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Boensvang NN, Weibel M, Wakefield CE, Bidstrup PE, Olsen M, Nissen KB, Spager V, Fridh MK, Larsen HB. Online Ambassador Visits for Hospitalized Children With Cancer: Qualitative Evaluation of Implementation. JMIR Pediatr Parent 2024; 7:e53309. [PMID: 39231427 DOI: 10.2196/53309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 05/30/2024] [Accepted: 06/12/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Children with cancer or cancer-like disease risk treatment-related isolation, which can negatively impact their peer relationships and social competencies and exacerbate their loneliness. During the COVID-19 pandemic, increased online socialization became the new normal imposed by national isolation guidelines. To adhere to the treatment-related isolation guidelines, children with cancer were offered online classmate "ambassador" visits during hospitalization. OBJECTIVE This study aimed to identify facilitators and barriers to online classmate "ambassador" visits during children with cancer's hospitalization through a qualitative descriptive process evaluation using the Consolidated Framework for Implementation Research. METHODS From January to April 2022, we conducted 39 individual semistructured interviews with hospitalized children (n=16), their classmates (n=16), teachers from their schools (n=3), and study nurses (n=4) from involved hospitals. Most interviews (n=37, 95%) were conducted online using Microsoft Teams or Google Meet, while 2 (5%) interviews were conducted in person at the participants' residences. This approach allowed us to gain a broad understanding of the facilitators and barriers to online ambassador visits. RESULTS We identified four themes: (1) working together, (2) ensuring participation, (3) staying connected, and (4) together online. The themes are described in terms of facilitators and barriers to online ambassador visits with 3 Consolidated Framework for Implementation Research domains: innovation, individuals, and the implementation process. CONCLUSIONS Addressing the social needs of hospitalized children through online visits with their classmates may be relevant when one-on-one meetings are problematic. The online visits are highly dependent on collaboration between study nurses and teachers and assessing the needs of the hospitalized children. While a high degree of adult engagement and a stable internet connection are pivotal, these online visits can promote much-needed social interaction between children across physical settings.
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Affiliation(s)
- Natasha Nybro Boensvang
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
| | - Mette Weibel
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
| | - Claire E Wakefield
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- School for Women's and Children's Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Marianne Olsen
- Department of Paediatrics and Adolescent Medicine, Paediatric Haematology and Oncology Section, University Hospital Aalborg, Aalborg, Denmark
| | - Karin Bækgaard Nissen
- Department of Paediatric and Adolescent Medicine, University Hospital Aarhus, Aarhus, Denmark
| | - Vibeke Spager
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark
- The Paediatric Clinic, Juliane Marie Centre, University Hospital of Copenhagen, Copenhagen, Denmark
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Wang MJ, Dzifa KL, Lei J, Kan X, Zhang RX. The experiences of children and adolescents with cancer returning to school: A qualitative meta-synthesis. J Pediatr Nurs 2024; 76:140-149. [PMID: 38402745 DOI: 10.1016/j.pedn.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Returning to school can be challenging for children and adolescents with cancer who have been absent for a long time. As there is little known about the return to school experience of children and adolescents with cancer, this meta-synthesis aimed to describe the experiences of children and adolescent cancer patients as they return to school. METHODS Seven English databases and three Chinese databases were searched from inception to March 14, 2023. The Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to appraise study quality. Data were synthesized using the Thomas and Harden thematic and content analysis method. RESULTS Twelve qualitative studies met the inclusion criteria and were analyzed into meta-synthesis. Data synthesis led to constructing four analytical themes and twelve sub-themes. The four major themes constructed were:benefits to school re-entry, barriers to school re-entry, motivators to school re-entry and the adaptation process after returning to school. CONCLUSION Children and adolescents with cancer were willing to return to education and can adapt to school life over time. But they were faced with challenges, including physical, psychological, and social barriers. Appropriate measures need to be taken to reduce those barriers. IMPLICATIONS TO PRACTICE Findings can be used to inform future research and interventions to support a successful return to education for children and adolescents with cancer. Healthcare providers should address the needs of children and adolescents at different stages and actively work with schools, hospitals and families to help childhood cancer survivors successfully return to school.
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Affiliation(s)
- Meng-Jia Wang
- College of Nursing and health, Zhengzhou University, Zhengzhou, China
| | - Kodzo Lalit Dzifa
- College of Nursing and health, Zhengzhou University, Zhengzhou, China
| | - Jinjin Lei
- College of Nursing and health, Zhengzhou University, Zhengzhou, China
| | - Xiaodi Kan
- College of Nursing and health, Zhengzhou University, Zhengzhou, China
| | - Rui-Xing Zhang
- College of Nursing and health, Zhengzhou University, Zhengzhou, China.
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Spencer BKC, Hugh-Jones S, Cottrell D, Pini S. The INSCHOOL project: Young people with long-term physical health conditions: An in-depth qualitative study of their needs at school. J Adolesc 2024; 96:337-349. [PMID: 38013246 DOI: 10.1002/jad.12278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION The INSCHOOL project aimed to understand the school experiences and unmet needs of young people across a diversity of long-term physical health conditions. METHODS Young people aged 11-18 years, in mainstream secondary school in the United Kingdom, with one of 11 physical health conditions were invited to unique participant-driven interviews, focus groups, or written activities. Creative preparation activities were provided to give participants increased control over the data collection and prioritize their voices. A needs analysis, in combination with participatory analysis sessions with young people, identified the common needs of participants in relation to their school lives. RESULTS Eighty-nine young people participated from April 2022 to 2023. Analysis of their transcripts defined six common needs across all the health conditions: Need to safely manage my health at school; need for a flexible education pathway; need to be acknowledged and listened to in the right way; need to be included in and supported by the school community; need to build toward my future; need to develop attitudes and approaches to help me cope in school. CONCLUSIONS This study has generated new, actionable knowledge by identifying six major needs that young people have in relation to the intersection of their health condition and their school life. This paper shows that a commonalities approach to research and policy development is warranted given the similarities in experiences and needs. The common needs identified in the INSCHOOL project highlight six areas where future interventions could be targeted to begin making meaningful changes for all young people with long-term health conditions.
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Affiliation(s)
| | | | - David Cottrell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Simon Pini
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Spencer BKC, Wright J, Flemming K, Cottrell D, Pini S. School lives of adolescent school students living with chronic physical health conditions: a qualitative evidence synthesis. Arch Dis Child 2023; 108:225-229. [PMID: 36460338 PMCID: PMC9985755 DOI: 10.1136/archdischild-2022-324874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/11/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Assess the existing evidence base in order to synthesise the current qualitative findings for the impact of chronic health conditions on the school lives of young people. DESIGN Qualitative evidence synthesis using thematic synthesis. PATIENTS Young people aged 11-18 years with a chronic health condition from one of the following groups: oncology, cystic fibrosis, diabetes, asthma, rheumatology, neuromuscular, colorectal, chronic pain, allergies and dermatology. OUTCOME MEASURE Qualitative findings and discussions present in included studies formed the data for the thematic synthesis. RESULTS From a search identifying 19 311 records, a sample of 35 papers were included. The included papers represented 15 countries and primarily employed interviews as part of data collection. Thematic synthesis resulted in six themes: 'keeping up/catching up/missing out/looking forward'; 'identity'; 'relationship with peers'; 'normality and difference'; 'autonomy'; 'relationships with staff'. CONCLUSIONS Thematic synthesis highlighted the commonalities, rather than divergence, of issues for young people across different chronic conditions. Policies need to be based on the experiences of the people they aim to provide for, and while attendance and attainment remain important, there is clearly more that needs to be considered when gathering data, designing interventions and developing policies to support this population. It may also be advisable for clinical professionals to include the broader psychosocial aspects of school life in discussions and plans to support young people with long-term conditions. PROSPERO REGISTRATION NUMBER CRD42021278153.
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Affiliation(s)
- Bethan K C Spencer
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - Kate Flemming
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - David Cottrell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - Simon Pini
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
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Hen M. Mothers' and teachers' experience of school re‐entry after a child's prolonged absence due to severe illness. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Meirav Hen
- Department of Psychology Tel‐Hai Academic College Qiryat Shemona Israel
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Magrath CM, Critoph DJ, Smith LAM, Hatcher HM. "A Different Person Entirely": Adolescent and Young Adults' Experiences Returning to Education after Cancer Treatment. J Adolesc Young Adult Oncol 2021; 10:562-572. [PMID: 33689455 DOI: 10.1089/jayao.2020.0168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose: Adolescent and young adults (AYAs) establish their independent, adult identities as part of their psychosocial development, a process that is largely informed by educational experiences. Not only is a cancer diagnosis disruptive to this process but also AYA cancer survivors (AYACs) face barriers as they attempt to reintegrate into educational systems. This study explores the experiences of AYACs as they return to education, to identify these obstacles and the implications for care teams. Methods: In-depth semistructured interviews were conducted with AYACs (n = 8), 16-19 years of age at diagnosis and 18-27 years of age at time of interview. Interviews were transcribed verbatim and analyzed using the principles of Giorgi's phenomenological analysis. Results: Four major themes were identified: AYACs suffer from debilitating late effects (theme 1) post-treatment as they adjust to a loss of normality and other fundamental losses (theme 2) associated with a cancer diagnosis, such as irrecoverable future plans. The educational systems (theme 3) to which they return can be both accommodating, capable of making allowances, and uncompromising, unable to adapt to AYAC survivors' needs. Appropriate mechanisms to facilitate resilience (theme 4) among AYACs are vital for successful return to education. Conclusions: This study supports previous findings that late effects and systemic barriers can hinder return to education, but further research focused on this age group is required. We believe that treating clinicians and specialist services can facilitate the return of AYACs to education by providing warning and comprehensive information about late effects, as early as possible before treatment completion, as well as effective information sharing with educational institutions.
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Affiliation(s)
- Cameron M Magrath
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Deborah J Critoph
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Luke A M Smith
- North West Anglia NHS Foundation Trust, Peterborough, United Kingdom
| | - Helen M Hatcher
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Martinez-Santos AE, Fernandez-De-La-Iglesia JDC, Sheaf G, Coyne I. A systematic review of the educational experiences and needs of children with cancer returning to school. J Adv Nurs 2021; 77:2971-2994. [PMID: 33598984 DOI: 10.1111/jan.14784] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/11/2020] [Accepted: 01/25/2021] [Indexed: 11/28/2022]
Abstract
AIMS To critically review and synthesize empirical studies on childhood cancer survivors' experiences and needs on returning to school after treatment. DESIGN A mixed-method systematic review. DATA SOURCES A search of CINAHL, PsycINFO, EMBASE, MEDLINE, ERIC and Web of Science was conducted for studies published in English, Spanish and Portuguese languages between January 2010 and May 2020. REVIEW METHODS Twenty-one studies were eligible for inclusion (13 qualitative studies, 6 quantitative and 2 mixed-method studies). The quality of the studies was assessed using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. Findings were synthesized using data-based convergent synthesis design. RESULTS Findings were synthesized under four themes: academic continuity and school re-entry; physical and psychological well-being; school life and participation and stakeholders' responses to childhood cancer. Findings indicated that prolonged/recurring absences, physical and mental changes, personal/health factors impacted children's social participation, peer relationships and school re-integration. Factors which contributed to a more positive experience included maintaining contact with peers and teachers throughout treatment, peer relationships, understanding and support from school community. Sharing information about cancer was an ongoing challenging issue for children, that needed to be handled sensitively. CONCLUSION It is evident that re-entry to school was very challenging for most children due to treatment side effects, prolonged absences, disrupted peer relationships, lack of preparation and lack of communication between schools, families and healthcare professionals. IMPACT Despite the growing number of childhood cancer survivors worldwide, there is a deficit of studies about children's re-entry experiences and educational needs. This review illustrates the considerable challenges that children face on school re-entry and the critical importance of better care, support and collaboration from healthcare professionals, parents and school personnel. Nurses could help by raising awareness and leading on preparation for school re-entry.
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Affiliation(s)
- Alba-Elena Martinez-Santos
- Faculty of Education Sciences, University of Santiago de Compostela, Santiago de Compostela, Spain.,Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Greg Sheaf
- The Library of Trinity College Dublin, Trinity College Dublin, Dublin, Ireland
| | - Imelda Coyne
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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8
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Greenblatt A, Saini M. Experiences of adolescents with cancer from diagnosis to post-treatment: a scoping review. SOCIAL WORK IN HEALTH CARE 2019; 58:776-795. [PMID: 31311459 DOI: 10.1080/00981389.2019.1640338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 05/19/2019] [Accepted: 06/27/2019] [Indexed: 06/10/2023]
Abstract
Adolescence is a turbulent time of transition. Facing a serious health issue such as cancer during this time can be challenging and confusing. This study presents a scoping review of 33 research articles including quantitative, qualitative, mixed method, and reviews focused on the experiences of adolescents throughout the cancer journey. Extracted themes across studies identified individual, interpersonal, and environmental aspects of adolescents' experiences in each stage of this trajectory. Implications for these findings are discussed including a need for early diagnosis and treatment of adolescent cancers and developmentally appropriate clinical supports.
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Affiliation(s)
- Andrea Greenblatt
- Factor-Inwentash School of Social Work, University of Toronto , Toronto , Ontario , Canada
| | - Michael Saini
- Factor-Inwentash School of Social Work, University of Toronto , Toronto , Ontario , Canada
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Levin NJ, Zebrack B, Cole SW. Psychosocial issues for adolescent and young adult cancer patients in a global context: A forward-looking approach. Pediatr Blood Cancer 2019; 66:e27789. [PMID: 31058418 PMCID: PMC10599653 DOI: 10.1002/pbc.27789] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 04/12/2019] [Accepted: 04/19/2019] [Indexed: 02/01/2023]
Abstract
The first decade of adolescent and young adult (AYA) oncology psychosocial care and research (2005-2015) was driven by a normative, developmental framework that assumed a generalizable life experience for AYAs that is distinct from both younger children and older adults. As we proceed through a second decade, new considerations emerge regarding diversity of life experiences as occurring within and influenced by a complex global context. The purpose of this paper is to review and provide commentary on the impact of global and contextual conditions on AYAs. We expound upon the effects of precarious labor conditions, changing timetables and priorities for developmental tasks, sexual and gender plurality, and expanding cultural diversity. We discuss the implications of social genomics and technology and social media for enhancing precision psychosocial medicine. To build a forward-looking approach, this paper calls for tailored, multilevel treatments that consider variability of AYAs within the social and global contexts in which they live.
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Affiliation(s)
- Nina Jackson Levin
- School of Social Work and Department of Anthropology, University of Michigan, Ann Arbor, Michigan
| | - Bradley Zebrack
- School of Social Work, University of Michigan, Ann Arbor, Michigan
| | - Steve W. Cole
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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Pini S, Hugh-Jones S, Shearsmith L, Gardner P. ‘What are you crying for? I don't even know you’ – The experiences of teenagers communicating with their peers when returning to school. Eur J Oncol Nurs 2019; 39:28-34. [DOI: 10.1016/j.ejon.2018.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 11/21/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
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Paré‐Blagoev EJ, Ruble K, Bryant C, Jacobson L. Schooling in survivorship: Understanding caregiver challenges when survivors return to school. Psychooncology 2019; 28:847-853. [DOI: 10.1002/pon.5026] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 02/08/2019] [Accepted: 02/09/2019] [Indexed: 12/27/2022]
Affiliation(s)
| | - Kathy Ruble
- Life Clinic and Leukemia Survivorship Program, Sidney Kimmel Cancer Center, Pediatric OncologyJohns Hopkins School of Medicine Baltimore Maryland USA
| | - Camille Bryant
- School of EducationJohns Hopkins University Baltimore Maryland USA
| | - Lisa Jacobson
- Clinical NeuropsychologistKennedy Krieger Institute, Johns Hopkins School of Medicine Baltimore Maryland USA
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Kirk S, Hinton D. "I'm not what I used to be": A qualitative study exploring how young people experience being diagnosed with a chronic illness. Child Care Health Dev 2019; 45:216-226. [PMID: 30652354 DOI: 10.1111/cch.12638] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/06/2018] [Accepted: 12/12/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood long-term conditions are usually diagnosed in infancy or early childhood. Little is known about the particular experiences and needs of young people who receive a chronic illness diagnosis during adolescence or late childhood. This paper will examine this experience in relation to multiple sclerosis (MS), which is increasingly being diagnosed before adulthood. AIMS To explore how young people experience an MS diagnosis. METHODS Qualitative study using a grounded theory approach. In-depth interviews were conducted with 21 young people diagnosed with MS. Participants were recruited through health service and voluntary sector organizations in the United Kingdom. RESULTS Young people's pre-illness normality was disrupted by the diagnosis of a chronic illness (MS). Participants experienced their body as changed physically, cognitively, and emotionally and as changeable due to symptom unpredictability. This influenced how participants perceived and presented their identity, disrupted their relationships, and altered their future biography. Young people developed strategies to manage their condition and identities in order to incorporate MS into their current and future lives, which required continual illness and identity work in response to changing symptoms, social contexts, and relationships. CONCLUSIONS Although young peoples' experience of living with chronic illness has been widely explored, the aftermath of diagnosis has been underresearched from their perspective. This study contributes to this knowledge gap by illuminating how young people experience a chronic illness diagnosis and negotiate the resulting changes to their identity, relationships, and future. The findings suggest that young people need preparation and support in disclosing their diagnosis to others. Professionals supporting young people with long-term conditions need to work closely with specialist mental health services to ensure that they receive appropriate emotional support. Schools have an important role in ensuring young people with long-term conditions achieve their academic potential and receive appropriate careers advice.
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Affiliation(s)
- Susan Kirk
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Denise Hinton
- School of Health Sciences, University of Manchester, Manchester, UK
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13
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Coughtrey AE, Shafran R, Su MT, Allcott-Watson H, Christie D, Hough R. Health Professionals' Perspectives on the Nature of Distress and Low Mood in Young People with Cancer. J Adolesc Young Adult Oncol 2018; 8:190-196. [PMID: 30418093 DOI: 10.1089/jayao.2018.0082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Young people with cancer are at increased risk of depression, yet evidence-based psychological interventions that are tailored to the specific needs of young people with cancer are scarce, and depression in this group may be particularly challenging to recognize and treat. The aims of this study were to (1) explore the views of health professionals in recognizing and treating low mood in young people with cancer and (2) identify the key components of an effective online treatment package for depression in this population. METHODS Eighteen NHS health professionals with a range of professional backgrounds working directly with young people with cancer were interviewed using a semi-structured interview schedule. Responses were analyzed using thematic analysis. RESULTS Five themes emerged: (1) one size doesn't fit all-the nature of depression is complex and varied, and symptoms fluctuate greatly in relation to physical health; (2) distress is completely understandable-it is important not to pathologize a normal reaction; (3) a stepping stone intervention-online interventions may promote engagement with face-to-face therapy; (4) connecting with others-the intervention should promote sharing experiences with others to reduce isolation; and (5) ownership and empowerment-lack of independence may be a cause of distress, and young people should have control of the intervention. CONCLUSION The nature of depression in young people with cancer is complex and multifaceted. Online guided self-help may be useful when added as a component or first step of a treatment package including face-to-face talking therapies.
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Affiliation(s)
- Anna E Coughtrey
- 1 UCL Great Ormond Street Institute of Child Health , London, United Kingdom
| | - Roz Shafran
- 1 UCL Great Ormond Street Institute of Child Health , London, United Kingdom
| | - Merina T Su
- 1 UCL Great Ormond Street Institute of Child Health , London, United Kingdom
| | | | - Deborah Christie
- 2 University College London Hospital NHS Trust , London, United Kingdom
| | - Rachael Hough
- 2 University College London Hospital NHS Trust , London, United Kingdom
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Pini S, Gardner P, Hugh-Jones S. How and Why School Is Important to Teenagers with Cancer: Outcomes from a Photo-Elicitation Study. J Adolesc Young Adult Oncol 2018; 8:157-164. [PMID: 30300045 DOI: 10.1089/jayao.2018.0068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Simon Pini
- The School of Psychology, The University of Leeds , Leeds, England
| | - Peter Gardner
- The School of Psychology, The University of Leeds , Leeds, England
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Chien CH, Chang YY, Huang XY. The Lived Experiences of Adolescents With Cancer: A Phenomenological Study. Clin Nurs Res 2018; 29:217-225. [PMID: 30188183 DOI: 10.1177/1054773818799226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This descriptive phenomenological study was conducted to explore the lived experiences of adolescents with cancer. Purposive sampling was used to recruit participants. In-depth, nonstructured interviews were conducted to collect data, and narratives were analyzed using Colaizzi's seven-step method. Data saturation was achieved after interviewing 16 participants. The study was divided into three main themes and 16 subthemes: suffering (caused by symptoms, therapy, cancer recurrence, the feeling of being trapped in hospital, the burden of food therapy, delayed education, the absence of peer relationships, and limited activities), emotional reactions (fear, worry, sadness, anger, and loneliness), and rebalancing (strong family relationships, optimistic thinking, and healthy lifestyles). While adolescents with cancer experience changes in lifestyle, and physical, psychological, and social burden, they also have positive life experiences. Building appropriate learning systems, improving communication skill, and providing appropriate food therapy may alleviate the psychological burden experienced by young patients.
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Affiliation(s)
- Ching-Hui Chien
- National Taipei University of Nursing and Health Sciences, Taiwan
| | | | - Xuan-Yi Huang
- National Taipei University of Nursing and Health Sciences, Taiwan
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Fardell JE, Wakefield CE, Patterson P, Lum A, Cohn RJ, Pini SA, Sansom-Daly UM. Narrative Review of the Educational, Vocational, and Financial Needs of Adolescents and Young Adults with Cancer: Recommendations for Support and Research. J Adolesc Young Adult Oncol 2018; 7:143-147. [DOI: 10.1089/jayao.2017.0086] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joanna E. Fardell
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Kensington, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Claire E. Wakefield
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Kensington, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Pandora Patterson
- Department of Research, Evaluation and Social Policy, CanTeen Australia, Sydney, Australia
- Cancer Nursing Research Unit, Sydney Nursing School, University of Sydney, Sydney, Australia
| | - Alistair Lum
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Kensington, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Richard J. Cohn
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Kensington, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Simon A. Pini
- Patient Centered Outcomes Research Group, Leeds Institute of Cancer and Pathology, Faculty of Medicine, University of Leeds, Leeds, England
| | - Ursula M. Sansom-Daly
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Sydney, Kensington, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
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17
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Lum A, Donnan B, Wakefield CE, Fardell JE, Marshall GM. Establishing Australian school re-entry service guidelines for children diagnosed with cancer. J Paediatr Child Health 2017; 53:529-533. [PMID: 28497503 DOI: 10.1111/jpc.13563] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/24/2016] [Accepted: 02/17/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Alistair Lum
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Barb Donnan
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Ronald McDonald House Charities, Sydney, New South Wales, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Joanna E Fardell
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Glenn M Marshall
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Affiliation(s)
- Alex King
- Imperial College Healthcare NHS Trust, London, UK
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