providing care, their feelings about being informed about resources, and their perceptions of their problem-solving ability. RESULTS At baseline, most participants reported low confidence about their ability to provide cancer care and felt uninformed about community resources, but they viewed themselves as moderate-to-good problem solvers. Forty-two educational sessions were delivered to 49 caregivers and 40 patients. Two months later, participants reported feeling more informed about community resources and achieved higher posteducation scores for problem-solving ability. More caregivers than patients reported that reading The Home Care Guide for Cancer made a great deal of difference in their approach to home care. CLINICAL IMPLICATIONS Most educational sessions for families affected by cancer focus on delivering information, not on building skills. These findings suggest that a one-on-one educational session that teaches problem-solving skills can be successfully delivered in a busy clinic setting. Family caregivers are especially likely to benefit from this program.
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Affiliation(s)
- J A Bucher
- Bloomsburg University, Bloomsburg, Pennsylvania, USA
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Katz ER. Problem solving skills training in pediatric oncology nurses: mediating the stress-response sequence. J Pediatr Oncol Nurs 2000; 17:76-7. [PMID: 10810831 DOI: 10.1177/104345420001700206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- E R Katz
- Behavioral Sciences Section, Children's Hospital, Los Angeles, CA, USA.
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