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Jin X, Wong CL, Li H, Yao W. 'I cannot accept it' distressing experiences in parents of children diagnosed with cancer: A qualitative study. J Adv Nurs 2024. [PMID: 39104125 DOI: 10.1111/jan.16339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 07/04/2024] [Accepted: 07/08/2024] [Indexed: 08/07/2024]
Abstract
AIMS To explore the distressing experiences of Chinese parents of children with cancer from the perspective of psychological inflexibility. DESIGN A qualitative study using a descriptive qualitative approach based on the model of psychological inflexibility was adopted. METHODS Individual semi-structured interviews through synchronized online video were conducted with 21 Chinese parents of children with cancer from October 2020 to May 2021. Data were analysed using content analysis. RESULTS Four themes and 11 subthemes were identified: (i) immersion in struggling and suffering, (ii) avoidance and suppression, (iii) blaming and complaint and (iv) helplessness and worthlessness. Parents were unwilling to accept the diagnosis and witness their children's suffering, trapped in uncontrollable negative emotions and thoughts. Avoiding emotions and socializing, blaming themselves or complaining of injustice were common. They felt helpless towards life and valueless without the child. CONCLUSION The research findings provide additional perspectives in understanding the distressing experiences in parents of children with cancer. Overall, the emotional and coping styles indicated the lack of psychological flexibility of parents when facing childhood cancer, which is profoundly influenced by Chinese culture. IMPLICATIONS FOR THE PROFESSION Healthcare professionals are recommended to provide culturally sensitive strategies or interventions for building psychological flexibility in addressing parental psychological distress. IMPACT The study provides insights into exploring distressing experiences and reveals the inflexible psychological and behavioural patterns in parents of children with cancer, which could benefit healthcare providers in managing parental psychological distress and helping these parents build flexible coping strategies. REPORTING METHOD The COREQ guideline was followed. PATIENT OR PUBLIC CONTRIBUTION No patient or public involvement.
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Affiliation(s)
- Xiaohuan Jin
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wenying Yao
- Nursing Department, Children's Hospital of Soochow University, Suzhou, China
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Faust C, Auquier P, Bertrand Y, Tabone MD, Ansoborlo S, Baruchel A, Gandemer V, Dalle JH, Chastagner P, Kanold J, Poirée M, Theron A, Plat G, Pellier I, Michel G, Berbis J. Impact of childhood leukemia on siblings: their long-term perception of family functioning and its relationship with their psychosocial characteristics using structural equation modeling. J Cancer Surviv 2024; 18:1403-1415. [PMID: 37162684 DOI: 10.1007/s11764-023-01385-2] [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: 02/06/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE In the context of pediatric cancer, siblings' adaptation and needs have been previously investigated; however, research on the long-term consequences on siblings, especially on their family environment, is scarce. We aimed to (1) assess the family functioning (FF) perceived by siblings of childhood leukemia survivors long after diagnosis and (2) explore characteristics likely associated and investigate associations with psycho-behavioral and social factors. METHODS Childhood leukemia survivors' siblings older than 11 years were recruited through the LEA cohort, a French long-term follow-up program, and completed the family assessment device (FAD). Logistic regression analysis was used to determine factors likely associated with unhealthy functioning in families as perceived by siblings. Structural equation modeling (SEM) was used to examine relationships that predict siblings' perception of FF. RESULTS We included 605 siblings (mean follow-up time from diagnosis 14.1 ± 6.8 years), of whom 175 (28.9%) perceived unhealthy functioning. SEM showed that older siblings were more likely to perceive problematic functioning (β = 0.095, p = 0.014). Sex and leukemia burden had indirect effects on FF through mediators. Family financial situation at diagnosis was not associated with the risk of reporting unhealthy functioning. CONCLUSIONS Our study contributed to identifying siblings at risk of facing family issues and reinforced the need to provide more consideration and suitable resources to avoid late consequences. Often considered as the "forgotten children", future research should focus on developing targeted interventions to facilitate family communication and improve siblings' social support. IMPLICATIONS FOR CANCER SURVIVORS Overall, results regarding FF perceived by siblings are reassuring and provide new enlightening elements that allow for better support to all families.
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Affiliation(s)
- Cindy Faust
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France.
| | - Pascal Auquier
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology-Oncology, University Hospital of Lyon, Lyon, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology-Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology-Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - André Baruchel
- Department of Pediatric Hematology-Oncology, Saint Louis Hospital, AP-HP, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology-Oncology, University Hospital of Rennes, Rennes, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, AP-HP, Paris, France
| | - Pascal Chastagner
- Department of Pediatric Hematology-Oncology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Justyna Kanold
- Department of Pediatric Hematology-Oncology, University Hospital of Clermont-Ferrand, CIC Inserm 501, Clermont-Ferrand, France
| | - Maryline Poirée
- Department of Pediatric Hematology-Oncology, University Hospital of Nice, Nice, France
| | - Alexandre Theron
- Department of Pediatric Hematology-Oncology, University Hospital of Montpellier, Montpellier, France
| | - Geneviève Plat
- Department of Pediatric Hematology-Oncology, University Hospital of Toulouse, Toulouse, France
| | - Isabelle Pellier
- Department of Pediatric Hematology-Oncology, University Hospital of Angers, Angers, France
| | - Gérard Michel
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Pediatric Hematology-Oncology, Timone Children's Hospital and Aix-Marseille University, Marseille, France
| | - Julie Berbis
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
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Broden EG, Boyden JY, Keller S, James R, Mooney-Doyle K. Who, What, Where, and How? The State of Family Science in Pediatric Palliative Care. J Pain Symptom Manage 2024:S0885-3924(24)00844-3. [PMID: 38992396 DOI: 10.1016/j.jpainsymman.2024.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 06/04/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
CONTEXT Families are vital providers and recipients of pediatric palliative care (PPC) services. Understanding the scope and nature of evidence at the intersection of family science and PPC research is necessary to develop family-focused interventions that enhance child and family health. OBJECTIVES Explore and describe the family-level impact of pediatric serious illness. METHODS We conducted a librarian-assisted scoping review using Arskey and O'Malley's approach. We searched PubMed, Scopus, CINAHL, and EMBASE databases for empirical publications from 2016 to 2021 that focused on families navigating serious pediatric illness published in English. Two reviewers assessed eligibility, with discrepancies resolved by a third. We used Covidence and REDCap for data management and extraction. RESULTS We screened 10,983 abstracts; 309 abstracts were included in full text screening. The final group of 52 citations was analyzed by the entire team. Most research was conducted in Western Europe and North America. The perspectives of parents of children with cancer were most frequently described; voices of seriously ill youth and their siblings were less often presented. Most of the research was descriptive qualitative, followed by descriptive quantitative. Few studies were mixed methods, inferential, or interpretive. Studies most often described parent, youth, and family experience with illness and less often explored family processes and relationships. Irrespective of the approach (i.e., qualitative, quantitative), few studies focused on families as the analytic unit or used family-level analysis techniques. Study participants were usually from local dominant populations and less often from historically marginalized communities. CONCLUSION The robust, descriptive, and individual-level evidence describing family impact of serious pediatric illness provides a solid foundation for future research priorities. Stronger integration of family techniques and diverse family voices in pediatric palliative care research can clarify family processes, illuminate structural barriers, and inform interventions that are responsive to family needs. These steps will enhance the education, policy, and clinical provision of PPC to all who would benefit, thereby advancing health equity for children living with serious illness and their families.
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Affiliation(s)
- Elizabeth G Broden
- Yale National Clinician Scholars Program (E.G.B.), Yale University, New Haven, CT; School of Public Health (E.G.B.), Yale University, New Haven, CT.
| | - Jackelyn Y Boyden
- Department of Family and Community Health (J.Y.B.), School of Nursing, University of Pennsylvania, Philadelphia, PA; Division of General Pediatrics (J.Y.B.), Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Susan Keller
- Research Library (S.K.M.), Children's National Hospital, Washington, DC
| | - Richard James
- Nemours Children's Health (R.J.M.), Wilmington, DE; Fontan Outcomes Network
| | - Kim Mooney-Doyle
- Department of Family and Community Health (K.M-D.), School of Nursing, University of Maryland, Baltimore, MD
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Han J, Zhang L, Yang F, Wang L. Illness cognition and associated socio-demographic and clinical factors in parents of children with leukemia. BMC Psychol 2024; 12:289. [PMID: 38783376 PMCID: PMC11119300 DOI: 10.1186/s40359-024-01798-3] [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: 10/20/2023] [Accepted: 05/19/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE Illness cognition is an important mediator between psychological and behavioral adjustment and the quality of life for patients and their caregivers. Evidence related to illness cognition among parents of children with leukemia is limited. The purpose of this study is to explore the illness cognition status and associated factors in parents of children with leukemia. METHODS A cross-sectional survey was conducted with the parents of 335 children with leukemia from three general children's hospitals in China from January to December 2022. A parents' version of the illness cognition questionnaire was used to collect data. This included three subscales: helplessness, acceptance, and perceived benefits. RESULTS The mean scores of helplessness, acceptance and perceived benefits of parents regarding their children's disease were 15.56 (4.60), 16.25 (4.41), and 19.96 (3.69) respectively. The multiple regression model indicated seven factors associated with the parents' illness cognition (adjusted R [2] ranged from 0.182 to 0.134): four socio-demographic factors (parent's age, role, education level, and family income) and three clinical factors (length of time spent each day caring for the child, the child's age at diagnosis, and the duration of the disease). CONCLUSION This study reports on different levels of illness cognition and associated factors among parents of children with leukemia. The results may help pediatric oncology medical staff identify risk factors for poor psychological adjustment to children's diseases. Parents may benefit from psychological support aimed at improving positive illness cognition.
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Affiliation(s)
- Jing Han
- School of Nursing, Xuzhou Medical University, Xuzhou, 221004, China.
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
| | - Li Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, 221004, China
| | - Feng Yang
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Linlin Wang
- School of Nursing, Xuzhou Medical University, Xuzhou, 221004, China
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Arshad M, Bibi B. An Exploration of Common Dyadic Coping Strategies: A Perspective from Pakistani Couples Living with Chronic Conditions. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02037-0. [PMID: 38691261 DOI: 10.1007/s10943-024-02037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 05/03/2024]
Abstract
This qualitative study was conducted to explore the common dyadic coping (DC) efforts of married couples, with a chronically ill partner. The sample for the study consisted of twelve couples chosen from Gujrat, Pakistan. The semi-structured interviews were conducted with the help of an interview guide and analyzed using thematic analysis (Braun and Clarke, 2006). The following four major themes were emerged: "common problem-focused DC," "common emotion-focused DC," "common religious DC," and "combined pattern of intimate relationships." The findings indicated that partners are not preferring relational coping resources for problem- and emotion-focused DC. However, the majority of couples participate in religious DC process in a complementary way to cope with stressful situation in the result of chronic illness. The study also indicated various indigenous factors, for example, socioeconomic status, family culture, lack of physical resource, and religious standpoints contributing in the lack of connectivity and sexual intimacy. To conclude, the results revealed that future research is required to investigate the patient and partner's relationship in greater depth, focusing on above-mentioned contextual factors.
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Affiliation(s)
- Misbah Arshad
- Department of Psychology, Faculty of Social Sciences, University of Gujrat, Ibn-e-Khaldun Block (R212), Gujrat, Pakistan.
| | - Bushra Bibi
- Department of Psychology, Faculty of Social Sciences, University of Gujrat, Ibn-e-Khaldun Block (R212), Gujrat, Pakistan
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Kusudo M, Terada M, Kureyama N, Wanifuchi-Endo Y, Fujita T, Asano T, Kato A, Mori M, Horisawa N, Toyama T. Characterizing user demographics in posts related to breast, lung and colon cancer on Japanese twitter (X). Sci Rep 2024; 14:6485. [PMID: 38499598 PMCID: PMC10948868 DOI: 10.1038/s41598-024-56679-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 03/09/2024] [Indexed: 03/20/2024] Open
Abstract
Various cancer-related information is spreading on social media. Our study aimed to examine the account types associated with cancer-related tweets (currently known as posts) on Twitter (currently known as X) in Japan, specifically focusing on breast, lung, and colon cancer. Using the Twitter application programming interface, we collected tweets containing keywords of the three cancers type in August-September 2022. The accounts were categorized into seven types: Survivor, Patient's family, Healthcare provider, Public organization, Private organization, News, and Other according to account name and texts. We analyzed the sources of the top 50 most liked and retweeted tweets. Out of 7753 identified tweets, breast cancer represented the majority (62.8%), followed by lung cancer (20.8%) and colon cancer (16.3%). Tweets came from 4976 accounts. Account types varied depending on the cancer type, with breast cancer topics more frequently from Survivor (16.0%) and lung cancer from Patient's family (16.3%). Healthcare provider and Public organization had minimal representation across three cancer types. The trends in the top 50 tweets mirrored the distribution of accounts for each cancer type. Breast cancer-related tweets had the highest frequency. There were few from public organizations. These findings emphasize the need to consider the characteristics of cancer-related information sources when sharing and gathering information on social media.
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Affiliation(s)
- Maho Kusudo
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
- Department of Breast Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Mitsuo Terada
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Nari Kureyama
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
- Department of Breast Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Yumi Wanifuchi-Endo
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Takashi Fujita
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Tomoko Asano
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Akiko Kato
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Makiko Mori
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Nanae Horisawa
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Tatsuya Toyama
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
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Bates CR, Pallotto IK, Moore RM, Covitz LM, Dreyer Gillette ML. Barriers and facilitators of family rules and routines during pediatric cancer treatment. J Pediatr Nurs 2023; 72:e33-e39. [PMID: 37308340 DOI: 10.1016/j.pedn.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Pediatric nurses work closely with families of children with new cancer diagnoses and can provide essential supports to promote coping and adjustment. This cross-sectional qualitative study aimed to gather caregiver perspectives on barriers and facilitators to adaptive family functioning during the early phases of cancer treatment, with a focus on family rules and routines. METHODS Caregivers (N = 44) of a child diagnosed with cancer and receiving active treatment completed a semi-structured interview about their engagement in family rules and routines. Time since diagnosis was abstracted from the medical record. A multi-pass inductive coding strategy was utilized to extract themes identifying caregiver-reported facilitators and barriers to maintaining consistent family rules and routines during the first year of pediatric treatment. RESULTS Caregivers identified three primary contexts that presented barriers and facilitators to engagement in family rules and routines: the hospital setting (n = 40), the family system (n = 36), and the broader social and community setting (n = 26). Caregivers reported barriers primarily related to the demands of their child's treatment, additional caregiving needs, and needing to prioritize basic daily tasks (e.g., food, rest, household needs). Caregivers reported that different networks of support across contexts facilitated family rules and routines by expanding caregiver capacity in distinctive ways. CONCLUSIONS Findings provided insight into the importance of having multiple networks of support to extend caregiving capacity in the context of cancer treatment demands. PRACTICE IMPLICATIONS Providing nurses with training to facilitate problem-solving skills in the context of competing demands may provide a new avenue of clinical intervention at the bedside.
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Affiliation(s)
- Carolyn R Bates
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA; Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA; University of Kansas Cancer Center, Kansas City, KS, USA.
| | | | - Rachel M Moore
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA; University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA
| | - Lynne M Covitz
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA; University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA
| | - Meredith L Dreyer Gillette
- Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA; Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA; University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA
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Smith NDW, Boone DM, Schimmel-Bristow A, Rawlins J, Ellingham L, Sobalvarro S, Faith MA. The mediating role of caregiver hope in relations among caregivers' coping and emotional socialization beliefs in pediatric oncology. J Psychosoc Oncol 2023; 42:271-285. [PMID: 37589450 DOI: 10.1080/07347332.2023.2241855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
The purpose of this study is to identify links between caregiver hope, caregiver coping behaviors, and caregivers' coaching versus dismissing emotion socialization (ES) beliefs in a pediatric cancer sample. Self-report measures. Caregivers (N = 183, 80.20% mothers; 58.5% white; 32.2% Hispanic) of youth undergoing cancer treatment (51.10% hematological malignancy, 15.30% brain or spinal [CNS] tumor, and 25.14% non-CNS solid tumor) for at least six weeks. We used a series of mediation models to examine links between caregivers' coping behaviors, hope, and ES beliefs. Caregivers' hope significantly mediated a positive relation between caregivers' coping and their emotion coaching beliefs, as well as an inverse relation between caregivers' maladaptive coping and their emotion dismissing beliefs. Enhancing caregivers' hope or adaptive coping may support caregivers' beliefs during the pediatric cancer experience. Our findings support future research to evaluate whether enhancing caregivers' hope or adaptive coping may help support evidence-based interventions that target ES beliefs and behaviors.
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Affiliation(s)
- Nicholas David W Smith
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida Health System, Tampa, Florida, USA
| | - Dianna M Boone
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Allison Schimmel-Bristow
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Jonathan Rawlins
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Lauren Ellingham
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Sarah Sobalvarro
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Melissa A Faith
- Center for Behavioral Health, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
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Howard Sharp KM, Tillery Webster R, Cook J, Okado Y, Long A, Phipps S. Profiles of Resilience, Distress, and Posttraumatic Growth in Parents of Children with Cancer and the Relation to Subsequent Parenting and Family Functioning. J Pediatr Psychol 2023; 48:375-385. [PMID: 36668686 PMCID: PMC10118855 DOI: 10.1093/jpepsy/jsac097] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The aim of this study was to identify patterns of distress and growth in parents of children with cancer and examine associations with subsequent parenting, parent-child relationship, and family environment. METHODS Participants included children with cancer history (8-17 years) stratified by time since diagnosis and their parent. At enrollment, parents (n = 254) reported depression and anxiety, and post-traumatic stress symptoms, posttraumatic growth (PTG), and benefit finding in relation to their child's cancer. Three years later, children (n = 214) reported parenting behavior, parent reactions to their distress, and family environment. Parents reported their reaction to children's distress and qualities of the parent-child relationship. RESULTS Latent profile analysis empirically identified 3 cross-sectional profiles using baseline data: "Resilience, High Growth" (50%), characterized by the lowest distress and the highest PTG/benefit finding; "Moderate Distress with Growth" (33%), characterized by relatively high levels of all indicators; and "Resilience, Low Growth" (17%), characterized by relatively low distress with low PTG/benefit finding. Membership in profiles was associated with parent gender; parents' stressful life events; socioeconomic status; and child diagnosis, on versus off treatment status, and treatment intensity. Parent membership in the Moderate Distress with Growth profile was generally linked with poorer parenting behavior, parent-child relationship quality, and family functioning. CONCLUSION The majority of parents exhibited resilience and growth. However, a subset of parents displaying moderate distress may be at risk for subsequent parenting and family functioning challenges. Findings further highlight the importance of screening for even moderate parent distress and the possible impact of parent psychosocial interventions indirectly on parenting and family functioning.
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Affiliation(s)
| | | | - Jessica Cook
- Department of Psychology, St. Jude Children’s Research Hospital, USA
- Department of Psychology, The University of Memphis, USA
| | - Yuko Okado
- Department of Psychology, California State University, USA
| | - Alanna Long
- Department of Psychology, St. Jude Children’s Research Hospital, USA
| | - Sean Phipps
- Department of Psychology, St. Jude Children’s Research Hospital, USA
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Perceived family impact and coping mechanisms of caregivers of children with nephrotic syndrome. Pediatr Nephrol 2023; 38:1177-1185. [PMID: 35913565 DOI: 10.1007/s00467-022-05619-w] [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: 11/18/2021] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Pediatric chronic disease impacts the affected child and their family structure. There is limited literature investigating the psychosocial impact of nephrotic syndrome on families. METHODS Caregivers of children with nephrotic syndrome completed two validated surveys: (1) Impact on Family (IOF) that evaluates the family impact (degree to which family is affected by a pediatric chronic illness) and (2) Coping Health Inventory for Parents (CHIP) that examines the coping patterns used by caregivers. Linear regression models were utilized to determine predictors of perceived family impact and coping patterns. RESULTS Seventy-five caregivers of a child with nephrotic syndrome completed the surveys. On a scale from low impact to significant impact to very serious impact, results indicated that nephrotic syndrome had a significant impact on families (mean revised IOF total score 33.04 ± 9.38). Families in the steroid-resistant nephrotic syndrome (SRNS) group reported a higher financial impact compared to the steroid-sensitive nephrotic syndrome (SSNS) group (p = 0.03). Families in the frequently relapsing group (FRNS) reported a higher impact on the caregiver's ability to cope with the child's condition compared to the SRNS group (p = 0.02). Tacrolimus use was associated with increasing the perceived family impact (β = 4.76, p = 0.046). CHIP scores indicated that caregivers did not cope well with family integration (component I) but coped well with social support (component II) and communication (component III). CONCLUSIONS Childhood nephrotic syndrome has a significant overall perceived impact on the family, and caregivers did not cope well regarding strengthening their family life. These findings can be used as outcome measures for future intervention studies to find solutions that would decrease the perceived family burden. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Brillet L, Peries M, Vernhet C, Rattaz C, Michelon C, Baghdadli A. Dyadic Effect of Coping on the Perceived Impact of ASD of Children on Parental Quality of Life: Report from the ELENA Cohort. J Autism Dev Disord 2023; 53:38-49. [PMID: 34994927 DOI: 10.1007/s10803-021-05414-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 02/03/2023]
Abstract
Autism spectrum disorder (ASD) has a significant impact on the quality of life (QoL) of families. This study aimed to examine, for parents of children with ASD, the dyadic effect of each parent's coping strategy on the perception of the impact of ASD on their QoL. In total, 164 couples completed self-report questionnaires, including the Par-DD-QoL, to evaluate the parental perception of QoL. Results from the actor-partner interdependence model showed that, in addition to the effect of the mothers' and fathers' emotion-focused coping on their own perception of QoL, the mothers' emotion-focused coping plays a key role in the fathers' perception of QoL. These findings suggest that both parents of children with ASD would benefit from couple-focused interventions.
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Affiliation(s)
- Leïla Brillet
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence Sur Les Troubles Neuro-Développementaux, CHU Montpellier, Montpellier, France
- University of Medecine, Montpellier, France
| | - Marianne Peries
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence Sur Les Troubles Neuro-Développementaux, CHU Montpellier, Montpellier, France
| | - Christelle Vernhet
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence Sur Les Troubles Neuro-Développementaux, CHU Montpellier, Montpellier, France
| | - Cécile Rattaz
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence Sur Les Troubles Neuro-Développementaux, CHU Montpellier, Montpellier, France
| | - Cécile Michelon
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence Sur Les Troubles Neuro-Développementaux, CHU Montpellier, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence Sur Les Troubles Neuro-Développementaux, CHU Montpellier, Montpellier, France.
- University of Medecine, Montpellier, France.
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, 39 Avenue Charles Flahault, 34295 Cedex 05, Montpellier, France.
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Flujas-Contreras JM, García-Palacios A, Gómez I. Parenting Intervention for Psychological Flexibility and Emotion Regulation: Clinical Protocol and an Evidence-Based Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095014. [PMID: 35564408 PMCID: PMC9101648 DOI: 10.3390/ijerph19095014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022]
Abstract
Psychological flexibility has been found as a protective factor for several psychological problems, including the field of parenting. The present study aims to illustrate a clinical protocol, session by session, for the promotion of parental psychological flexibility and emotion regulation in a case study. The clinical protocol is based on third-wave behavior therapy in a brief intervention of four sessions. The intervention is presented in a clinical case of a mother with a child diagnosed with Oppositional Defiant Disorder. Both mother and child experienced problems with emotional regulation and psychological flexibility. The results show clinically significant improvements in psychological flexibility, emotional regulation, and stress parenting in the mother both after the intervention and at follow-up. In the child, emotional perspective-taking skills, acceptance, and valued actions improved. The case illustrates in detail the application of different strategies of acceptance, mindfulness, emotion regulation, and emotional defusion applicable to parenting. Clinical implications are discussed.
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Affiliation(s)
- Juan M. Flujas-Contreras
- Department of Psychology, University of Almeria, 04120 Almeria, Spain;
- Health Research Centre (CEINSA/UAL), University of Almeria, 04120 Almeria, Spain
- Correspondence:
| | - Azucena García-Palacios
- Department of Psychology, University Jaume I, 12071 Castellon, Spain;
- CIBER of Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Inmaculada Gómez
- Department of Psychology, University of Almeria, 04120 Almeria, Spain;
- Health Research Centre (CEINSA/UAL), University of Almeria, 04120 Almeria, Spain
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Pediatric Cancer as a Factor of Changes in the Family. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095002. [PMID: 35564396 PMCID: PMC9105820 DOI: 10.3390/ijerph19095002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022]
Abstract
The occurrence of pediatric cancer is an example of a non-normative situation that reorganizes family life. The aim of the study was to evaluate the functioning of a family with a child affected by cancer. The study was conducted on 339 families. The study group consisted of 153 families with children with cancer (mean age 36.4 ± 6.8 years). The control group was composed of 186 families with healthy children (mean age 39.0 ± 6.3 years). All of them completed the author’s survey questionnaire on family functioning and the Resilience Measurement Scale (RMS). A statistically significant association was found between the place of residence (p < 0.001), education (p < 0.001), assessment of the material status (p < 0.001) and employment structure (p < 0.001) of parents and the membership in the study group or the control group. Statistical significance was achieved for the main effects as measured on the RMS (5 factors and 2 groups). The study group showed consistently lower levels of the factors of the scale. Statistically significant observations were reported for Factor 1 (perseverance, proactive approach) and Factor 4 (tolerance to failure, life as a challenge) (12.0 vs. 14.5, p < 0.001, 13.4 vs. 14.2, p = 0.04, respectively). Parents of children with cancer were characterized by lower persistence, determination and tolerance to failure, which could affect the quality of life of the whole family. In addition, different socio-economic conditions of family functioning were found in families with children with cancer as compared to families with healthy children.
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14
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Xie Z, Yang C, Zhao Y, Yang Y, Xia W, Zong Y, Chi T, Shi B, Huang H, Gong C. Anxiety in Chinese Patients With Cleft Lip and/or Palate: A Preliminary Study. Front Pediatr 2022; 10:842470. [PMID: 35237543 PMCID: PMC8882858 DOI: 10.3389/fped.2022.842470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/20/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To preliminarily analyze factors that affected the prevalence of anxiety in Chinese patients with cleft lip and/or palate (CL/P). METHODS The Generalized Anxiety Disorder Scale (GAD-7) was used to screen anxiety in Chinese CL/P patients. Non-CL/P individuals were also included as the control group. Sociodemographic and clinical data consisting of diagnosis, gender, only child or not, monthly household income, and current family location were collected to analyze possible factors that could affect the anxiety of this patient population. RESULTS One hundred forty-two and 78 valid questionnaires were collected from the study and control groups, respectively. The mean GAD-7 score of the study group (3.092 ± 3.381) was significantly lower than the control (3.987 ± 2.505). Moreover, the proportion of patients presenting with moderate-severe anxiety was larger in the study group than in the control group (6.6 vs. 0.0%). Statistically significant differences in GAD-7 scores were observed between the study and control groups when the patient was the only child, living in an urban area, or the monthly household income was between 1,000 and 5,000 yuan. CONCLUSION Although the severity of anxiety in Chinese CL/P patients was not severer than those without CL/P, there was a relatively high incidence of moderate-severe anxiety in CL/P patients, while the only child, current family location and the monthly household income played significant roles in affecting anxiety psychology.
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Affiliation(s)
- Zhuojun Xie
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chao Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuxi Zhao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yichun Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Weiyao Xia
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Zong
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ting Chi
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bing Shi
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hanyao Huang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Caixia Gong
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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15
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Pozo Muñoz C, Bretones Nieto B, Vázquez López MÁ. When Your Child Has Cancer: A Path-Analysis Model to Show the Relationships between Flourishing and Health in Parents of Children with Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12587. [PMID: 34886313 PMCID: PMC8657391 DOI: 10.3390/ijerph182312587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/25/2021] [Accepted: 11/27/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Childhood cancer is a disease with a psychosocial impact on parents who experience health problems and distress. Their reactions depend on the relationship of multiple factors. The objective of this paper is to evaluate the interrelationships between flourishing and the variables linked to the health and wellbeing of parents of children with cancer. METHODS Mothers/fathers of children with cancer participated in an exploratory study in response to a series of questionnaires. Likert-type scales were used to measure perceived health, wellbeing, flourishing, stress, coping, and social support. RESULTS Out of a total of 94 children, 138 parents (60 men/78 women) are represented. Participants show physical symptoms and an unstable coping pattern. A path analysis model is presented. As to the goodness of adjustment of the statistics used, good results were obtained. Flourishing tends to coexist with wellbeing, while flourishing coexists negatively with symptoms. There is an indirect relationship between flourishing and poor health. There is a positive relationship between flourishing and coping, as well as between flourishing and satisfaction with the support received (especially from sons/daughters). This support was negatively related to the subjective health report. CONCLUSIONS Flourishing is shown as a healthy coping strategy. The results can enrich the development of psychosocial interventions aimed at promoting adequate adaptation.
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Affiliation(s)
- Carmen Pozo Muñoz
- Department of Psychology, University of Almeria, 04120 Almeria, Spain;
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Kalaycı E, Çalışkan Z. The Quality of Life and Influencing Factors in Turkish Children Receiving Cancer Treatment. J Pediatr Nurs 2021; 61:213-218. [PMID: 34126331 DOI: 10.1016/j.pedn.2021.06.003] [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: 12/17/2020] [Revised: 06/06/2021] [Accepted: 06/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study was conducted to determine the quality of life and the influencing factors in children aged 8-12 years who are treated for cancer in Turkey. DESIGN AND METHODS The cross-sectional and descriptive study was conducted on 300 children with cancer and their parents. The data were collected using the Questionnaire Form and the Pediatric Quality of Life Inventory PedsQL (4.0) Child and Parent Form. Descriptive statistics, the independent t-test, univariate and multiple binary logistic regression analysis were used for the evaluation. RESULTS The mean age of the children was 8.92 ± 0.98 years and the quality of life scores in all sub-dimensions and in total (36.26 ± 5.23) were found to be low. According to the univariate binary logistic regression analysis, the father being unemployed, the house being heated with a stove, and development of extravasation during the chemotherapy treatment process created a risk of decreasing the children's quality of life score (7.15 units, 41.29 units, and 44.47 units, respectively) (p < 0.05). CONCLUSIONS The father's unemployment, heating the house with a stove, and the development of extravasation during treatment were found to affect the children's quality of life negatively in the study. Inter-institutional cooperation, taking the necessary measures to decrease the frequency of extravasation development, and ensuring nurses continue family-centered care during these processes are recommended to support the families. PRACTICE IMPLICATIONS Interventions for early detection and prevention of the negative changes related to the quality of life in children with cancer need to be planned.
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Affiliation(s)
- Eda Kalaycı
- Erciyes University, Children Oncology-Hematology Clinic, Turkey
| | - Zehra Çalışkan
- Department of Pediatric Nursing, Semra and Vefa Küçük Faculty of Health Sciences, Nevşehir Hacı Bektaş Veli University, Turkey.
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Nap-van der Vlist MM, van der Wal RC, Grosfeld E, van de Putte EM, Dalmeijer GW, Grootenhuis MA, van der Ent CK, van den Heuvel-Eibrink MM, Swart JF, Bodenmann G, Finkenauer C, Nijhof SL. Parent-Child Dyadic Coping and Quality of Life in Chronically Diseased Children. Front Psychol 2021; 12:701540. [PMID: 34393938 PMCID: PMC8355494 DOI: 10.3389/fpsyg.2021.701540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Different forms of dyadic coping are associated with positive outcomes in partner relationships, yet little is known about dyadic coping in parent-child relationships. The current research explored the association between parent-child dyadic coping and children’s quality of life in 12–18-year old children with a chronic disease (i.e., cystic fibrosis, autoimmune diseases, and children post-cancer treatment). In a sample of 105 parent-child dyads, self-reported forms of dyadic coping (i.e., stress communication, problem-oriented, emotion-oriented, and negative dyadic coping) and children’s quality of life were assessed. Children reported more stress communication and negative dyadic coping than their parents, while parents reported more problem-oriented dyadic coping and emotion-oriented dyadic coping than their children. More stress communication of the child was associated with more emotion-oriented dyadic coping and less negative dyadic coping of the parent. More negative dyadic coping of the child was associated with less stress communication, problem-oriented dyadic coping and emotion-oriented dyadic coping of the parent. Additionally, both children’s and parents’ negative dyadic coping were associated with lower self-reported pediatric quality of life and parents’ emotion-oriented dyadic coping was associated with higher pediatric quality of life. These findings emphasize that children and their parents mutually influence each other and that dyadic coping is associated with children’s quality of life. Theoretical and practical implications are discussed.
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Affiliation(s)
- Merel M Nap-van der Vlist
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Reine C van der Wal
- Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Eva Grosfeld
- Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Elise M van de Putte
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Geertje W Dalmeijer
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | | | - Cornelis K van der Ent
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | | | - Joost F Swart
- Department of Pediatric Rheumatology/Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Guy Bodenmann
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Catrin Finkenauer
- Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Sanne L Nijhof
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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Effectiveness of Theraplay in Internalizing and Externalizing Problems in Bereaved Siblings of Children with Cancer. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2021. [DOI: 10.5812/ijpbs.103992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Sibling relationships are very significant relationships, and their termination due to death will have profound long-term effects on the life of the surviving children. Objectives: The purpose of the current study was to determine the effectiveness of theraplay on internalizing and externalizing problems in bereaved siblings. Methods: This study was carried out using a single-subject multiple baseline design with follow-up. The statistical population included siblings and mothers of children aged 6 - 10 years who were on treatment at Mahak Pediatric Cancer Hospital and died one or two years ago. From this population, four mother-child pairs were selected as the study sample by convenience sampling. Each mother-child pair participated in 15 theraplay sessions once a week (45-min sessions). The assessments were carried out using the Child Behavior Checklist (CBCL) at baseline and in the intervention sessions and follow-up. Visual analysis of graphic displays of level, Reliable Change Index (RCI), and clinical significance were used to analyze the data. Data analysis and drawing the graphs were performed in Microsoft Excel 2016. Results: The results of the visual and quantitative data analysis showed a significant reduction in the four participants' internalizing problems during therapy. The reduction in the scores of this subscale in participants 1, 2, and 3 continued into the follow-up period and was noticeable. The results also showed that theraplay reduced the externalizing problems of most participants. A large proportion of these results persisted into the follow-up period. Conclusions: Theraplay appears to effectively reduce the internalizing and externalizing problems of bereaved siblings.
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Chia JMX, Goh ZZS, Chua ZY, Ng KYY, Ishak D, Fung SM, Ngeow JYY, Griva K. Managing cancer in context of pandemic: a qualitative study to explore the emotional and behavioural responses of patients with cancer and their caregivers to COVID-19. BMJ Open 2021; 11:e041070. [PMID: 33518518 PMCID: PMC7852065 DOI: 10.1136/bmjopen-2020-041070] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Having to access life-sustaining treatment during the emerging COVID-19 outbreak has placed patients with cancer at an especially vulnerable position notwithstanding their immunocompromised condition. The present study aimed to elucidate cancer patients' and their caregivers' experiences during this outbreak. DESIGN Face-to-face semistructured interviews were conducted. SETTING A tertiary cancer care facility. PARTICIPANTS 16 patients with cancer and 14 caregivers. Inclusions criteria were: (A) diagnosed with cancer, (B) receiving active treatment or follow-ups, (C) aged 21 years and above and (D) fluent in English or Mandarin. RESULTS Thematic analysis was conducted. Five themes were identified: heightened sense of threat, impact on healthcare experience, responsibility falls on oneself, striving for normalcy and sense of safety and trust. Heightened threat of COVID-19 was more pronounced in patients and linked to vulnerability and fear, uncertainty and actions of socially irresponsible others. Dominant in their healthcare experience was prioritising cancer and treatment amidst heightened threat and anticipatory worry about treatment disruptions. Both noted on the importance of taking responsibility for one's health, with caregivers reporting a reinforced sense of duty towards patients. They strived to maintain normalcy by viewing COVID-19 as beyond personal control, downplaying and living life as usual. Their resolve was supported by a sense of safety from the actions of authorities, hospitals and trust towards healthcare providers. CONCLUSIONS Cancer intensifies threat and the emotional impact of COVID-19 and may trigger specific concerns related to treatment. Psychoeducation interventions led by healthcare providers over digital platforms could help address cancer-specific concerns and support patients and caregivers during the pandemic.
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Affiliation(s)
- Jace Ming Xuan Chia
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Zack Zhong Sheng Goh
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Zi Yang Chua
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Kennedy Yao Yi Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Diana Ishak
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Si Ming Fung
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Joanne Yuen Yie Ngeow
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Konstadina Griva
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
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[Parents' satisfaction in onco-hematology units]. J Healthc Qual Res 2021; 36:66-74. [PMID: 33446453 DOI: 10.1016/j.jhqr.2020.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/05/2020] [Accepted: 10/16/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION patient satisfaction is a quality of care predictor that allows to identify specific areas of improvement. Frequently, parents are who provide this information when their children are too young or cannot communicate. The aim of the study was to determine parents' satisfaction with paediatric oncology care and its relationship with sociodemographic variables. MATERIAL AND METHODS a cross-sectional observational study was carried out. Parents whose children suffered from cancer and were treated in the oncology ward and oncology day hospital in Asturias were included. A questionnaire with sociodemographic variables and the Cuestionario de Calidad de Cuidados de Enfermería (CUCACE), that evaluates experience and satisfaction with care through two dimensions (range from 0 to 100), were used. RESULTS 24 parents agreed to particape. The average in experience dimension of CUCACE was 88,99 and 87,01 in satisfaction. All participants referred as positive the treat received at the units, however, 41,7% declared it should be enhanced. No relationship between satisfaction and sociodemographic variables were found. CONCLUSIONS Parents of children with cancer demonstrated high satisfaction with care. Information and communication with medical staff need to be strengthened.
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