Young carers supporting a relative with cancer: What is the healthcare professionals' knowledge in France? An exploratory study

PURPOSE

Many children and adolescents support relatives with cancer. However, literature about young carers (YCs) shows a lack of awareness among professionals, especially in oncology. This quantitative study aims to explore the level of knowledge and perceptions of healthcare professionals working with cancer patients about the situations and characteristics of YCs.

METHODS

395 professionals participated in an online survey. Professionals reported sociodemographic and professional information and answered several questions evaluating their perceptions about YCs, such as the types of support provided and the consequences of being a YC. Descriptive analysis and group comparisons (Chi-square, Mann-Whitney U, and Kruskal-Wallis tests) by sex, occupation, and patients treated (adult and/or pediatric) are performed on the data collected.

RESULTS

Overall, per the literature on YCs, professionals provide an adequate description of what a YC can be, even though one in two professionals have never heard the term. Several differences are observed: Men mention fewer types of support that YCs can provide, while women report more negative consequences of being a YC; psychologists and social workers report fewer positive impacts for these young people than the other professionals; professionals who work with pediatric patients mention fewer negative consequences than those who work with adults.

CONCLUSION

Oncology healthcare professionals have sufficient awareness of YCs; however, several professionals struggle to fully understand the situation of YCs. These findings underline the need for awareness programs in oncology to improve health professionals' understanding of YCs and enhance their identification and support.

What characterizes adolescent young carers? A multigroup comparative study

CONTEXT

To identify the characteristics of adolescent young carers (AYCs), studies in the literature have compared them with non-AYCs, but without considering that in the latter group, some face the illness of a relative whereas others do not.

OBJECTIVES

The aims of the study were (1) to identify the characteristics of AYCs as compared with adolescents who are not young carers but are facing the illness/disability of a relative, or adolescents not facing the illness/disability of a relative, and (2) to identify factors associated with being a carer within adolescents facing a relative illness.

METHODS

A total of 4000 high school students (grades 10-12, mainly aged 15-17 years, 568 identified as AYCs, 1200 as adolescents facing the illness/disability of a relative without being a carer and 2232 as adolescents not facing the illness/disability of a relative) completed a self-reported questionnaire assessing sociodemographic characteristics, illness/disability in the family, caregiving activities (MACA-YC18 and specific emotional support scale), quality of life (KIDSCREEN-10) and mental health (GHQ-12). Chi-square tests, ANOVAs and logistic regressions were performed.

RESULTS

AYCs scored lower on the quality-of-life measure compared with adolescents not facing the illness/disability of a relative (p < .001) and had poorer mental health compared with adolescents facing the illness/disability of a relative without being a carer and adolescents not facing the illness/disability of a relative (p < .001). Logistic regressions showed that youth were more at risk to be an AYC when they were females (p < .001), when they had an extracurricular job (p < .001), spoke another language at home (p < .01), had siblings and were one of the oldest siblings (p < .001), and when the relative had a serious or chronic physical illness (p < .001) and lived with the youth (p < .001).

CONCLUSIONS

These results highlight the importance of distinguishing AYCs, adolescents facing the illness/disability of a relative without being a carer and adolescents not facing the illness/disability of a relative to better describe AYCs, recognizing that as the level of care provided might change over time, adolescents facing the illness/disability of a relative without being a carer could become AYCs or inversely. The factors that emerged could be used by professionals to better identify AYCs.

Professionals' Awareness of Young Carers in Schools: Results from a French Survey

Few studies have investigated professionals' awareness of young carers (YCs). Therefore, the main aim of this study was to explore school professionals' awareness of YCs. The secondary aim was to compare professionals' responses according to their occupation. A total of 2658 professionals took part in this study by completing an online questionnaire. The results indicated that the mean for the perceived age for care beginning was 10.3 years old, with parents being perceived as the most frequent care recipient. The main caring activities reported were domestic chores, emotional support and sibling care, while care provided directly to the care recipient was perceived as less frequent. Many suggestions for improving the identification, referral and support of YCs were seen as relevant, but professionals were less supportive of suggestions for adjustments within schools. The key training needs centered around better identifying YCs and developing better knowledge of their difficulties. Differences were observed according to occupation, with administrative staff and teachers having less accurate perceptions than school counsellors as well as social and health professionals. This study shows that it can be difficult for school professionals to imagine a child providing care. Specific training, therefore, needs to be proposed according to school professionals' occupations.

Profiles of French young carers taking part in an arts and respite care program

Young carers (YCs) are children and adolescents who provide meaningful, regular support to a relative with a health problem. In France, only one programme exists to support them: the arts and respite care programme of the national association JADE. The aim of this study is to describe the profiles of YCs who had participated in this programme and to evaluate their expectations, opinions, and the evolution of their quality of life over the course of the programme. All YCs enrolled in the programme between 2017 and 2020 were invited to participate in the study. Upon arrival, the youths completed a self-report questionnaire addressing their sociodemographic and family situations, their caregiving activities, their quality of life, and their expectations for the programme. At the end of each week, a questionnaire evaluating their opinion of the programme and their quality of life was completed. A hundred and seventeen children participated (average age: 12; 71.8% girls). Most YCs provided support to a parent or sibling with a chronic somatic disease. The support mainly concerned doing domestic tasks and providing emotional support for the relative and was significantly higher among adolescents. Their expectations were mainly about getting respite and meeting other young people. Their levels of satisfaction were high and aligned with their expectations. Their quality of life increased significantly. French YCs in this programme had characteristics comparable to those observed internationally. The results underline the importance of respite and the benefits such a programme can bring to YCs.

Teachers' Perceptions of Supporting Young Carers in Schools: Identifying Support Needs and the Importance of Home-School Relationships

Recognition and support for young carers has improved steadily in the past two decades; with stronger legislation and more visibility and awareness of the challenges that many of the YC face, especially with respect to their education. Recent UK-based initiatives providing toolkits and guidance for school staff have provided much needed direction for schools, to support the loosely defined statutory requirements. The aim of the current research was to hear from school staff about their experiences in identifying and supporting young carers, to better understand any enablers and barriers. The thematic analysis of the interview data from 18 school staff was organized into two main themes: perceptions regarding the characteristics of young carers; and perceptions regarding the importance of home-school communication. Each superordinate theme contained several sub-themes. Overall, the teachers perceived many difficulties identifying young carers who did not volunteer this information and felt that the main enabler of identification was the trust relationships between the school and the pupil and parents. Once identified, the schools perceived the main areas of need that they could provide support for were the emotional wellbeing of the pupils and additional academic opportunities. They spoke too of the difficulties balancing the provision of this extra support within the constraints of the school context, both in terms of the school day, and the competing priorities relating to academic and social-emotional needs. School staff recognized that extra time outside of school was difficult for young carers to attend. Other subthemes are discussed with consideration to enablers and barriers. The implications for the dissemination of good practice, and addressing policy are considered.