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Ohan JL, Jackson HM, Bett R, Farmer GM, Martini A. Experiences and needs of children and adolescents affected by a parent's acquired brain injury: a systematic review and thematic synthesis. Disabil Rehabil 2024; 46:1034-1044. [PMID: 36861777 DOI: 10.1080/09638288.2023.2179673] [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: 05/09/2021] [Revised: 12/21/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE To identify the experiences and needs of dependent children who have a parent with an acquired brain injury (ABI) using a systematic review and thematic synthesis. MATERIALS AND METHODS A systematic search of Medline, Embase, PsycINFO, CINAHL Plus, and Web of Science was conducted. The search included variants of: "children," "parents," "acquired brain injury," and "experiences" or "needs." Eligible articles reported on the experiences/needs of dependent children who have a parent with an ABI, from the child's perspective. Thematic analysis was used to identify themes. RESULTS A total of 4895 unique titles were assessed, and 9 studies met inclusion. Four themes were identified: (1) Sustained Emotional Toll (subthemes: (i) Initial Shock and Distress; (ii) Ongoing Loss and Grief; (iii) Present-Day Stress and Emotions), (2) Responsibilities Change and Children Help Out, (3) Using Coping Strategies (subtheme: Talking Can Help), and (4) Wanting Information about the Injury. CONCLUSION Themes highlighted significant disruption and challenges to children's wellbeing across development, with ongoing and considerable impacts many years after the parent's injury. The nature of the experiences shifted with time since the parent's injury. These children need ongoing support starting shortly after their parent's injury that is grounded in their particular experiences.IMPLICATIONS FOR REHABILITATIONWhen a parent has an acquired brain injury (ABI), dependent children and adolescents face emotional upheaval, significant stressors, increased responsibilities, and lack of information about their parent's injury that persist even many years after injury.The nature of these experiences and therefore their needs change based on the acute versus later stages of the parent's injury.Children often do not ask questions or tell others how they feel, which means that they need support that asks about, and listens and responds to their needs.Support for children needs to start soon after the parent's injury, be grounded in the lived experiences of this group, consider their parent's recovery stage, and be embedded as part of service provision rather than rely on children or families to make service contact.
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Affiliation(s)
- Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Hayley M Jackson
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Robyn Bett
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Glenda M Farmer
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
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Almulla HA, Lewis FM, Oxford ML. Development and Psychometric Evaluation of the Children's Illness-Related Concerns Scale. Nurs Res 2023; 72:E172-E179. [PMID: 37625187 PMCID: PMC10463208 DOI: 10.1097/nnr.0000000000000670] [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] [Indexed: 08/27/2023]
Abstract
BACKGROUND Despite the effect of maternal breast cancer on many children, there is no valid or reliable quantitative measure of the concern that children attribute to their mothers' disease, which constrains both science and clinical practice. OBJECTIVES This study aimed to develop and psychometrically evaluate the initial measures of child-reported, illness-related concerns associated with maternal cancer. METHODS The study was conducted in three phases: scoping review, item extraction from a battery of items obtained from school-aged children about general issues related to their mothers' breast cancer, and testing of the three proposed structural models of these extracted items using confirmatory factor analysis. The scoping review yielded five categories of illness-related concerns: altered family routines, uncertainty, concerns about illness contagion, maternal death, and maternal well-being. To reflect these five categories, 18 items were extracted from a 93-item questionnaire completed by 202 school-aged children regarding their mothers' breast cancer. Next, three structural models were hypothesized to assess the construct validity of illness-related concerns: five-, three-, and one-factor models. Confirmatory factor analysis was used to test and compare the models. RESULTS The five-factor model best fit the data, and each factor showed adequate internal consistency reliability. These findings align with the a priori five-factor model informed by the scoping review. CONCLUSION The results provide initial evidence of the construct validity of the 18-item Children's Illness-Related Concerns Scale, which can be used to assess children's concerns and inform future intervention studies.
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Affiliation(s)
- Hebah A. Almulla
- Imam Abdulrahman Bin Faisal University, College of Nursing, Dammam, Saudi Arabia
| | - Frances Marcus Lewis
- University of Washington, School of Nursing, Seattle, WA
- Fred Hutchinson Cancer Research, Public Health Sciences and Clinical Research Divisions, Seattle, WA
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Communication between mothers with breast cancer and minor children: a qualitative systematic review and meta-synthesis. Support Care Cancer 2023; 31:169. [PMID: 36786856 DOI: 10.1007/s00520-023-07630-9] [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: 05/18/2022] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Both women with breast cancer and their minor children were affected by a breast cancer diagnosis. The purpose of this review was to synthesize the evidence from qualitative studies on illness-related communication between mothers with breast cancer and their minor children from mothers' perspectives. METHODS A thorough systematic review and meta-synthesis of qualitative studies was conducted. English articles published prior to 6 November 2021 were searched from five databases, including PubMed/ MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO. After screening the titles, abstracts, and full texts, seven articles were finally included in the quality appraisal and meta-aggregation. RESULTS Four synthesized findings were derived from seven articles, including disclosure dilemma, factors impacting disclosure, methods of communication, and information needs. CONCLUSIONS This systematic review offered insight into the communication between mothers with breast cancer and their minor children. Various factors influenced the decision-making process on illness-related disclosure, as well as the methods and contents of the communication. Future studies should be undertaken to explore the common model shared by mothers and children who have had comparable experiences, as well as to completely analyze the differences between different cultures in this topic.
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Kleinhaus H, Brähler E, Romer G, Ernst J. [Communicating about Parental Cancer with Minor Children: Necessity, Burden, and Issues from a Parent's Perspective]. Psychother Psychosom Med Psychol 2023; 73:85-88. [PMID: 36413984 DOI: 10.1055/a-1961-1219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND In addition to coping with their own stresses, parents of minor children with cancer face the difficult task of communicating the diagnosis and its effects to their children. The aim of this study is to examine parents' perceptions of conversations with their children and to identify key topics for psychosocial support. METHODS Using a questionnaire, N=82 cancer patients with N=162 minor children were asked about their experiences when talking to their children about the disease. RESULTS Communication about the disease was perceived as necessary by most parents. This was especially the case for older children. With 143 out of 162 children (88.3%), the conversation was held. Of the 82 parents interviewed, 16.5% felt no burden as a result of the talks, 15.2% reported a very high burden. The feeling of not being able to protect the children was perceived as particularly stressful. DISCUSSION Most parents consider communication with the children to be important and seek it. However, many find this difficult, e. g. because they actually want to protect their children. Additional stress can be caused by questions from the children to which the parents cannot give an answer. CONCLUSION Psychosocial support can be helpful here. Experiences discussed by parents can help other parents in similar situations.
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Affiliation(s)
- Hannah Kleinhaus
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Mainz, Mainz, Germany
| | - Georg Romer
- Klinik für Kinder- und Jugendpsychiatrie, -psychosomatik und -psychotherapie, Universitätsklinikum Münster, Münster, Germany
| | - Jochen Ernst
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Leipzig, Germany
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Fu C, Glasdam S, Stjernswärd S, Xu H. A Qualitative Systematic Review About Children's Everyday Lives when a Parent Is Seriously Ill with the Prospect of Imminent Death - Perspectives of Children and Parents. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228221149767. [PMID: 36628967 DOI: 10.1177/00302228221149767] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Parental dying is a life changing experience for children. This study explores children's strategies and (inter)actions in their everyday life when facing critically ill parents and imminent death, from the children's and parents' perspectives. A qualitative systematic review was carried out, registered in PROSPERO (CRD42022306862). A literature search and screening in six databases resulted in eighteen articles. Thematic analysis showed that children were capable of developing various strategies to cope in everyday life, even in vulnerable situations. From parents' and children's perspectives, inclusion, openness, and communication about parents' situations, taking children's age and needs into consideration, were important to face and cope with the situation. Children were life-capable, also in vulnerable and difficult situations. This calls for the necessity of developing children-led support, by acknowledging, and taking the children's experiences, and resources, as starting points to tailor adequate support for children of critically ill parents.
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Affiliation(s)
- Cong Fu
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Stinne Glasdam
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Sigrid Stjernswärd
- Health-promoting Complex Interventions, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Hongxuan Xu
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Mjøsund NH, Eide T, Kufås E, Faugli A, Eilertsen G. Mental health promotion as perceived by Norwegian adolescents with somatically ill parents - an interpretative phenomenological analysis. Health Psychol Behav Med 2023; 11:2213298. [PMID: 37201175 PMCID: PMC10187081 DOI: 10.1080/21642850.2023.2213298] [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: 04/12/2022] [Accepted: 05/03/2023] [Indexed: 05/20/2023] Open
Abstract
Objective Having a somatically ill parent can influence adolescents' daily lives and mental health. This study aimed to explore the lived experiences of mental health promotion among adolescents with a somatically ill parent, based on a salutogenic orientation. Methods Individual interviews with 11 adolescents (13-18 years of age) with a somatically ill parent were conducted. The data were analysed according to interpretative phenomenological analysis. Results A superordinate theme, feeling at home in a house of mental health-promoting conversations, frames the participants' perceptions of a prominent mental health promotion experience, including decisive characteristics of the significant conversation partners and different important conversation contexts. The metaphor of feeling at home expresses that the participants ascribe the conversations taking place there as promoting mental health. The themes elucidate the superordinate theme: (a) significant conversation partners characterised by the three subthemes: (i) being available, (ii) being competent and (iii) being caring and (b) rooms reflecting conversation contexts containing four subthemes: (i) room of increased knowledge, (ii) room of disclosure, (iii) room for meeting points and (iv) room for breaks. Conclusion Adolescents with a somatically ill parent perceived that conversations about important topics with significant others with special characteristics in distinct contexts promoted mental health.
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Affiliation(s)
- Nina Helen Mjøsund
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
- Nina Helen Mjøsund Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, NO3004, Norway
| | - Torill Eide
- University of South-Eastern Norway – Campus Drammen, Drammen, Norway
| | - Elin Kufås
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Anne Faugli
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Grethe Eilertsen
- University of South-Eastern Norway – Campus Drammen, Drammen, Norway
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Granrud MD, Sandsdalen T, Anderzén-Carlsson A, Steffenak AKM. Public health nurses’ experiences working with children who are next of kin: a qualitative study. BMC Health Serv Res 2022; 22:1427. [PMCID: PMC9703408 DOI: 10.1186/s12913-022-08841-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/16/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
There are a substantial number of children who are the next of kin of parents suffering from illness or substance abuse. These children can experience emotional and behavioral problems and may need support from professionals. In Norway, the specialist health service in hospitals is required to have a designated practitioner in each department to ensure support for and follow up of children who are next of kin; however, this is not regulated by law in the health care in the municipalities. The aim of this study was to explore public health nurse’s experiences working with children who are next of kin.
Methods
Qualitative interviews were conducted with 10 public health nurses working in the child health clinic and the school health service in four municipalities. Data were analysed using content analysis. Reporting of this study is conducted in accordance to COREQ’s checklist.
Results
The analysis resulted in one main theme: ‘Lack of guidelines and routines among public health nurses working with children who are next of kin’. The main theme consisted of four categories: (1) identifying children who are next of kin are incidental; (2) public health nurses must be observant and willing to act; (3) communication is an important tool; and (4) follow up over time is not always provided.
Conclusion
The public health nurses experienced uncertainty concerning how to identify and follow up children who are next of kin but were vigilant and willing to act in the children’s best interest. Doing so necessitated collaboration with other professionals. The need for guidelines around the role and responsibilities for the public health nurse were emphasized. The knowledge provided by the current study offers valuable insight into strengths and limitations in the support of children who are next of kin and can inform stakeholders in organizing sustainable support for this group.
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Bergersen E, Larsson M, Lövgren M, Olsson C. Adolescents' and young people's needs and preferences for support when living with a parent with life-threatening cancer: a grounded theory study. BMC Palliat Care 2022; 21:164. [PMID: 36138453 PMCID: PMC9502590 DOI: 10.1186/s12904-022-01055-7] [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: 06/02/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Living with a parent facing life-threatening illness and losing a mom or dad at a young age can cause both short- and long-term health problems. Without satisfactory support, adolescents' and young people are at risk of developing low self-esteem, behavioural difficulties (e.g., anger and aggression), long-term illness or premature death caused by severe mental illness, substance abuse, self-harm and suicide attempts. The aim of this study was to explore adolescents' and young people's needs and preferences for support as they live with a parent with life-threatening cancer. METHODS Qualitative interviews were conducted with 10 respondents (17-24 years) in Norway and Sweden. Data were analysed through grounded theory according to Charmaz. RESULTS Adolescents' and young peoples' needs and preferences for support were described through the main category 'To feel safe and secure and to be prepared' and further broken down into five subcategories 'Relationships in the immediate family-balancing support and protection'; 'The social network-support and normalcy in a carefully selected group'; 'Maintaining everyday life-challenges in school and working life'; 'The right support at the right time-competence, trust and continuity in meeting health care professionals'; and 'Support outside the home-an opportunity for full transparency'. CONCLUSION Adolescents' and young peoples' preferences for support when living with a parent facing life-threatening illness are individual and unique, but they share a common need to feel safe and secure and to be prepared. Adolescents and young people express that they primarily want support from parents and friends, but they also want support from health care professionals, especially in situations when the ill parent becomes worse. Therefore, it is of the utmost importance for health care professionals to identify the most vulnerable adolescents and young people by mapping their social networks and paying extra attention to their needs for support when there is deterioration in the parent's illness state. This study also highlights the importance for health care professionals to establish a good relationship with adolescents and young people to meet their needs and preferences for support. In addition, information and support are needed in a timely manner and adapted to the life-threatening ill parent's illness state and individual's needs and preferences to optimise preparedness.
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Affiliation(s)
- Emily Bergersen
- Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden. .,Inland Norway University of Applied Sciences, Strandvegen 3, 2206, Kongsvinger, Norway.
| | - Maria Larsson
- Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden
| | - Malin Lövgren
- Marie Cederschiöld University, Box 11189, 100 61, Stockholm, Sweden
| | - Cecilia Olsson
- Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden.,Lovisenberg Diaconal University College, Lovisenberggt. 15b, 0456, Oslo, Norway
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[Partnership and family aspects of cancer]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:446-452. [PMID: 35181794 PMCID: PMC8979853 DOI: 10.1007/s00103-022-03495-1] [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: 10/11/2021] [Accepted: 01/21/2022] [Indexed: 11/02/2022]
Abstract
Cancer is not only a challenge for the patient, but can also be associated with psychosocial distress for relatives, especially partners and minor children. Although studies on the long-term effects of cancer on partners, the partnership, and child development are still rare, there are indications that the psychological distress on relatives may become chronic, and that parental illness is a risk factor for a child to develop mental disorders. In addition, a deterioration in partnership satisfaction also increases the risk of separation.Psycho-oncology care should therefore not only consider the patient's psychosocial burden but also that of the partner, as well as its effect on the partnership. Appropriate offers, for example to increase partnership and sexual satisfaction, communication, or dyadic coping, should be made. Children should also be treated as relatives in care. Focusing on both the child's distress and on improving the parent-child relationships and parenting behavior can help children to cope with parental illness in the long term. Thus, cancer should be viewed on the individual, dyadic, and family level, and psychosocial care services should be provided at all levels.
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Wray A, Seymour J, Greenley S, Boland JW. Parental terminal cancer and dependent children: a systematic review. BMJ Support Palliat Care 2022:bmjspcare-2021-003094. [PMID: 35091436 DOI: 10.1136/bmjspcare-2021-003094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/28/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND When a parent has terminal cancer, their children are part of that experience. Parents often want to protect their children from their disease and prognosis. Knowledge of dependent children's experience will help ensure they receive appropriate support. To date, there is lack of synthesis of this evidence examining children's perspectives. OBJECTIVES To systematically search and synthesise the qualitative literature exploring the experiences of dependent children when their parent has terminal cancer. METHODS Databases of MEDLINE, Embase, PsycINFO, CINAHL, Assia and the Cochrane library were searched systematically from inception to July 2020 to determine eligible studies. Included studies were appraised for quality and thematically synthesised using Thomas and Harden's thematic synthesis framework. RESULTS Fourteen studies were included, which interviewed children about their experiences (n=654 children aged 4-18 years at the time of parental death), from six countries. Five descriptive themes were identified, further categorised into two broad themes: (1) finding out about parental cancer and its impact on the family and (2) coping with life with parental cancer, death and beyond. CONCLUSION Children want to be involved in their parent's cancer experience and to help support the family. Healthcare professionals are ideally placed to support and encourage parents to include their children. They should reassure parents that children can cope well and that maintaining normality will help, and explain the benefits of honest and open communication and how they can include dependent children from diagnosis and beyond.
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Affiliation(s)
- Alexandra Wray
- Wolfson Palliative Care Research Centre, Hull York Medical School, Univeristy of Hull, Hull, UK
| | - Julie Seymour
- Institiute of Clinical Applied Health Research, Hull York Medical School, Univeristy of Hull, Hull, UK
| | - Sarah Greenley
- Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | - Jason W Boland
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
- Palliative Medicine, Care Plus Group and St Andrew's Hospice, NE Lincolnshire, UK
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Steffenak AKM, Anderzén-Carlsson A, Opheim E, Sandsdalen T. Community-based support for children who are next-of-kin for a parent experiencing illness or disability - a scoping review. BMC Health Serv Res 2021; 21:1250. [PMID: 34798870 PMCID: PMC8603592 DOI: 10.1186/s12913-021-07270-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Children who are next-of-kin, for a parent who experience illness or disability, need support. In Norway, guidelines, routines and structured approaches in the community health services are lacking regarding involving children in the care of a parent and for services when supporting children as next-of-kin. Additionally, no existing international review has focused on support from community health and social services for children who are next-of-kin to a parent regardless of the specific illness or disability. Aims This scoping review examined the current knowledge regarding the types of community health and social services support to children 0 to 17 years old living with a parent experiencing illness or disability. The review also identified children’s support preferences and needs. Methods The scoping review involved five stages; identifying research question; identifying relevant articles; selecting articles; charting the data and finally, collating, summarizing and reporting the results. Results Articles which included community health and social services interventions and children’s preferences or needs for support were included. The foci of interventions included preventive education, peer support, psychosocial support, and interventions focusing on family communication and recovery planning. Articles focusing on children’s preferences or need for support described their wish to be recognized as a next-of-kin, having someone to talk to and professional and peer support. Conclusion The review highlighted the importance of children receiving support according to their preferences. It is important to elicit children’s voices, to ensure community health and social services are developed for and tailored to this population.
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Affiliation(s)
| | - Agneta Anderzén-Carlsson
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Elin Opheim
- Inland Norway University of Applied Sciences, Faculty of Health and Social Sciences, Elverum, Norway
| | - Tuva Sandsdalen
- Inland Norway University of Applied Sciences, Faculty of Health and Social Sciences, Elverum, Norway
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Hauken MA, Farbrot IM. The Fuelbox "Young Next of Kin"-A Mixed-Methods Study on the Development and Piloting of a Communication Tool for Adolescents Coping With Parental Cancer or Death. Cancer Nurs 2021; 45:148-160. [PMID: 34010217 DOI: 10.1097/ncc.0000000000000960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adolescents' ability to cope with parental cancer and death is largely dependent on information and open communication, but parents and professionals often feel uncertain in such circumstances. OBJECTIVES To develop and pilot a communication tool to enhance communication with adolescents living with or having lost a parent with cancer. METHODS A Fuelbox was developed in a 4-phased process including adolescents and professionals and piloted by 51 participants (adolescents, parents, and professionals) over 4 months. Using a mixed-methods study with a convergent design, data were collected via a questionnaire and interviews and were then merged. RESULTS The final "Young Next of Kin" Fuelbox consisted of 8 topics and 176 questions. Participants used the Fuelbox in different contexts, utilizing a variety of approaches. The participants found that it covered significant topics and questions important to adolescents' situation. The Fuelbox was considered a very useful and beneficial tool to promote communication with adolescents, given that users maintain awareness of voluntary participation, confidentiality, preparedness, time, and safe frames. CONCLUSION The Fuelbox "Young Next of Kin" seems to be a flexible and accessible communication tool in private and professional settings to enhance communication with adolescents living with or having lost a parent with cancer. As the Fuelbox is diagnosis-neutral in nature, it may be transferable to other populations and settings. IMPLICATIONS FOR CLINICAL PRACTICE The Fuelbox is a flexible, accessible, and useful tool for communication between adolescents and parents, and adolescents and healthcare professionals in specialist and primary healthcare settings.
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Affiliation(s)
- May Aasebø Hauken
- Author Affiliations: Center for Crisis Psychology, University of Bergen (Dr Hauken); and Cancer Care Rogaland, Norway (Mrs Farbrot)
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Losing Her: Children's Reported Concerns in the First 6 Months of Their Mother's Breast Cancer Diagnosis. Cancer Nurs 2019; 43:514-520. [PMID: 31833918 DOI: 10.1097/ncc.0000000000000763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Maternal breast cancer has a significant impact on the well-being of school-aged children, but we know very little about the concerns these children attribute to their mother's illness. OBJECTIVE The aim of this study was to describe child-reported illness-related concerns experienced in the initial 6 months of their mother's diagnosis and to identify any differences by age and gender of the child. METHODS Data were obtained from 140 school-aged children (7-12 years) within 6 months of their mother diagnosis with stage 0 to III breast cancer. Children's written responses to an open-ended question were analyzed: "Think about a situation that has bothered you during the last month that had to do with your mom's breast cancer." Inductive content analysis was used to analyze the data using methods adapted from grounded theory. Trustworthiness of results was protected by coding to consensus, formal peer debriefing, and maintaining an audit trail. RESULTS "Losing Her", the core construct, was identified and organized the children's concerns in 4 domains: (1) her being away from me, (2) worrying about her, (3) seeing my mother be different, and (4) changing how things work. CONCLUSION All children reported illness-related concerns about which they were bothered. Even seemingly short-term treatment-related absences from the child were interpreted as difficult. IMPLICATION FOR PRACTICE Findings from the current study add to nurses' awareness and knowledge about the concerns of school-aged children during their mother's initial treatment of breast cancer. Nurses are in a key position to provide services directly to the child or through the mother.
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Hauskov Graungaard A, Roested Bendixen C, Haavet OR, Smith-Sivertsen T, Mäkelä M. Somatic symptoms in children who have a parent with cancer: A systematic review. Child Care Health Dev 2019; 45:147-158. [PMID: 30690768 DOI: 10.1111/cch.12647] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/29/2018] [Accepted: 01/22/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND This systematic review explored the occurrence and types of somatic symptoms in children (0-20 years) who have experienced parental cancer. METHODS We complemented a systematic literature search from PubMed and PsycInfo with a reference search. We identified 1,694 articles, which were independently screened by two authors; they further evaluated potentially relevant papers for quality and extracted the data. We found nine relevant studies (10 publications) on altogether 672 children with a parent who had cancer; four studies included a control group. RESULTS The studies typically focused on children's psychosocial reactions on parental cancer rather than somatic complaints, so symptom prevalence cannot be reliably summarized. Several studies were small, and the types of somatic symptoms were only specified in five studies. Somatic symptoms were reported as a measure of emotional reactions in the remaining four studies. Three studies provided longitudinal data. The main types of specific symptoms reported were eating problems, pain, sleeping troubles, and bed-wetting. Children of cancer patients tended to show an increase of unspecified somatic symptoms and pain, but evidence was inconsistent. There was a tendency that somatic complaints were associated with increased emotional distress in the children. The material did not allow for separate analysis by age group or bereavement status. CONCLUSIONS Children in families with parental cancer may present with somatic complaints, but the prevalence and significance is not possible to estimate due to very sparse research in this area. Health professionals or counselling providers should not overlook this possible sign of distress. Qualitative studies report significant health anxiety in these children; this may represent a specific topic for counselling in this population. Targeted studies are needed to evaluate the prevalence and significance of somatic symptoms, and especially vulnerable groups need to be identified.
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Affiliation(s)
- Anette Hauskov Graungaard
- Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Christina Roested Bendixen
- Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Ole Rikard Haavet
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Marjukka Mäkelä
- Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
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The Effects on Children’s Anxiety and Quality of Life of a Psychoeducational Program for Families Living With Parental Cancer and Their Network. Cancer Nurs 2018; 41:473-483. [DOI: 10.1097/ncc.0000000000000529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Faccio F, Ferrari F, Pravettoni G. When a parent has cancer: How does it impact on children's psychosocial functioning? A systematic review. Eur J Cancer Care (Engl) 2018; 27:e12895. [DOI: 10.1111/ecc.12895] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/21/2018] [Accepted: 06/26/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Flavia Faccio
- Department of Oncology and Hemato-Oncology; University of Milan; Milan Italy
- Applied Research Division for Cognitive and Psychological Science; European Institute of Oncology; Milan Italy
| | - Federica Ferrari
- Applied Research Division for Cognitive and Psychological Science; European Institute of Oncology; Milan Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology; University of Milan; Milan Italy
- Applied Research Division for Cognitive and Psychological Science; European Institute of Oncology; Milan Italy
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Ghofrani M, Nikfarid L, Nourian M, Nasiri M, Saiadynia M. Levels of unmet needs among adolescents and young adults (AYAs) impacted by parental cancer. Support Care Cancer 2018; 27:175-182. [PMID: 29922938 DOI: 10.1007/s00520-018-4310-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 06/06/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE In this study, we aim to assess types and levels of psychosocial needs in adolescents and young adults (AYAs) who have a parent with cancer. And define and describe the variables analyzing the demographic characteristics. METHODS This descriptive study with cross-sectional design was conducted on 217 participants from five hospitals in Tehran. By use of the "Offspring Cancer Needs Instrument," in adolescents and young adults who had the inclusion criteria, information about the psychosocial needs were collected. Also, a demographic questionnaire was completed by the participants. Mean and standard deviation calculated for each domain and overall scores. Independent t test and one-way ANOVA was used for the comparison of needs' mean and demographic variables. RESULTS Total scores' mean was 126 and among domains, the "information" got the highest and the "support from friends" the lowest mean. Among demographic variables, we found a relationship between parent education (p value = 0.007), treatment statue (p value = 0.015), parent gender (p value = 0.018), and parent-child relationship (p value = 0.027) with the level of psychosocial needs. CONCLUSIONS In this target group of adolescents and young adults, the need for "information" is the strongest domain of psychosocial need during parent cancer trajectory.
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Affiliation(s)
- Marjan Ghofrani
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lida Nikfarid
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Manijheh Nourian
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maliheh Nasiri
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahindokhat Saiadynia
- Ayatollah Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Stefanou K, Zografos E, Zografos GC, Vaslamatzis G, Zografos CG, Kolaitis G. Emotional and behavioural problems in children dealing with maternal breast cancer: a literature review. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2018. [DOI: 10.1080/03069885.2018.1487530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Kalliopi Stefanou
- 1st Department of Propaedeutic Surgery, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
- Transfusion Medicine and Blood Bank Department, General Hospital of Nea Ionia “Konstantopouleio-Patision”, Athens, Greece
| | - Eleni Zografos
- 1st Department of Propaedeutic Surgery, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Georgios C. Zografos
- 1st Department of Propaedeutic Surgery, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Grigoris Vaslamatzis
- 1st Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Constantine G. Zografos
- 1st Department of Propaedeutic Surgery, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Gerasimos Kolaitis
- Department of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Athens, Greece
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The psychological, social, and behavioural impact of a parent's cancer on adolescent and young adult offspring aged 10–24 at time of diagnosis: A systematic review. J Adolesc 2018; 65:61-71. [DOI: 10.1016/j.adolescence.2018.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 02/12/2018] [Accepted: 03/04/2018] [Indexed: 11/17/2022]
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Children's understanding of maternal breast cancer: A qualitative study. Eur J Oncol Nurs 2018; 34:8-14. [PMID: 29784143 DOI: 10.1016/j.ejon.2018.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 02/09/2018] [Accepted: 02/26/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE To explore how children understand their mother's diagnosis of and treatment for breast cancer. METHOD Interpretive description was adopted as the methodology in this study. Eight children aged 8-18 years old, whose mother has been diagnosed with non-terminal breast cancer, were interviewed individually and six of them drew a picture to express their understanding of maternal breast cancer. RESULTS Four themes were identified in this study: "the cancer word is scary" - children's understanding of cancer; "scars and tubes" - children's understanding of surgery; "hair loss" - children's understanding of chemotherapy, and "I can't explain it" - children's understanding of other treatments. Children's understanding of maternal breast cancer and its treatment was relatively realistic, although sometimes inaccurate. CONCLUSIONS Individual evaluation and appropriate explanation is significant to further children's understanding of their mother's illness. Future studies with larger sample size are needed to explore the understanding for children of different ages, in order to provide specific help for these children.
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Stafford L, Sinclair M, Turner J, Newman L, Wakefield C, Krishnasamy M, Mann GB, Gilham L, Mason K, Rauch P, Cannell J, Schofield P. Study protocol for Enhancing Parenting In Cancer (EPIC): development and evaluation of a brief psycho-educational intervention to support parents with cancer who have young children. Pilot Feasibility Stud 2017; 3:72. [PMID: 29238608 PMCID: PMC5725968 DOI: 10.1186/s40814-017-0215-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/01/2017] [Indexed: 12/04/2022] Open
Abstract
Background Parents with cancer have high rates of psychological morbidity, and their children are at risk of poor psychosocial outcomes, particularly in the context of parental distress and poor family communication. Parents express concerns about the impact of cancer on their children and report a lack of professional guidance in meeting their children’s needs. Few parenting interventions exist and current interventions have extensive infrastructure demands making them unsuitable for routine use in most health settings. The aims of this study are to develop and establish the feasibility and acceptability of a novel and accessible psycho-educational intervention to improve parenting efficacy and decrease parental stress among adults with cancer who have children aged 3–12 years. The intervention will be suitable for parents with cancer who are receiving treatment with a view to longer term survival, irrespective of cancer diagnosis, and their respective co-parents. Methods/design This study comprises two phases using the UK Medical Research Council framework for developing complex interventions. In the development phase, intervention content will be iteratively developed and evaluated in consultation with consumers, and in the piloting phase, feasibility will be tested in a clinical sample of 20 parents with cancer and their co-parents using a single arm, pre-test post-test design. The intervention will comprise an audiovisual resource (DVD), a question prompt list, and a telephone call with a clinical psychologist. Questionnaires administered pre- and 1 month post-intervention will assess parental stress, psychological morbidity, quality of life, self-efficacy and perceptions of child adjustment, and family functioning. Intervention feasibility will be determined by mixed-method participant evaluation of perceived usefulness, benefits, and acceptability. Discussion This new initiative will translate existing descriptive evidence into an accessible intervention that supports parenting during cancer treatment and meets the information needs of parents with cancer and their families. This is an important advance: despite increasing recognition of the impact of parental cancer on the family, intervention research lags behind the descriptive literature. This low-intensity, accessible, and targeted intervention places minimal burden on infrastructure and promotes patient autonomy and self-management. If feasible, this style of intervention may be a template for future interventions with similar populations.
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Affiliation(s)
- Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia.,School of Psychological Sciences, University of Melbourne, Melbourne, Victoria Australia
| | - Michelle Sinclair
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia
| | - Jane Turner
- Discipline of Psychiatry, University of Queensland, Herston, Queensland Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland Australia
| | - Louise Newman
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
| | - Claire Wakefield
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales Australia
| | - Mei Krishnasamy
- Department of Nursing, University of Melbourne, Melbourne, Victoria Australia.,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Parkville, Victoria Australia
| | - G Bruce Mann
- Breast Service, Victorian Comprehensive Cancer Centre, Parkville, Victoria Australia.,Department of Surgery, University of Melbourne, Melbourne, Victoria Australia
| | - Leslie Gilham
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia
| | - Kylie Mason
- Parkville Integrated Haematology Service, Victorian Comprehensive Cancer Centre, Parkville, Victoria Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria Australia
| | - Paula Rauch
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA
| | - Julia Cannell
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia
| | - Penelope Schofield
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Parkville, Victoria Australia.,Department of Psychology, Swinburne University, Hawthorn, Victoria Australia
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Zheng R, Lee SF, Bloomer MJ. How nurses cope with patient death: A systematic review and qualitative meta-synthesis. J Clin Nurs 2017; 27:e39-e49. [DOI: 10.1111/jocn.13975] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Ruishuang Zheng
- School of Nursing and Midwifery; Monash University; Melbourne Vic Australia
| | - Susan Fiona Lee
- School of Nursing and Midwifery; Monash University; Melbourne Vic Australia
| | - Melissa Jane Bloomer
- School of Nursing and Midwifery; Faculty of Health; Deakin University; Geelong Vic Australia
- Centre for Quality and Patient Safety Research; Deakin University; Geelong Vic Australia
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Holst-Hansson A, Idvall E, Bolmsjö I, Wennick A. Hoping to reach a safe haven - Swedish families' lived experience when a family member is diagnosed with breast cancer. Eur J Oncol Nurs 2017; 31:52-58. [DOI: 10.1016/j.ejon.2017.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/08/2017] [Accepted: 10/09/2017] [Indexed: 11/30/2022]
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Accessing support before or after a parent dies from cancer and young people’s current wellbeing. Support Care Cancer 2017; 26:797-805. [DOI: 10.1007/s00520-017-3891-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/11/2017] [Indexed: 11/30/2022]
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Golsäter M, Enskär K, Knutsson S. Contributing to making the school a safe place for the child: School nurses' perceptions of their assignment when caring for children having parents with serious physical illness. Nurs Open 2017; 4:267-273. [PMID: 29085652 PMCID: PMC5653391 DOI: 10.1002/nop2.92] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 08/07/2017] [Indexed: 11/17/2022] Open
Abstract
Aim To explore how school nurses perceive their assignment when caring for children having parents with serious physical illness. Design An explorative inductive qualitative design. Method The study is based on interviews with 16 school nurses. The interviews were subjected to qualitative content analysis. Results The main category, “Contribute in making the school a safe place for the child”, reveals how the school nurses try to contribute to making the school a safe place for a child when his/her parent has a serious physical illness. They support children through individual support, as well as at an overall level in the school health team to make the school, as an organization, a safe place. Routines and collaboration to recognize the child when his/her parent has become ill is described as crucial to accomplishing this assignment.
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Affiliation(s)
- Marie Golsäter
- CHILD -Research Group Department of Nursing Science School of Health and Welfare Jönköping University Jönköping Sweden.,Futurum Academy for Health and Care Region Jönköping County Jönköping Sweden
| | - Karin Enskär
- CHILD -Research Group Department of Nursing Science School of Health and Welfare Jönköping University Jönköping Sweden
| | - Susanne Knutsson
- CHILD -Research Group Department of Nursing Science School of Health and Welfare Jönköping University Jönköping Sweden
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Walczak A, McDonald F, Patterson P, Dobinson K, Allison K. How does parental cancer affect adolescent and young adult offspring? A systematic review. Int J Nurs Stud 2017; 77:54-80. [PMID: 29035733 DOI: 10.1016/j.ijnurstu.2017.08.017] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To i) identify and synthesise evidence published since 2007 regarding the impact of parental cancer on adolescent and young adult offspring, ii) identify methodological and evidence gaps addressed during this period and iii) highlight those requiring further attention. DESIGN A systematic review and thematic synthesis of peer reviewed literature regarding the impact of parental cancer upon AYA offspring. DATA SOURCES Online searches of CINAHL, Embase, Medline, PsychInfo and Scopus databases were conducted. Reference lists of included articles were screened and additional searches by prominent authors were performed. REVIEW METHODS Study selection, data extraction and quality analysis was undertaken by three independent researchers. Extracted study data was iteratively reviewed and discussed to achieve consensus regarding thematic synthesis of included studies. RESULTS Database and hand-searching yielded 1730 articles, 54 of which were included in the final synthesis. Included studies are discussed with respect to the following themes: i) study design and quality; ii) measurement and sampling; iii) positive and negative aspects of parental cancer; iv) needs; v) communication and information; vi) coping strategies; vii) interventions; and viii) family functioning and other predictors. Twenty-nine studies reported negative impacts related to parental cancer, while eight identified positive outcomes related to post-traumatic growth. Five returned null or mixed findings. Unmet needs were frequently explored and a new validated measure developed. Communication and information were particularly important for offspring, though these needs were often unmet and parents wanted guidance regarding discussions with their children. Offspring may adopt a variety of coping strategies, some of which appear maladaptive, and may cycle between different approaches. Few evaluations of interventions were identified, and further work in this area is needed. Further evidence has emerged that poorer family functioning and other family and illness-related factors predict worse psychosocial outcomes for offspring, however evidence for other predictors such as age and gender remain mixed. CONCLUSIONS Additional evidence for the negative psychosocial impact of parental cancer on adolescent and young adult offspring, their needs, and factors predicting psychosocial outcomes has emerged in the last decade. However, substantial gaps and methodological issues remain and evidence for the development, efficacy or implementation of interventions for this population is very limited. There is also a clear need for greater focus on bereaved and young adult offspring and those from non-western cultural groups, who remain under-represented in research conducted to date.
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Affiliation(s)
| | - Fiona McDonald
- Canteen Australia, NSW, Australia; Cancer Nursing Research Unit, University of Sydney, NSW, Australia
| | - Pandora Patterson
- Canteen Australia, NSW, Australia; Cancer Nursing Research Unit, University of Sydney, NSW, Australia
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Psychoedukative Gruppeninterventionen für Familien mit einem krebskranken Elternteil. Prax Kinderpsychol Kinderpsychiatr 2017; 66:161-178. [DOI: 10.13109/prkk.2017.66.3.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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30
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Azarbarzin M, Malekian A, Taleghani F. Adolescents' Experiences When Living With a Parent With Cancer: A Qualitative Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e26410. [PMID: 26889396 PMCID: PMC4753004 DOI: 10.5812/ircmj.26410] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 01/11/2015] [Accepted: 02/15/2015] [Indexed: 11/21/2022]
Abstract
Background: Cancer affects not only the patient but also their entire family, especially adolescents. Adolescents whose parents are ill may manifest their distress through changes in school performance, physical complaints of pain and discomfort, as well as changes in social and interpersonal relations. There has been very little research about the effects of cancer on adolescents in Iran. Objectives: The purpose of this qualitative study was to explore the Iranian adolescents’ experiences when living with a parent with cancer. Patients and Methods: In this research, the descriptive-explorative approach was used. There were a total of 27 participants. Purposeful sampling was used and data collection methods were semi-structured deep interviews. Constant comparative analysis was used to study the data. Results: The findings of this study showed that the main experiences of these adolescents were categorized into seven themes: 1- psychological problems of adolescents; 2- supportive-educative needs; 3- cancer as a two edged sword in family relationships; 4- stages of confrontation with the parent’s cancer; 5- effect of cancer on social dimensions; 6- affective and helpful supportive agents; 7- Need of support for education under special conditions. Conclusions: This research showed that Iranian adolescents had the same experiences as other adolescents in other countries in many aspects yet in some issues, such as religious strategy, they had strong religious beliefs that would help them cope with their parents’ cancer. Also it was shown that we must plan a program in which education and support should be provided to enable adolescents to cope with this detrimental situation with minimal disruption.
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Affiliation(s)
- Mehrdad Azarbarzin
- Students’ Research Center, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Azadeh Malekian
- Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran
- Corresponding Author: Fariba Taleghani, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-3137922928, Fax: +98-3136699398, E-mail:
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Parenting challenges in the setting of terminal illness: a family-focused perspective. Curr Opin Support Palliat Care 2015; 9:52-7. [PMID: 25588207 DOI: 10.1097/spc.0000000000000114] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW In the advanced stages of illness, families with dependent children experience disruption across all dimensions of family life. The need for family support during palliative care is well recognized, yet little is understood about how parents and their children navigate these difficult circumstances. This review summarizes the current body of research on parenting challenges in advanced cancer. RECENT FINDINGS To date, the study of parental cancer has focused predominantly on the early stages of disease and its impact on children and adolescents. Less is known about how families with minor children prepare for parental loss. Evidence suggests that having dependent children influences parents' treatment decisions at the end of life, and that a central concern for children and parents is optimizing time spent together. Parents may feel an urgency to engage in accelerated parenting, and maintaining normalcy remains a consistent theme for the ill and healthy parent alike. There is a growing evidence base affirming the importance of responsive communication prior to death. SUMMARY Advancing knowledge about the parenting experience at the end of life is critical for ensuring effective support to the entire family, as it accommodates and prepares for the loss of a vital member.
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Azarbarzin M, Malekian A, Taleghani F. Effects of supportive-educative program on quality of life of adolescents living with a parent with cancer. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2015; 20:577-81. [PMID: 26457095 PMCID: PMC4598904 DOI: 10.4103/1735-9066.164510] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background: Cancer has significant traumatic effects on the family members of the patients, particularly in Asia's tightly knitted families. Research evidence suggests a debilitating impact of cancer on the quality of life of the afflicted individuals, their spouses, and their families. Since a few studies have been carried out on the quality of life of adolescents living with parents diagnosed with cancer, especially in Iran, the research team decided to evaluate the quality of life of them and also investigate the effects of supportive-educative program on it. Materials and Methods: The present quasi-experimental, one-group study had a pre-test–post-test design and was performed in Esfahan in 2014. The sample of this study consisted of 30 adolescents. The data gathering tool was the short form of quality of life questionnaire (SF-36). Data were analyzed by descriptive statistics and paired sample t-test. P-value of 0.05 was considered significant. Results: The paired sample t-test showed that before and after presenting the program, there were significant statistical differences in some aspects of quality of life, such as physical functioning (P = 0.01), energy/fatigue (P < 0.0001), emotional well-being (P < 0.0001), social functioning (P = 0.001), pain (P < 0.0001), and general health (P = 0.01). Conclusions: This research showed that supportive-educative program can enhance some aspects of quality of life. Therefore, nurses and other health professionals can use this scheme or similar programs for helping adolescents living with a parent with cancer.
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Affiliation(s)
- Mehrdad Azarbarzin
- Nursing Student Research Centre, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Malekian
- Psychosomatic Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
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Huang X, Lee S, Hu Y, Gao H, O'Connor M. Talking About Maternal Breast Cancer With Young Children: A Content Analysis of Text in Children's Books. J Pediatr Psychol 2014; 40:609-21. [PMID: 25502613 DOI: 10.1093/jpepsy/jsu110] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 11/22/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Examine the content of children's books and summarize the main issues related to communication with young children about maternal cancer, especially breast cancer. METHODS A search of English books discussing early-stage (breast) cancer and written for children aged 3-12 years was conducted on the Amazon.com Web site. Each of 45 identified books was analyzed independently by two of three coders using inductive qualitative content analysis. RESULTS The main contents of these books included cancer-related knowledge, impacts of maternal cancer, and coping strategies. The concept of (breast) cancer and its treatment was introduced in plain language and some common misunderstandings were clarified. The consequences of maternal cancer were highlighted. CONCLUSIONS These books are beneficial to children and adults. However, impacts on school life, children's concerns about financial burdens, and instructions about age-appropriate use of the books have been neglected. Additional studies should be undertaken to explore the value of these books.
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Affiliation(s)
- Xiaoyan Huang
- School of Nursing and Midwifery, Monash University, School of Nursing, Fudan University, and Psychological Medicine Department, Children's Hospital of Fudan University
| | - Susan Lee
- School of Nursing and Midwifery, Monash University, School of Nursing, Fudan University, and Psychological Medicine Department, Children's Hospital of Fudan University
| | - Yan Hu
- School of Nursing and Midwifery, Monash University, School of Nursing, Fudan University, and Psychological Medicine Department, Children's Hospital of Fudan University
| | - Hongyun Gao
- School of Nursing and Midwifery, Monash University, School of Nursing, Fudan University, and Psychological Medicine Department, Children's Hospital of Fudan University
| | - Margaret O'Connor
- School of Nursing and Midwifery, Monash University, School of Nursing, Fudan University, and Psychological Medicine Department, Children's Hospital of Fudan University
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Hellmüller J, Blasco Blasco T. Estructura básica de una página web para apoyo psicológico a adolescentes cuyos padres tienen cáncer. PSICOONCOLOGIA 1970. [DOI: 10.5209/psic.63655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cuando un padre o una madre enferma de cáncer, a los hijos les afecta el diagnóstico, siendo los adolescentes el grupo más vulnerable a sufrir las consecuencias. Éstos consideran que sus necesidades son poco escuchadas. Por lo tanto se propone crear los elementos de una página web de apoyo psicológico para adolescentes con padres con cáncer. A partir de entrevistas semiestructuradas con adolescentes, padres afectados, y psicooncólogas, y de la comparación de estos datos con los provenientes de la literatura, hemos llegado a la conclusión de que la página web debería incluir tres elementos fundamentales: información, asesoramiento para el uso de estrategias de afrontamiento, y posibilidad de interactuar con otros adolescentes en la misma situación y también con profesionales. Es también muy necesario que la página web no sea iatrogénica por lo que se propone un sistema de filtros que permitan dirigir al adolescente a los contenidos adecuados para su situación, evitando, en la medida de lo posible, que realice interpretaciones y desarrolle expectativas erróneas que puedan generarle confusión o malestar.
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Fuentes S, Blasco T. Padres diagnosticados de cáncer: malestar emocional y recursos para comunicarse con sus hijos meno. PSICOONCOLOGIA 1970. [DOI: 10.5209/psic.57082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo: Conocer los recursos que poseen los padres afectados por cáncer al comunicar la enfermedad a sus hijos menores y su relación con el malestar emocional de estos pacientes. Método: Se evaluó el estilo de comunicación familiar mediante una subescala del FAD (Mc Master Family Assessment Device). Se elaboró un cuestionario específico para evaluar los recursos de los pacientes, donde cada ítem era valorado con una escala de 0 a 10 (siendo 0 nada en absoluto y 10, la máxima puntuación posible). También se utilizó una escala numérica de valoración del malestar emocional, en forma de un solo ítem (0-10). El conjunto de pruebas se aplicó a 60 pacientes de edades comprendidas entre los 34 y los 60 años todos ellos padres afectados de cáncer con hijos menores a su cargo. Resultados: Los recursos que parecen poseer en mayor medida los padres evaluados son los recursos relacionados con la gestión de la vida doméstica (media = 8,3), seguidos de los que hacen referencia a delegar a terceras personas los cuidados de sus hijos durante momentos difíciles. Al analizar con más profundidad estos dos recursos, detectamos que más del 80% de los padres de la muestra poseen el recurso relacionado con la gestión de la vida doméstica. Por el contrario, el recurso de como informar sobre la situación de enfermedad a los niños, lo tiene poco más de la mitad de los pacientes evaluados (55%). Los datos indican que existe una relación inversa entre la disponibilidad de este recurso y el nivel de malestar emocional, ya que los pacientes que consideran tener recursos para hablar de la enfermedad a sus hijos, presentan un menor malestar emocional. Conclusiones: Los padres recién diagnosticados de cáncer que plantean comunicar la situación de enfermedad a sus hijos menores, poseen más recursos para gestionar la vida doméstica y delegar el cuidado de sus hijos cuando lo precisan a terceras personas, que para informar sobre la enfermedad y sostener emocionalmente a sus hijos. Así mismo, el no disponer de recursos para comunicar el diagnóstico a los hijos se asocia con una mayor presencia de malestar emocional.
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