Parenting experiences of cancer patients with minor children and their conversations about the possibility of death: a cross-sectional web-based survey for an online cancer community

PURPOSE

Many cancer patients with minor children experience difficulty talking about their illness with their children. This study aimed to investigate the parenting experiences of cancer patients with minor children and their conversations about the possibility of death.

METHODS

A cross-sectional web-based survey was conducted between April and May 2019. Cancer patients with at least one child aged < 18 years were recruited from an online peer support group called "Cancer Parents." The participants were asked to complete a questionnaire about their experiences of talking about their illnesses with their children. The participants were classified into those who disclosed their cancer to their children ("disclosing group"), and those who did not disclose ("non-disclosing group"). The association between whether they talked with their children about their cancer, and whether it included conversations about the possibility of death, was examined.

RESULTS

A total of 370 parents participated (with 80.8% female parents, with a median age of 43.0 years). The disclosing group (n = 274, 74.1%) wanted to know what their child felt, more than the non-disclosing group did (p < 0.001). Members of the non-disclosing group had a greater tendency than those in the disclosing group to report that they did not want their children to see their suffering (p = 0.002) and did not know how to explain their disease status (p < 0.002). Some members of both the disclosing (42.1%) and non-disclosing (6.5%) groups told their children about the possibility of death.

CONCLUSION

This study showed that 74.1% of the patients with minor children disclosed their cancer to their children. The parents' feelings when thinking about interacting with their children differed significantly between the disclosing and non-disclosing groups. It is important for healthcare professionals treating patients with cancer to provide appropriate multidisciplinary support for discussing their diagnosis and prognosis with their children.

Association Between Loneliness and the Frequency of Using Online Peer Support Groups Among Cancer Patients With Minor Children: A Cross-Sectional Web-Based Study

CONTEXT

Cancer patients with minor children are increasing; however, they do not receive sufficient support.

OBJECTIVE

This study aimed to investigate the association between loneliness and the frequency of using online peer support groups among cancer patients with minor children.

METHODS

A cross-sectional web-based survey was conducted from April to May 2019. Cancer patients with minor children were recruited from an online peer support group called "Cancer Parents." Individuals diagnosed with cancer and whose youngest children were younger than 18 years were enrolled. Materials included: the UCLA Loneliness Scale version 3 (UCLA-LS), K6 scale, abbreviated Lubben Social Network Scale, and the sociodemographic/clinical characteristics questionnaire. Multivariate logistics regression analysis was performed to determine the factors associated with the high loneliness group (defined as those above the median score on the UCLA-LS).

RESULTS

A total of 334 patients participated (79.9% female; mean age 43.1 years, standard deviation 5.8). The most common primary cancer type was breast (34.1%). The median score of the UCLA-LS was 45 (interquartile range 37-53). The multivariate logistics regression analysis revealed that the high loneliness group was significantly associated with the frequent use of online peer support group less than once a week (odds ratio [OR] = 0.47; 95% CI = 0.26-0.85; P = 0.012), with a smaller social network (OR = 0.78; 95% CI = 0.73-0.83; P < 0.001), and higher psychological distress (OR = 1.16; 95% CI = 1.09-1.23; P < 0.001).

CONCLUSIONS

Frequent use of online peer support groups was associated with less loneliness among cancer patients with minor children.

Exploring the Score Equivalence of the English and Chinese Versions of the Brief Assessment Scale for Caregivers

Background:

Multilingual outcome measures are used so that research studies are more generalizable across language contexts.

Objective:

To determine the score equivalence of the English and Chinese versions of Brief Assessment Scale for Caregivers (BASC) in Singapore.

Method:

Caregivers of patients with advanced cancer completed the BASC in either English or Chinese. Multivariable linear regression analysis was used to compare the mean BASC total and factor scores between the 2 language versions, with adjustment for possible confounding variables. Equivalence was declared if the 90% confidence interval of the mean scores fell entirely within an equivalence zone of ±0.5 standard deviation.

Results:

There were 521 ethnic Chinese participants, of whom 214 answered the English version and 307 answered the Chinese version. The BASC total and factor scores met the criteria for equivalence. Cronbach α coefficients were similar and exploratory factor analysis showed similar 2-factor structures for both language versions.

Conclusion:

The English and Chinese versions of the BASC were found to be equivalent in terms of similar adjusted mean scores, Cronbach α, and factor structures.

The Experiences of Family Caregivers at the End of Life: Suffering, Compassion Satisfaction and Support of Health Care Professionals: Experiences of Caregivers at the End of Life

A death with dignity is influenced by the quality of care offered to patients. The objective of this study was to identify, through the firsthand experiences and insights of family caregivers, the key elements related to the care offered to patients with a terminal illness at the end of life. This multicenter qualitative study was based on the paradigm of hermeneutic phenomenology. Participants were relatives of patients with terminal illness who had been identified as primary caregivers. Five discussion groups and 41 in-depth interviews were organized with a total of 81 participants. The content of the interviews was analyzed based on the methods developed by Giorgi (J Phenom Psychol 1997;28(2):235-260). The results indicate the existence of 3 dimensions: the caregiver's suffering, compassion satisfaction with the care provided, and the support of health care professionals. Understanding the experiences of family members providing end-of-life care allows improved care and provides dignity in death. Health and social systems must provide comprehensive assistance covering the different aspects of needed care. Health professionals occupy a privileged position in the care of these patients and their families.