Perceptions of children with cancer and their parents regarding illness: A qualitative study

Comparing the effectiveness of mandala art and value clarification on the anxiety and emotional state of parents of children with cancer: A randomized controlled trial

PURPOSE

The study aims to compare the effectiveness of mandala art and value clarification practices based on Watson's Theory of Human Caring on the anxiety and emotional state of parents of children with cancer.

METHODS

The study was conducted as a randomized controlled trial and included parents of children being treated for cancer at the Pediatric Hematology and Oncology Clinic of a university hospital. The sample of the study is three groups; it consisted of a total of 75 people as mandala group (n:25), value clarification group (n:25) and control group (n:25). The mandala group participated in 2 sessions of individual mandala art accompanied by music. Value clarification group participated in the value clarification activity in 2 sessions of individual writing accompanied by music. For the pre-test data, the Personal Information Form, State Anxiety Inventory (SAI), and Positive-Negative Affect Scale (PANAS) were administered to both groups before the first session. After the second session, the same two scales were used again for the post-test data. The analyses of data were carried out with the Statistical Package for the Social Sciences software (version 23.0, SPSS Inc.). Chi-squared tests, t-tests, and one-way ANOVA were used to analyze the differences in the mean scores between the groups.

RESULTS

The parents' average age was 36.2 years (SD = 7.40), with 92.0% being female. The SAI score and PANAS negative emotion score of the mandala and value clarification groups decreased significantly compared to the control group, and the PANAS positive emotion score increased significantly (p < 0.05). However, when comparing the mandala group with the value clarification group, no statistically significant differences were found in the mean SAI and PANAS scores (p > 0.05).

CONCLUSION

The individual mandala art and writing value clarification interventions based on Watson's Theory of Human Caring are effective in increasing positive emotions and reducing negative emotions and anxiety levels among parents of children with cancer.

Intercultural differences in parental perceptions of children's cancer

PURPOSE

Cultural influences on parental perceptions of their children's cancer effect familial coping and adjustment. We investigated parental perceptions of their child's illness severity and treatment among Jewish Israeli and Arab (Palestinian Israelis and Palestinians from the West Bank /Gaza) parents of pediatric oncology patients to better understand possible cultural differences and similarities.

METHODS

During this mixed-methods cross sectional study, the Brief Illness Perception Questionnaire was completed by 205 parents of children receiving treatment in four medical centers throughout Israel.

RESULTS

Jewish parents perceived the hospital treatment to be more effective. Arab parents perceived that cancer has a greater negative emotional influence on them as compared to Jewish parents. Further, Jewish parents felt that their child's illness had greater impact on their lives compared to Arab parents. Finally, Arab parents felt they had greater control of the illness and better understanding of the illness. When asked what they believed had 'caused' their children's cancer, both groups expressed, spiritual-religious, child's immunity status and environmental causes, yet Arab parents mentioned unhealthy food, superstitions and Supernatural (the evil eye) causes more frequently.

CONCLUSIONS

Understanding how culture influences parental illness perceptions can assist pediatric oncology nurses and social workers to offer more effective treatment management.

IMPLICATIONS FOR NURSING PRACTICE

These results highlight the need to extend cultural competence to incorporate illness perception among different ethnic and religious groups being treated in a pediatric oncology department.

Identifying Typologies of Symptoms and Functional Impairments in Chinese Children With Leukemia and Their Population Characteristics: A Latent Profile Analysis

BACKGROUND

Symptom distress and functional impairments in children with leukemia directly affect their quality of life.

OBJECTIVES

To identify subgroups of symptom distress and functional impairments in Chinese children with leukemia and to examine the associations of the latent classes with individual characteristics.

METHODS

This multicenter cross-sectional survey study recruited children with leukemia who received chemotherapy in 4 hospitals in Shanghai, Jiangsu, Zhejiang, and Guangdong Province. The participants were surveyed via PROMIS-25 (Patient-Reported Outcomes Measurement Information System Pediatric-25 Profile). Latent profile analysis and multinomial logistic regression model were performed to identify subgroups of symptom distress and function impairments among children with leukemia.

RESULTS

Latent profile analysis results suggested the classification of 3 subgroups: profile 1: "moderate symptom distress, moderate mobility impairment with fair peer relationship function" group (69, 28.3%), profile 2: "mild symptom distress, no mobility impairment with good peer relationship function" group (97, 39.8%), and profile 3: "no symptom distress, no mobility impairment with good peer relationship function" group (78, 32.0%). Sociodemographic characteristics, including gender of the children, gender and marital status of the parents, average monthly income of the family, and reimbursement ratio of treatment expenses, had significant associations with the latent profile membership ( P < .05).

CONCLUSION

This study identified 3 distinct profiles of symptom distress and functional impairments in children with leukemia and found significant associations between these profiles and sociodemographic characteristics.

IMPLICATIONS FOR PRACTICE

The classification of the 3 latent profiles in children with leukemia helps to provide targeted supportive intervention to those children and their families.

Challenges and coping strategies among caregivers of children with cancer receiving care at a national referral hospital in Kenya

BACKGROUND

The number of children diagnosed with cancer is expected to increase by 2050. The caring aspect of these children is usually left to members of the family, more so the mothers. Caregivers are usually faced with various challenges, such as financial issues, social stigma, and emotional and psychological issues. Caregivers use various coping strategies to manage the challenges they experience in the caring process, which can be positive or negative coping strategies.

OBJECTIVE

To explore the challenges and coping strategies of caregivers of children with cancer receiving care at a national referral hospital in Kenya.

METHODS

This study employed a descriptive phenomenological approach to explore the challenges and coping strategies of caregivers of children with cancer receiving treatment at a national referral hospital in Kenya. Purposive and snowball sampling techniques were used to select 44 participants for five focus group discussions (FGDs) conducted between October and December 2023. The data were analysed via inductive thematic analysis.

RESULTS

Four themes arose from the challenges experienced, which included psychological, financial, treatment-related, and social/family-related issues. These eleven subthemes included stress, depression, lack of transport, lack of food, loss of employment, treatment delays, and marital issues, among others. Two themes related to coping strategies were positive adaptation and denial, which were highlighted as negative coping strategies. Positive coping included praying, crying, talking to people, and seeking help.

CONCLUSION

Caregivers of children with cancer undergo various challenges and apply various coping strategies to try and adapt to their new normal. Reinforcing positive coping strategies and helping caregivers utilize other coping strategies, such as the use of support groups, could help them better care for their children.

Mothers' efforts to overcome difficult twists and turns in living with children with cancer: a phenomenological study

BACKGROUND

Child cancer impacts the entire family. However, those who identify as mothers may be most negatively affected due to the societal expectations placed upon them in primary caregiving. This study was conducted with the aim of exploring the lived experiences of mothers of children with cancer and their adaptation to their child's illness.

METHODS

This study employed a qualitative and hermeneutic approach using Heideggerian phenomenology as a philosophical framework. Our sampling strategy was purposive. Mothers (n = 14) of children diagnosed with cancer participated in face-to-face semi-structured interviews. The seven-steps of critical hermeneutic analysis were used to summarize and interpret findings.

RESULTS

Analysis revealed that participants' adaptation to their child's illness occurs through comprehensive support and the utilization of empowering beliefs. The theme of comprehensive support included sub-themes of seeking informational support, seeking psychological support, and seeking social support. The theme of utilizing empowering beliefs encompassed sub-themes of resilience against cultural misconceptions and reliance on spiritual beliefs. Furthermore, one constitutive pattern 'mothers' efforts to overcome difficult twists and turns in living with children with cancer' was identified.This related to participants' striving to navigate the twists and turns of life's hardships.

CONCLUSIONS

Relationships and social context are vital and important features of this phenomena. Employing a team approach to provide comprehensive support to mothers of children with cancer involving physicians, nurses, and psychologists can be supportive in their adaptation to their child's cancer. Additionally, reductions in cultural taboos surrounding cancer could facilitate improved adaptation to childhood cancer for these mothers.

Well-being in parents of children with cancer: illness perceptions' mediating role for hope and social support

Introduction

Parents of children with cancer may experience enormous physical and emotional pressures. During such times, perception of the situation can be important in mediating the link between one's basic resources (mainly cognitive and social) and the well-being one attains as an emotional and cognitive response. This study aimed to explore the role of illness impact perceptions in mediating the link between hope, social support and subjective well-being in parents of children with cancer.

Methods

The cross-sectional study included 108 parents of children aged 7-18 diagnosed with cancer at least 6 months prior to the study. The parents completed one questionnaire comprising five instruments: perceived impact of illness, hope, social support, positive and negative affect (the emotional component of well-being) and life satisfaction (the cognitive component of well-being). Descriptive statistics and Pearson correlations were conducted for all study variables. SEM analysis was performed to examine the study's theoretical model.

Results

The current sample included 108 parents of children with cancer recruited from two pediatric hematology-oncology wards in two different hospitals in central Israel. Most participants were mothers (70.4%), and the mean age was 44.46. The main results indicated that hope and social support correlated negatively with perceptions of the illness' impact. Illness impact perceptions mediated the relations between hope, social support and positive emotions, which means that when the parents perceived their child's illness as less impactful on the family, they experienced higher levels of emotional well-being.

Conclusion

A parent with social support resources and higher levels of hope experiences higher levels of positive perceptions regarding their child's illness. Higher levels of positive perceptions allow the parent to express more positive than negative emotions, thus maintaining a more optimal level of subjective emotional well-being. The findings offer implications for healthcare teams to enhance sensitivity to parents' needs and to help parents attain more resources, positive perceptions, and well-being.

Illness cognition and associated socio-demographic and clinical factors in parents of children with leukemia

PURPOSE

Illness cognition is an important mediator between psychological and behavioral adjustment and the quality of life for patients and their caregivers. Evidence related to illness cognition among parents of children with leukemia is limited. The purpose of this study is to explore the illness cognition status and associated factors in parents of children with leukemia.

METHODS

A cross-sectional survey was conducted with the parents of 335 children with leukemia from three general children's hospitals in China from January to December 2022. A parents' version of the illness cognition questionnaire was used to collect data. This included three subscales: helplessness, acceptance, and perceived benefits.

RESULTS

The mean scores of helplessness, acceptance and perceived benefits of parents regarding their children's disease were 15.56 (4.60), 16.25 (4.41), and 19.96 (3.69) respectively. The multiple regression model indicated seven factors associated with the parents' illness cognition (adjusted R [2] ranged from 0.182 to 0.134): four socio-demographic factors (parent's age, role, education level, and family income) and three clinical factors (length of time spent each day caring for the child, the child's age at diagnosis, and the duration of the disease).

CONCLUSION

This study reports on different levels of illness cognition and associated factors among parents of children with leukemia. The results may help pediatric oncology medical staff identify risk factors for poor psychological adjustment to children's diseases. Parents may benefit from psychological support aimed at improving positive illness cognition.

Gaps in pediatric oncologic end of life care as recounted by the bereaved parents in Isarel

PURPOSE

This study investigated parents' perception of their needs and those of their children with cancer at the end-of-life period, including unmet needs and their expectations regarding providers.

DESIGN AND METHODS

This cross-sectional study involved 26 parents recruited from three pediatric hematology-oncology wards in Israel who completed demographic and medical questionnaires of the child, and a parental needs questionnaire based on The Needs Assessment of Family Caregivers-Cancer questionnaire, following the death of their child.

FINDINGS

Parents expressed needs related to medical care, including pain management, decision-making, and finding optimal treatment options for their children. The most prominent unmet needs were financial and psychological factors, of which, paying for medical expenses and helping their child adjust to the end of their life received the highest mean scores. There were notable gaps between desired and actual support from service providers, particularly in relation to emotional aspects. While over half of the parents believed the psychosocial team should assist with their child's emotional distress, this need was not adequately fulfilled. Some parents also expressed a desire for better emotional support during the end-of-life period.

CONCLUSIONS

The study emphasizes the importance of understanding parents' needs and perspectives during this challenging time. The identified gaps in support can be attributed to parental roles, the struggle with losing hope, communication barriers between care teams and parents, among others.

PRACTICE IMPLICATIONS

By gaining insight into these needs and perceptions, care teams can enhance the provision of palliative care and optimize the distribution of responsibilities within the team.