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Holmbom M, Andréasson F, Grundström H, Bernild C, Fålun N, Norekvål TM, Kikkenborg Berg S, Strömberg A. Young Spouses' Experiences of Having a Partner With Heart Disease and Adolescents Living at Home. Health Expect 2024; 27:e14129. [PMID: 38970211 PMCID: PMC11226407 DOI: 10.1111/hex.14129] [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: 12/08/2023] [Revised: 06/02/2024] [Accepted: 06/19/2024] [Indexed: 07/08/2024] Open
Abstract
AIM To describe the life situation of spouses having a partner with heart disease and adolescents living at home. DESIGN Qualitative inductive design. METHOD Participants (n = 22) were included from three Scandinavian countries. Semi-structured interviews were analysed using thematic analysis with an inductive and latent approach. RESULTS Three themes were derived. 'Being in spousal and parental role transition' described how daily life had been affected and parental responsibilities had been doubled due to their partner's heart disease. 'Living with unpredictability and insecurity' included how the unpredictable illness trajectory caused worries and affected the well-being of the family. 'Managing a challenging life situation' highlights how spouses coped with their partners' heart disease and adapted to a new life situation. CONCLUSION Young spouses' life situation was greatly affected by their partner's heart disease, resulting in increased responsibilities and double parenthood. Having a positive attitude and mindset towards life was used as a strategy to cope with the changed life situation and find a new way of life. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE All family members are affected by heart disease. Spouses needed additional professional support and guidance on how to involve the children when a parent is ill. IMPACTS This study highlights how young spouses, with adolescents living at home, experience their life situation. The life situation is unpredictable due to the partner's heart disease, as they must handle both caring for their partner and taking on double parenthood. Research involving family members can improve person- and family-centred care and treatment outcomes in health care and society. REPORTING METHOD COREQ checklist was used preparing the manuscript. PATIENT OR PUBLIC CONTRIBUTION Data collection included interviews with spouse. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: By highlighting the spouses changed life situation due to heart disease and the importance of including them in health care.
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Affiliation(s)
- Matilda Holmbom
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | | | - Hanna Grundström
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Obstetrics and GynecologyNorrkopingSweden
- Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Camilla Bernild
- The Heart Center, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Nina Fålun
- Haukeland University HospitalBergenNorway
| | - Tone Merete Norekvål
- Haukeland University HospitalBergenNorway
- Department of Clinical ScienceUniversity of BergenBergenNorway
| | | | - Anna Strömberg
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of CardiologyLinköping UniversityLinköpingSweden
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Skrabal Ross X, Konings S, Schiena E, Phipps-Nelson J, Wang Y, Hodgson F, Patterson P, McDonald FEJ. Piloting a new cross-sector model of care to support parents with cancer: feasibility and acceptability of the Parent Support Worker role. Support Care Cancer 2024; 32:435. [PMID: 38878200 PMCID: PMC11180003 DOI: 10.1007/s00520-024-08629-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/03/2024] [Indexed: 06/19/2024]
Abstract
PURPOSE A new Parent Support Worker (PSW) service was piloted in three Australian hospitals. This study assesses the feasibility and acceptability (including preliminary effectiveness) of the service in supporting cancer patients with children. METHODS A multi-site, mixed-methods study collected quantitative and qualitative data on the effectiveness of the service (pre post-test, n = 36), qualitative and quantitative data on acceptability of the service (survey, n = 43), and qualitative data on acceptability (semi-structured interviews, n = 13). Feasibility was assessed through rates of service uptake amongst referred parents. RESULTS Of 1133 parents referred, 810 (71%) accepted to receive the service, suggesting high interest in PSW support. Interviewees likewise reported that the service was accessible and facilitated further referrals, indicating good feasibility. Surveys completed three months after accessing PSW support showed high acceptability and satisfaction. Additionally, there was preliminary evidence of service impacts: parents' distress, parenting concerns, parenting efficacy, and stress about situations of concern improved significantly from pre- to post-service (all p < 0.005). Interviewees further described how their emotional coping and confidence to support and communicate with their children had improved through contact with the service. CONCLUSION The PSW service, integrated into a novel cross-sector model of care, showed to be feasible and acceptable to parent patients and their partners and improved psychological and parenting outcomes. The study suggests refinements to the service and the need for future larger studies to explore the effectiveness of the service in improving parents' outcomes. This study complements previous evidence on the implementation of the PSW service in hospitals.
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Affiliation(s)
- X Skrabal Ross
- Policy and Patient Department, Canteen Australia, Sydney, Australia
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Australia
| | - S Konings
- Psycho-Oncology Department, Clinique Saint-Jean, Brussels, Belgium
| | - E Schiena
- Department of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Phipps-Nelson
- Department of Oncology, Sir Peter MacCallum, University of Melbourne, Melbourne, Australia
- Office of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Y Wang
- Policy and Patient Department, Canteen Australia, Sydney, Australia
- Guangxi Minzu University, Nanning, China
| | - F Hodgson
- John Hunter Hospital, Newcastle, Australia
| | - P Patterson
- Policy and Patient Department, Canteen Australia, Sydney, Australia
| | - F E J McDonald
- Policy and Patient Department, Canteen Australia, Sydney, Australia.
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
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Li JL, Ye Q, Liu N. Cancer parents' experiences of parenting concerns about minor children: A meta-synthesis of qualitative studies. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 6:100210. [PMID: 38872959 PMCID: PMC11169080 DOI: 10.1016/j.ijnsa.2024.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/08/2024] [Accepted: 05/21/2024] [Indexed: 06/15/2024] Open
Abstract
Background Some cancer patients not only endure physical and mental distress due to the disease and treatment but also shoulder the responsibility of raising their children. This situation significantly impacts the patients' quality of life. While there is a growing body of qualitative research focusing on parenting concerns among cancer patients, there remains a lack of comprehensive qualitative evidence. Objective This study aims to conduct a systematic review and synthesis of qualitative research evidence, investigating the experiences of cancer patients in raising minor children. Design Systematic review and synthesis of qualitative studies. Settings Through a screening process employing inclusion/exclusion criteria, qualitative studies specifically addressing cancer patients raising minor children were identified. Participants Participants: A total of 669 participants from 40 studies were included in the review. Methods Four English (Pubmed, Web of Science, Embase and Cochrane Library) and three Chinese (CNKI, Wanfang and Sinomed) databases were searched for qualitative studies of the real-life experiences of raising children in cancer patients from the establishment of the library to January 2024. The methodological quality of the included literature was assessed using the Critical Appraisal Skill Program (CSAP). Qualitative data were extracted, summarized, and meta-synthesized. Results A total of 26 studies were included in this meta-synthesis, encompassing 11 different countries. 160 themes were extracted from these included literatures, which were combined into ten categories, ultimately forming four themes: the impact of parents' disease on their children, the challenges of parenting, coping strategies, and multifaceted parenting needs. Based on the Confidence in the Output of Qualitative research synthesis (ConQual) approach, the confidence level of the synthesized findings ranged from moderate to low. Conclusions Cancer patients experience significant psychological stress while raising children, which can lead to a reduction in their quality of life and influence treatment decisions. These findings elucidate the parenting concerns experienced by cancer patients, allowing medical staff to understand their emotions and treatment preferences. Additionally, healthcare professionals should pay attention to the special needs of this group and develop targeted interventions to support and reduce patients' psychological stress and burden.
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Affiliation(s)
- Jing-Ling Li
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Qin Ye
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Ning Liu
- Department of Basic Teaching and Research in General Medicine, Department of Fundamentals, Zhuhai Campus of Zunyi Medical University, Guangdong, China
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Petermann-Meyer A, Panse JP, Bremen R, Dohmen M, Drueke B, Geiser F, Haastert B, Heier L, Heuser C, Holsteg S, Icks A, Karger A, Nakata H, Viehmann A, Brümmendorf TH, Ernstmann N. Effectiveness of a comprehensive support program for families with parental cancer (Family-SCOUT): results of a multicenter non-randomized controlled trial. ESMO Open 2024; 9:103493. [PMID: 38848662 PMCID: PMC11214994 DOI: 10.1016/j.esmoop.2024.103493] [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: 07/05/2023] [Revised: 03/21/2024] [Accepted: 05/06/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Cancer patients with minor children but also their families suffer from significant psychological distress and comorbidity. Protective factors predicting successful coping are well known. Corresponding systematic interventions are rare and limited by access barriers. We developed a comprehensive family-centered intervention for cancer patients with at least one dependent minor. PATIENTS AND METHODS Family-SCOUT represents a multicentric, prospective, interventional, and controlled study for families with parental cancer and their minor children. In the intervention group (IG), all family members were addressed using a care and case management approach for nine months. Families in the control group (CG) received standard of care. Participating parents were asked to complete the Hospital-Anxiety-Depression-Scale (HADS) questionnaire at enrolment (T0) and after 9 months (T2). The primary outcome was a clinically relevant reduction of distress in at least one parent per family, measured as minimal important difference (MID) of ≥1.6 in the HADS total score. The percentage of families achieving MID is compared between the IG and CG by exact Fisher's test, followed by multivariate confounder analyses. RESULTS T0-questionnaire of at least one parent was available for 424 of 472 participating families, T2-questionnaire after 9 months was available for 331 families (IG n = 175, CG n = 156). At baseline, both parents showed high levels of distress (HADS total: sick parents IG: 18.7 ± 8.1; CG: 16.0 ± 7.2; healthy partners: IG: 19.1 ± 7.9; CG: 15.2 ± 7.7). The intervention was associated with a significant reduction in parental distress in the IG (MID 70.4% in at least one parent) compared with the CG (MID 55.8%; P = 0.008). Adjustment for group differences from specific confounders retained significance (P = 0.047). Bias from other confounders cannot be excluded. CONCLUSIONS Parental cancer leads to a high psychosocial burden in affected families. Significant distress reduction can be achieved through an optimized and structured care approach directed at the family level such as family-SCOUT.
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Affiliation(s)
- A Petermann-Meyer
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen; Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD)).
| | - J P Panse
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen; Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD))
| | - R Bremen
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen; Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD))
| | - M Dohmen
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen; Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD))
| | - B Drueke
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen; Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD))
| | - F Geiser
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD)); Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn
| | - B Haastert
- mediStatistica, Wuppertal; Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf
| | - L Heier
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD)); Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn; Chair for Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
| | - C Heuser
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD)); Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn; Chair for Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
| | - S Holsteg
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD)); Clinical Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf
| | - A Icks
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf; Institute for Health Services Research and Health Economics, German Diabetes Center, Duesseldorf, Germany
| | - A Karger
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD)); Clinical Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf
| | - H Nakata
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD)); Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn
| | - A Viehmann
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf
| | - T H Brümmendorf
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen; Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD))
| | - N Ernstmann
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO(ABCD)); Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn; Chair for Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
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Schlander M, van Harten W, Retèl VP, Pham PD, Vancoppenolle JM, Ubels J, López OS, Quirland C, Maza F, Aas E, Crusius B, Escobedo A, Franzen N, Fuentes-Cid J, Hernandez D, Hernandez-Villafuerte K, Kirac I, Paty A, Philip T, Smeland S, Sullivan R, Vanni E, Varga S, Vermeulin T, Eckford RD. The socioeconomic impact of cancer on patients and their relatives: Organisation of European Cancer Institutes task force consensus recommendations on conceptual framework, taxonomy, and research directions. Lancet Oncol 2024; 25:e152-e163. [PMID: 38547899 DOI: 10.1016/s1470-2045(23)00636-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 04/02/2024]
Abstract
Loss of income and out-of-pocket expenditures are important causes of financial hardship in many patients with cancer, even in high-income countries. The far-reaching consequences extend beyond the patients themselves to their relatives, including caregivers and dependents. European research to date has been limited and is hampered by the absence of a coherent theoretical framework and by heterogeneous methods and terminology. To address these shortages, a task force initiated by the Organisation of European Cancer Institutes (OECI) produced 25 recommendations, including a comprehensive definition of socioeconomic impact from the perspective of patients and their relatives, a conceptual framework, and a consistent taxonomy linked to the framework. The OECI task force consensus statement highlights directions for future research with a view towards policy relevance. Beyond descriptive studies into the dimension of the problem, individual severity and predictors of vulnerability should be explored. It is anticipated that the consensus recommendations will facilitate and enhance future research efforts into the socioeconomic impact of cancer and cancer care, providing a crucial reference point for the development and validation of patient-reported outcome instruments aimed at measuring its broader effects.
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Affiliation(s)
- Michael Schlander
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany; Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany; Alfred Weber Institute (AWI), University of Heidelberg, Mannheim, Germany; Institute for Innovation & Valuation (InnoVal(HC)), Wiesbaden, Germany.
| | - Wim van Harten
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands; Department of Health Technology and Services Research, University of Twente, Enschede, Netherlands; Rijnstate Hospital, Arnhem, Netherlands
| | - Valesca P Retèl
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Phu Duy Pham
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany; Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Julie M Vancoppenolle
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands; Department of Health Technology and Services Research, University of Twente, Enschede, Netherlands
| | - Jasper Ubels
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany; Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Olaya Seoane López
- The Support Team, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Camila Quirland
- Health Technology Assessment Unit, Arturo López Perez Foundation, Santiago, Chile; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Felipe Maza
- Health Technology Assessment Unit, Arturo López Perez Foundation, Santiago, Chile
| | - Eline Aas
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway; Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Agustín Escobedo
- Oncology Care Management, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Nora Franzen
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Diego Hernandez
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Iva Kirac
- Genetic Counseling Unit, University Hospital for Tumors, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Artus Paty
- Department of Medical Information, Centre Henri Becquerel, Rouen, France
| | - Thierry Philip
- Organisation of European Cancer Institutes (OECI), Brussels, Belgium; Institut Curie, Paris, France
| | - Sigbjørn Smeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Cancer Medicine, Oslo University Hospital Comprehensive Cancer Centre, Oslo, Norway
| | | | - Elena Vanni
- Business Controlling, Humanitas Clinical and Research Center, Milan, Italy; Biomedical Sciences, Humanitas Clinical and Research Center, Milan, Italy
| | - Sinisa Varga
- Institute for Gastroenterological Tumours, Zagreb, Croatia
| | - Thomas Vermeulin
- Department of Medical Information, Centre Henri Becquerel, Rouen, France
| | - Rachel D Eckford
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Kahraman-Erkus O, Ar-Karci Y, Gençöz T. "My body is a cage": A qualitative investigation into the self-discrepancy experiences of young women with metastatic cancer. Chronic Illn 2024; 20:117-134. [PMID: 37036432 PMCID: PMC10865759 DOI: 10.1177/17423953231168014] [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: 05/10/2022] [Accepted: 03/20/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES The current study investigated self-discrepancy experiences of young women with metastatic cancer. METHODS Semistructured interviews were conducted. Data were analyzed through interpretative phenomenological analysis. FINDINGS Eight female patients with metastatic cancer aged between 27 and 38 years formed the sample. Three superordinate themes emerged: (1) compulsory changes in self-concept with ambivalent evaluations; (2) new ideals not on the agenda of a healthy young woman; and (3) so-called 'minimalist' expectations from others. DISCUSSION Findings indicated that diagnosis and treatment of metastatic cancer impose unique developmental challenges for young adult women. Advanced cancer disrupted the tasks and responsibilities of young adulthood, resulting in frustration, grief, isolation, and overcompensation. These findings suggest that a developmental perspective is crucial when working with self-discrepancy experiences of young women with metastatic cancer.
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Affiliation(s)
| | | | - Tülin Gençöz
- Department of Psychology, Middle East Technical University, Ankara, Turkey
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da Silva EF, Matsubara MDGS, Soares MADL, Mazzaia MC, De Domenico EBL. Communication between parents diagnosed with cancer and their children: study with data triangulation. Rev Esc Enferm USP 2024; 57:e20230079. [PMID: 38373186 PMCID: PMC10876183 DOI: 10.1590/1980-220x-reeusp-2023-0079en] [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: 04/05/2023] [Accepted: 12/14/2023] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE To characterize the perceptions and feelings of parents diagnosed with cancer in relation to communication with their children between 3 and 12 years old. METHOD A cross-sectional, multicenter, with data triangulation, through structured and semi-structured interviews, with a question with a Semantic Differential Scale, carried out with the father or mother with cancer undergoing outpatient treatment in two hospital institutions in the city of São Paulo, São Paulo, Brazil. Data were analyzed using descriptive statistics, content analysis, using the ATLAS.ti 8.0R software and the Social Representation Theory. RESULTS Forty-three respondents participated, 37 (86.0%) were female, 23 (53.5%) aged between 31 and 50 years old, 29 (67.5%) with only children between 7 and 12 years old. The experience was considered painful (73.1%), stressful (53.6%), clear (53.7%) and safe (51.2%). The feelings experienced generated two categories: Trial by fire; and Grateful rewards. Children's reactions from parents' perspective generated the categories: Sadness and suffering; Trust and support; Change of behavior; and Denial or insensitivity. CONCLUSION Communication was assessed as negative and conflicting, positive and welcoming, and causing changes in children's behaviors.
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8
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Johannsen L, Frerichs W, Inhestern L, Bergelt C. Exploring the perspectives of cancer patients parenting minor children: A qualitative study on family-centered cancer care experiences. PATIENT EDUCATION AND COUNSELING 2023; 117:107989. [PMID: 37812964 DOI: 10.1016/j.pec.2023.107989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVES Parents with cancer experience not only disease-related burden but also child- and family-related concerns. According to the German guidelines, all professionals working in oncology are responsible for addressing these burdens and needs and for involving the patient's relatives. This study aims to explore patients' perspectives on their experiences regarding family-centeredness in cancer care. METHODS We conducted interviews with 18 cancer patients parenting at least one minor child (< 18). The interviews were audio-recorded, transcribed verbatim and analyzed using qualitative content analysis. RESULTS Most parents reported that their healthcare professionals (HCPs) rarely or not routinely discussed family issues. There was a wide range of ways in which HCPs communicated about family issues. Parents often felt unsure about professionals' responsibilities and many of them expressed a desire for more proactive communication. CONCLUSIONS The findings suggest that the majority of patients have unmet needs related to comprehensive care as parents. PRACTICE IMPLICATIONS HCPs need to be sensitized to identify parents facing additional burdens and needs. It is essential that HCPs clarify parents' preferences regarding the extent of involvement of family issues in cancer care.
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Affiliation(s)
- Lene Johannsen
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany.
| | - Wiebke Frerichs
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany; Department of Medical Psychology, University Medicine Greifswald, Germany
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9
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Schliemann A, Teroerde A, Beurer B, Hammersen F, Fischer D, Katalinic A, Labohm L, Strobel AM, Waldmann A. Reduced Psychosocial Well-Being among the Children of Women with Early-Onset Breast Cancer. Curr Oncol 2023; 30:10057-10074. [PMID: 38132365 PMCID: PMC10742300 DOI: 10.3390/curroncol30120731] [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: 09/29/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Approximately 27% of female breast cancer patients are diagnosed before the age of 55, a group often comprising mothers with young children. Maternal psychosocial well-being significantly impacts these children's psychosocial well-being. This study assesses the well-being of children with mothers who have early-onset breast cancer. METHODS We examined the eldest child (up to 15 years old) of women with nonmetastatic breast cancer (<55 years old, mean age: 40) enrolled in the mother-child rehab program 'get well together'. Using maternal reports on children's well-being (the Strengths and Difficulties Questionnaire; SDQ), we describe the prevalence of abnormally high SDQ scores and identify protective and risk factors via linear regression. RESULTS The mean SDQ scores of 496 children (4-15 years old, mean age: 8) fell below the thresholds, indicating psychosocial deficits. However, most SDQ scores deviated negatively from the general population, especially for emotional problems, with one in ten children displaying high and one in five displaying very high deficits. Female sex, more siblings, a positive family environment and maternal psychosocial well-being were protective factors for children's psychosocial well-being. CONCLUSIONS Children of mothers with breast cancer may benefit from improved maternal well-being and family support. Further research is needed to identify appropriate interventions.
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Affiliation(s)
- Antje Schliemann
- Institute for Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (A.K.); (L.L.)
| | - Alica Teroerde
- Institute for Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (A.K.); (L.L.)
| | - Bjoern Beurer
- Department of Obstetrics and Gynaecology, Ernst von Bergmann Clinic, 14467 Potsdam, Germany
| | - Friederike Hammersen
- Institute for Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (A.K.); (L.L.)
| | - Dorothea Fischer
- Department of Obstetrics and Gynaecology, Ernst von Bergmann Clinic, 14467 Potsdam, Germany
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (A.K.); (L.L.)
| | - Louisa Labohm
- Institute for Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (A.K.); (L.L.)
| | - Angelika M. Strobel
- Department of Obstetrics and Gynaecology, University Hospital of Schleswig-Holstein, Campus Luebeck, 23562 Luebeck, Germany
| | - Annika Waldmann
- Institute for Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (A.K.); (L.L.)
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Kogan LR, Currin-McCulloch J, Cook LS. Breast cancer treatment and recovery: pets' roles as emotional buffers and stressors. BMC Womens Health 2023; 23:540. [PMID: 37848911 PMCID: PMC10583337 DOI: 10.1186/s12905-023-02662-z] [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: 09/18/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Research suggests pets foster affection, connection, and physical activity, yet has failed to address the challenges people diagnosed with cancer face in caring for their pets. The objective of this study was to better understand how pets serve as emotional buffers and/or stressors for people diagnosed with breast cancer, and how their ability to meet their pet's needs affects their well-being. METHODS A cross-section study of people diagnosed with breast cancer in the United States was conducted. Adults diagnosed with stages 0 (in situ) -IV breast cancer and currently the primary guardian of at least one dog or cat and owned the animal(s) for at least 6 months, were recruited for the study. A total of 211 responses, obtained between July - November 2022 were analyzed. The survey included questions about participants' demographics; attachment to their pets; physical, emotional, and functional well-being; social support received from their pet; and 'pet parenting' concerns. Descriptive statistics were calculated to describe participants' demographics. Multiple regression analyses were conducted to determine predictors of pet attachment, well-being, support from pet, and 'pet parenting' concerns. RESULTS People diagnosed with breast cancer derive substantial support from their pets (80% feel their pet makes them feel loved, needed, and offers a positive presence in the home), yet only 50% of participants feel this relationship is supported by their medical team. Controlling for owner demographics, heightened levels of pet-related guilt and concerns, along with lower perceived support from their pet, are all significant predictors of a lower quality of life. CONCLUSIONS Findings highlight the benefits pets offer people diagnosed with breast cancer, yet also the distress they feel in trying to meet their pet's needs. Assessment conversations about pet ownership, including pet-related support systems, are needed to validate people's concerns and support the identification and development of pet support teams. Medical team facilitated discussions about pet care needs is suggested to demonstrate support for the pet-parent bond and help normalize feelings of guilt related to challenges in meeting their pet's needs. These discussions could be aided through the development of research-driven intervention strategies and online, freely accessible targeted tools.
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Affiliation(s)
- Lori R Kogan
- Clinical Sciences Department, Colorado State University, 1680 Campus Delivery, Fort Collins, CO, 80523, USA.
| | - Jennifer Currin-McCulloch
- School of Social Work, Colorado State University, 1586 Campus Delivery, Fort Collins, CO, 80523, USA
| | - Linda S Cook
- Colorado School of Public Health, CU Anschutz Medical Campus, Building 500, 13001 East 17Th Place, B119, Aurora, CO, 80045-2601, USA
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11
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Plont M, Mejdahl CT, Haar TR, Skovlund P. Supporting Families with Breast Cancer: Insights from the Danish Nurse-Led Program "The Children's Tour" for Families with Parental Cancer. Semin Oncol Nurs 2023; 39:151482. [PMID: 37537028 DOI: 10.1016/j.soncn.2023.151482] [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: 05/20/2023] [Revised: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE This study explores how a Danish nurse-led program designed to provide support to families where mothers are affected by breast cancer is experienced by the women attending the program and the nurses organizing it. Their experiences provide insights into the program's impact and potential areas of improvement and inform future interventions targeting the well-being of this specific population. DATA SOURCES The study involved data collected through qualitative research. An observational study of the intervention was conducted to inform the development of an interview guide for semistructured individual interviews and a focus group interview. Five women with breast cancer and children aged 5 to 16 years were interviewed, and four nurses involved in the nurse-led program took part in the focus group interview. Data were audio recorded, transcribed verbatim, and thematically analyzed. CONCLUSION Families participating in the nurse-led program reported it helpful in many ways. Three themes emerged from the analysis of the interviews: 1) "How to talk about parental cancer with school-aged children," 2) "Setting up the room," and 3) "Exchanging imagination for reality." Getting familiar with the treatment room and nurses, playing with hospital gear (syringes, bandages, and the treatment chair), and watching a movie together indicate that the visit to the ward is important and cannot be entirely replaced by digital solutions. With the need for support and limited resources at the hospital, it is pivotal to identify the families most in need. IMPLICATIONS FOR NURSING PRACTICE Women with breast cancer parenting adolescent children need family-based care based at the hospital. Further research is needed to refine the program to cover the concerns of the whole family, including fathers and grandparents, and to apply the program to other families with parental cancer of other types.
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Affiliation(s)
- Marcell Plont
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark.
| | | | - Tina Rotbøl Haar
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
| | - Pernille Skovlund
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
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12
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Johannsen LM, Frerichs W, Philipp R, Inhestern L, Bergelt C. Effectiveness of a training program for healthcare professionals on parental cancer: Results of a randomized controlled pilot-study. Psychooncology 2023; 32:1567-1577. [PMID: 37649177 DOI: 10.1002/pon.6207] [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: 02/17/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Cancer patients parenting minor children face specific burden and supportive needs, which are often not adequately addressed by their healthcare professionals (HCPs), due to a lack of knowledge, self-efficacy and competencies. Therefore, we developed a 3-h intervention enhancing HCPs' competencies in caring for these patients. We pilot-evaluated the intervention's feasibility and efficacy, assuming intervention group participants reveal higher improvements over time compared to non-trained participants. METHODS We conducted a 3-armed randomized controlled pilot-trial (RCT), comparing face-to-face training (F2F), e-Learning (EL), waitlist-control group with three measurements (baseline, post-training, 3-month follow-up). Primary outcome was the competency to approach child- and family-related themes; secondary outcomes were knowledge, self-efficacy in (specific) communication skills. Intervention effects were analyzed using linear mixed models. RESULTS Participants (n = 152) were mostly female (89%) and psychologists (38%; physicians 26%; nurses 18%). F2F and EL participants reported high training satisfaction. Analyses did not reveal any significant differences on the primary outcome between groups, but indicate positive intervention effects over time regarding secondary outcomes including knowledge and self-efficacy in communication skills. CONCLUSIONS This is the first pilot-study evaluating a training for HCPs in oncology on parental cancer using a 3-armed RCT. The 3-h training program is a feasible approach and findings indicate to increase HCPs' knowledge and self-efficacy in caring for cancer patients with minor children. Further research is needed to verify preliminary findings of this pilot study. The study was pre-registered within the German Clinical Trial Register (DRKS-00015794).
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Affiliation(s)
- Lene Marie Johannsen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wiebke Frerichs
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rebecca Philipp
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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13
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Fugmann D, Richter P, Karger A, Ernstmann N, Hönig K, Bergelt C, Faller H, Maatouk I, Hornemann B, Stein B, Teufel M, Goerling U, Erim Y, Geiser F, Albus C, Senf B, Wickert M, Weis J. Caring for dependent children impacts practical and emotional problems and need for support, but not perceived distress among cancer patients. Psychooncology 2023; 32:1231-1239. [PMID: 37277899 DOI: 10.1002/pon.6173] [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: 02/15/2023] [Revised: 04/26/2023] [Accepted: 05/14/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE More than one in 10 cancer patients care for dependent children. It is unclear whether this status makes a difference in terms of the distress and associated problems they experience, or whether it is linked to differences in the need for or utilization of psychosocial support. METHODS Secondary analysis of a cross-sectional German study in National Comprehensive Cancer Centers using self-report standardized questionnaires administered to inpatients. Patients living with dependent children (n = 161) were matched by age and sex with a subsample of 161 cancer patients not living with dependent children. The resulting sample was tested for between-group differences in Distress Thermometer (DT) scores and the corresponding DT Problem List. Additionally, between-group differences in measures of the need for and utilization of psychosocial support were examined. RESULTS More than 50% of all patients suffered from clinically relevant distress. Patients living with dependent children reported significantly more practical (p < 0.001, η2 p = 0.04), family (p < 0.001, η2 p = 0.03), and emotional problems (p < 0.001, η2 p = 0.01). Although reporting a greater need for psychological support, parents with cancer were not found to more frequently utilize any type of psychosocial support. CONCLUSIONS The specific problems and needs of parents with cancer who care for dependent children are currently not sufficiently addressed in the clinical care pathways. All families should be helped to establish open and honest communication as well as understand the available support systems and what they can provide. Tailored interventions should be implemented for highly distressed families.
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Affiliation(s)
- Dominik Fugmann
- Medical Faculty, Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Peter Richter
- Medical Faculty, Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - André Karger
- Medical Faculty, Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nicole Ernstmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research (CHSR), University Hospital Bonn, Bonn, Germany
| | - Klaus Hönig
- Ulm University Clinic Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, Greifswald Medical School, Greifswald, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Imad Maatouk
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Beate Hornemann
- Comprehensive Cancer Center, University Clinic Center Dresden, Dresden, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Essen (WTZ) and LVR Hospital, University of Duisburg-Essen, Essen, Germany
| | - Ute Goerling
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität and Berlin Institute of Health, Berlin, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine, University Clinic Center Erlangen, Erlangen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine, University Clinic Center Bonn, Bonn, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine & Center Psychooncology (CePO), University Clinic Center Cologne, Cologne, Germany
| | - Bianca Senf
- University Clinic Center Frankfurt University Cancer Center, Frankfurt, Germany
| | - Martin Wickert
- Comprehensive Cancer Center, University Clinic Center Tübingen, Tübingen, Germany
| | - Joachim Weis
- Department of Self-Help Research, Faculty of Medicine and Medical Center, Comprehensive Cancer Center, University of Freiburg, Freiburg, Germany
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14
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Scarponi D, Sarti P, Rivi V, Colliva C, Marconi E, Pession A, Blom JMC. Emotional, Behavioral, and Physical Health Consequences in Caregivers of Children with Cancer: A Network Analysis Differentiation in Mothers' and Fathers' Reactivity. Cancers (Basel) 2023; 15:3496. [PMID: 37444606 DOI: 10.3390/cancers15133496] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/14/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Pediatric cancer presents mental and physical challenges for patients and their caregivers. However, parental distress has been understudied despite its negative impact on quality of life, disability, and somatic disorders. Parents of oncopediatric patients experience high levels of suffering with their resilience tested throughout their children's illness. Identifying at-risk parents and offering specific treatments is crucial and urgent to prevent or alleviate negative outcomes. METHODS This study used statistical and network analyses to examine symptom patterns assessed by the Kellner Symptom Questionnaire in 16 fathers and 23 mothers at different time points: diagnosis, treatment, and discharge. RESULTS The results indicated significantly higher distress levels in parents of oncopediatric children compared to the control reference population. Gender-specific differences in symptom profiles were observed at each time point, and symptoms showed a gradual but non-significant decrease over time. CONCLUSIONS The network analysis yielded valuable insights that, when applied in clinical practice, can guide the implementation of timely treatments to prevent and manage parental distress, thus addressing long-term, stress-related issues in primary caregivers of children diagnosed and treated for cancer.
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Affiliation(s)
- Dorella Scarponi
- Unità Operativa Pediatria Pession, IRSSC S. Orsola, 40138 Bologna, Italy
| | - Pierfrancesco Sarti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Veronica Rivi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | | | - Elisa Marconi
- Clinical Psychology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Radiation Oncology Unit, Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Andrea Pession
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Johanna M C Blom
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Centre for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Mota-George G, Martinez A, Dains JE. Quality of Life in Adult Cancer Patients With Underage Children: An Integrative Review. J Adv Pract Oncol 2023; 14:390-402. [PMID: 37576361 PMCID: PMC10414533 DOI: 10.6004/jadpro.2023.14.5.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
As many as 24.7% of cancer patients are also parents to children younger than 18 years of age. This population faces unique challenges, and quality of life in parental cancer patients has not been well studied. This integrative review assessed parental cancer patients' quality of life. PubMed and Scopus were searched using the following terms: quality of life, distress, anxiety, coping, emotion, social support, employment, work, psychosocial, physical, function, parental cancer, and parents with cancer. English publications conducted within the past 15 years that used an objective instrument to measure quality of life in adult cancer patients with children 18 years of age or younger were included. Studies with an intervention focus were excluded. After review of 672 articles, nine studies met the criteria for inclusion. Several instruments were utilized to measure quality of life. Some parental cancer patients reported decreased quality of life when compared with other cancer patients and the general population at diagnosis and years after. Parental cancer patients may be at an increased risk of decreased quality of life. With this understanding, health-care providers should complete comprehensive assessments routinely so that these patients' unique needs may be more adequately addressed.
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Affiliation(s)
| | - Ashley Martinez
- From The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joyce E Dains
- From The University of Texas MD Anderson Cancer Center, Houston, Texas
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16
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Analysis of patient experiences with gestational trophoblastic neoplasia reported on Instagram social media. Gynecol Oncol 2022; 165:603-609. [DOI: 10.1016/j.ygyno.2022.03.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 12/16/2022]
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