Hope in Iranian mothers of children with cancer: a descriptive correlational study

Relationship of caregiving burden and adaptive behaviors in mothers of children with chronic diseases

INTRODUCTION

Mothers of children with chronic diseases, as the main caregivers, face the care burden. The care burden of mothers can affect their adaptive behaviors and lead to the use of inappropriate adaptive behaviors. This study was conducted to determine the relationship between the caregiving burden and adaptive behaviors of mothers of children with chronic diseases.

METHODS

In this descriptive-analytical cross-sectional study, 238 mothers of children with chronic diseases participated by the convenience sampling method. Data collection tools included a demographic information questionnaire, a zarit care burden questionnaire, and a health matching questionnaire for parents. Data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson analysis in SPSS software version 26.

RESULTS

The majority of mothers had a mean age of 34.6 ± 7.6 years. The caregiving burden on the mothers of children with chronic diseases was high (21.95 ± 7.76) and most of the mothers had favorable adaptive behaviors in facing their child's illness (95.14 ± 17.15). The most intensity of the significant correlation was in the pattern of "family integrity and optimization of the situation" (P < 0.001, r = -0.434). The mother's illness (P = 0.009, β = 2.874), care of the child with chronic disease only by the mother (P = 0.008, β = 3.142), and immunodeficiency disease of the child (P = 0.021, β = 4.456) positively predicted the caregiving burden.

CONCLUSION

These findings help healthcare systems plan supportive and educational programs for decreasing the caregiving burden and increasing adaptive behaviors in mothers of children with chronic diseases.

LAY SUMMARY

A cross-sectional study was conducted to determine care burden and adaptive behaviors in mothers with chronically ill children. The results showed that mothers' care burden was high and significantly related to their behavior and adaptation. Mothers had favorable adaptive behaviors.

The mediating effects of parental hope and psychological resilience on social support and decision conflict in children with hypospadias

INTRODUCTION

The most common congenital genital abnormality of the urinary system in infants is hypospadias; its frequency is rising to 0.33 percent globally. Surgical reconstruction is the most effective treatment for hypospadias.Parents, as surrogate decision-makers for children, frequently experience decision-making conflicts when making decisions. Stress is neither a straightforward stimulus nor a simple response. However, a stressor (stimulus) caused by life events and influenced by numerous intermediate factors including personality, social support, and psychosomatic symptoms or diseases is a multi-factor process of stress response (response). The surgical decision conflict of parents of children with hypospadias is a type of stress response, and social support may have an effect on parents' hope, psychological resilience, and decision conflict, with hope and psychological resilience serving as mediators between social support and decision conflict.

AIM

To investigate the structural relationship between parental social support, hope, psychological resilience, and parents decision conflict in children with hypospadias.

STUDY DESIGN

A cross-sectional design was used to collect the data of 210 parents of children with hypospadias from Department of Urology, Shenzhen Children's Hospital from April 2022 to March 2023.

RESULTS

Social support indirectly affects decision conflict through hope and psychological resilience, with a total indrect effect of -0.511 (P < 0.05).

DISCUSSION

Decision conflicts and regret can be reduced if medical professionals provide adequate and clear information, decision assistance, and meet support requirements during the decision-making process. Improving the level of psychological resilience, hope, and social support among parents of children with hypospadias is a crucial strategy for reducing the level of decision conflict they experience. In the process of making surgical decisions for children with hypospadias, the more sufficient social support from relatives, friends, and medical staff can stimulate their hope, boost their belief in the success of surgery, and the greater their psychological resilience, the more effectively decision conflict can be reduced. Some potential limitations of this study should be considered. Firstly, this study was a cross-sectional survey design. It may have some limitations in providing causal relationships between selected variables. Second, the survey investigated only one hospital, which reduces the generalizability of the findings.

CONCLUSION

The data support the proposed model and confirm the structural relationship among the four study variables. This study provides new information on the mediating role of hope and psychological resilience between social support and decision-making conflict.

Predictors of Moderate-High Posttraumatic Growth in Parents of Children With Cancer: A Cross-sectional Study

BACKGROUND

Parents of children with cancer may experience posttraumatic growth (PTG). In clinical practice, this parental enhancement is more likely to be seen with a moderate-high PTG.

OBJECTIVE

The aim of this study was to determine the moderate-high PTG prevalence of parents of children diagnosed with cancer at least 6 months and to investigate its relationship with hope, social support, and patient-parent characteristics.

METHODS

This cross-sectional study was conducted with the parents of children with cancer admitted to the pediatric hematology-oncology unit using the Parent-Child Characteristic Questionnaire, Posttraumatic Growth Inventory, Multidimensional Scale of Perceived Social Support and Dispositional Hope Scale. Univariate and multivariate logistic regression analyses were performed to investigate the variables associated with moderate-high PTG.

RESULTS

One hundred one parents were enrolled in this study, and the prevalence of the moderate-high PTG was 79.2%. There was a statistically significant difference between moderate-high PTG and children's age (P = .037). Multivariate logistic regression analysis showed that social support from significant others (odds ratio = 1.138, 95% confidence interval = 1.030-1.257, P = .011) was a predictor of moderate-high PTG.

CONCLUSIONS

Moderate-high PTG is common among parents of children diagnosed with cancer. Perceived social support from healthcare professionals and other patient parents is a predictive factor.

IMPLICATIONS FOR PRACTICE

Interventions that encourage the support of health professionals and interaction with the parents of other patients, such as peer counseling, group-based interventions, and expanding the social support network, seem to be clinically promising in helping parents to improve from the cancer experience.

A parental burnout modelling based on perfectionism mediated through self-compassion in parents of students suffering from specific learning behavioral disorder

The association between parental burnout and perfectionism, and whether and to what extent it is mediated by self-compassion, in case of mothers of children with Specific Learning Disorder (SLD) were rarely investigated in the related literature. To fill the gap felt, the present study aimed at providing a model for self-compassion, parental burnout, and perfectionism. The participants were 305 mothers of children with SLD, from Hamedan province, Iran, who had been referred to the relevant treatment centers between 2020 and 2021. Selected through convenience sampling, they took part in the study by completing three questionnaires, i.e., Parental Burnout Assessment (Roskam et al., 2018), Multidimensional Perfectionism Scale (Hewitt & Flett, 1991), and Self-Compassion Scale (Neff, 2003). To fit the model, structural equation modelling was conducted in Amos v24 software. It was found that self-compassion mediates the negative relationship between parental burnout and perfectionism. It can be concluded that women during motherhood become emotionally vulnerable and are susceptible to face psychological challenges and such challenges can be exacerbated in the case of mothers of children with SLD or other learning disabilities.

Hope experiences in parents of children with cancer: A qualitative meta-synthesis

PURPOSE

To synthesise qualitative research on the parental hope experiences for children with cancer and identify the levels of parental hope experiences and psychosocial adjustment during cancer events.

METHODS

Five electronic databases (Cochrane Library, PubMed, Embase, Web of Science, and CINAHL) and three Chinese databases (CNKI, Wanfang, and VIP) were used to retrieve qualitative studies on the hope experiences of parents of children with cancer from inception to February 2023. The Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to assess the methodological quality of the included studies. Data were synthesised using a thematic analysis.

RESULTS

Four analytical themes were identified: the process and way hope exists, sources of hope, positive effects of hope, and obstacles to hope maintenance.

CONCLUSIONS

Maintaining hope is crucial for parents who are caring for their children with cancer. There are different sources of hope, and targeted interventions can enhance the experience of hope for parents of children with cancer. Families, healthcare providers, and society should pay more attention to the parents of children with cancer and provide them with psychological, social, and financial support to improve their level of hope and quality of care.

The effect of psychological resilience and spiritual well-being on the experience of hope in parents of children with cancer

PURPOSE

Hope in pediatric oncology guides parents as an inner guidance compass through their child's challenging journey toward cancer treatment. This study was designed to examine the effects of psychological resilience, spiritual well-being, and some child- and parent-related factors on parents' experience of hope while their child is undergoing cancer treatment.

DESIGN AND METHODS

This cross-sectional, correlational study was conducted between March and July 2022 in the pediatric oncology-hematology ward of a university hospital in Turkey. Parents of 120 children with cancer were included in the study. Data were collected using the child and parent questionnaire, Herth Hope Index, Connor-Davidson Resilience Short Form, and Spiritual Well-Being Scale. Correlation and multiple linear regression analysis were used to analyze the data. In addition, the content analysis method was used to analyze the open-ended structured questions. Ethical approval was obtained for the study.

RESULTS

In the study, 57.5% of the parents who participated were mothers. The mean age of the children was 9.46 ± 5.00 years. 30.8% of the children were diagnosed with Acute Lymphoblastic Leukemia, and the mean duration of treatment was 20.42 ± 13.75 months. According to multiple linear regression analysis, child gender (β = -0.16), number of children (β = -0.16), cancer diagnosis (β = -0.24), resilience (β =0.31), and parental spiritual well-being (β =0.40) were the determinant factors affecting parents' experiences of hope. All these predictors explained 55% of the change in parents' hope levels. In addition, two main themes (increasing and decreasing factors) were identified regarding parents' experiences of hope.

CONCLUSIONS

Insights from this study have the potential to shape interventions specifically designed to maintain parents' hope throughout their child's cancer treatment journey.

IMPLICATIONS FOR PRACTICE

This study may provide insights for the design of intervention programs in pediatric oncology hematology wards aimed at strengthening the hope and improving coping mechanisms of parents with children coping with cancer.

Investigation of the Relationship Between Spiritual Coping Styles and Hope Levels in Mothers with Disabled Children in Turkey

The birth of a child is a process in which family life and daily routines undergo significant changes and adjustments. This study aims to investigate the relationship between spiritual coping styles and hope levels in mothers with disabled children. The study was conducted between January and April 2022 with mothers whose children were enrolled in a rehabilitation center of a district located in eastern Turkey. The target population of the study was 110 mothers who had children enrolled in the rehabilitation center. The sample of the study was 102 mothers who agreed to participate in the study. Data were collected through the Personal Information Form, the Trait Hope Scale, and the Maternal Spiritual Coping Scale. Spiritual coping mean scores were high in mothers who had a female disabled child, did not have any other disabled children, received support from the state for their child's care, did not ignore their other children's care due to the special condition of the disabled child and did not feel guilty, and were worried about their children's future. The difference between the mean scores was statistically significant (p < 0.05). Hope mean scores were found to be high in women who had children with physical and hearing disability, were illiterate, had a low economic condition, and received psychological support for the condition of their children. The difference between the mean scores was statistically significant (p < 0.05). A positive relationship was found between maternal spiritual coping levels and hope levels. In-line with this result, it is recommended to organize programs to help mothers to accept their children's condition and cope with their situation.

Nursing care based on the Support-Based Spiritual Care Model increases hope among women with breast cancer in Iran

PURPOSE

Taking care of cancer patients and treating them are among major challenges in the field of health. Several studies have shown that promotion of hope is an efficient strategy for effectively treating this group of patients, reducing their symptoms, and improving the quality of their life. It seems that spiritual care can boost hope in these patients. This study aims to determine the effects of nursing care based on the Support-Based Spiritual Care Model on boosting hope among women with breast cancer.

METHODS

In this controlled clinical trial, 72 patients with breast cancer were selected through consecutive sampling and randomly assigned to two control and intervention groups (n = 36 in each group) based on four randomized blocks. The intervention was carried out based on the Support-Based Spiritual Care Model for the patients and their main caregivers in six sessions. Besides, the Snyder's hope scale was completed before and 1 month after the intervention by the participants in the intervention and control groups.

RESULTS

The results of the independent samples t-test showed no significant difference in the mean scores of hope between the intervention and control groups before the intervention (P > 0.05). However, after the intervention, the mean scores of hope for the intervention and control groups were 46.71 ± 4.61 and 40.40 ± 5.42, respectively, showing a significant intergroup difference as verified by the independent samples t-test (P < 0.05).

CONCLUSION

According to the results of this study, providing nursing care based on the Support-Based Spiritual Care Model can raise hope in patients with breast cancer.

CLINICAL IMPLICATIONS

Healthcare professionals can boost hope in cancer patients through proper planning and adequate support in providing nursing care based on the proposed model.

Hope level and associated factors among parents of retinoblastoma patients during COVID-19 pandemic: a cross-sectional study

BACKGROUND

The 2019 coronavirus disease (COVID-19) is a global public health emergency. So far, only a limited number of studies have investigated the impact of the COVID-19 pneumonia pandemic on the mental health of parents having children with cancer. This study investigated the hope, and relevant influencing factors (depression, anxiety, demographic data) among parents whose children had retinoblastoma (RB) during the COVID-19 pandemic.

METHODS

A cross-sectional survey and a convenient sampling survey were conducted on 317 parents of RB children admitted to the Ninth People's Hospital affiliated with Shanghai Jiao Tong University, School of Medicine, and Qilu Children's Hospital of Shandong University. The survey tools included Demographic Questionnaire, Herth Hope Index (HHI), The Generalized Anxiety Disorder (GAD-7), and the Patient Health Questionnaires (PHQ)-2.

RESULTS

The hope level score of the parents of RB patients was (35.36 ± 4.42), which was at the medium level. The highest dimension of hope score was inner positive readiness and expectancy (12.07 ± 1.57), and the lowest dimension was interconnectedness with self and others (11.50 ± 1.64). The incidence rate of depression and anxiety was 29.97% (95/317) and 41.32% (131/317), respectively. Monoculus or binoculus disease, sleep status, health status, and depression /anxiety had statistically significant effects on the parental hope level (p < 0.05). Multiple linear regression analysis revealed that time since diagnosis, education level, treatment type and depression were independent influencing factors (p < 0.05), accounting for 22.60% of the variation in hope level.

CONCLUSION

During the COVID-19 pandemic, medical staff should formulate targeted intervention measures according to different characteristics of ocular disease, time since diagnosis, treatment type, parental educational level and emotional state in order to improve the level of parental hope.