1
|
Sze Chong AS, Ahmad M, Alias H, Iqbal Hussain R, Lateh A, Chan CMH. An intervention module for caregivers of children with acute lymphoblastic leukemia (ALL). J Psychosoc Oncol 2024:1-15. [PMID: 38873844 DOI: 10.1080/07347332.2024.2364670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Childhood cancer caregivers report psychological distress and unmet psychosocial needs, affecting outcomes for their children. An experimental study was carried out to measure the effectiveness of an intervention in addressing traumatic stress, depression and anxiety. METHODS Caregivers (n = 59) of children with ALL were allocated to both groups (intervention, n = 29; TAU control, n = 30) via the SNOSE method. The intervention is a physical copy of a 2-week psychosocial self-help guidebook. Scores on the PCL-5, BDI and BAI were recorded at baseline, post-intervention and 1-month follow-up. RESULTS There was a statistically significant difference in traumatic stress symptoms post intervention (F(1, 57) = 5.760, p = .020, np2 = 0.093) in favor of the intervention group. No statistical significance was found for its effect at one-month follow-up, overall depression and anxiety. CONCLUSION A psychosocial module developed for caregivers of children with ALL was found to be effective in reducing symptoms of traumatic stress and potentially depression. However, the maintenance of its effectiveness and the effectiveness on anxiety requires further study.
Collapse
Affiliation(s)
- Agnes Shu Sze Chong
- Clinical Psychology and Behavioural Health Program/Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| | - Mahadir Ahmad
- Clinical Psychology and Behavioural Health Program/Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| | - Hamidah Alias
- Department of Paediatrics, UKM Medical Centre, Kuala Lumpur, Malaysia
| | | | - Afifi Lateh
- Department of Educational Evaluation and Research, Faculty of Education, Prince of Songkla University, Thailand
| | - Caryn Mei Hsien Chan
- Clinical Psychology and Behavioural Health Program/Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| |
Collapse
|
2
|
Peng L, Xiong SS, Li J, Wang M, Wong FKY. Promoting psychological support services for parents of children with sarcoma through health-social partnership: A quality improvement project. J Pediatr Nurs 2024:S0882-5963(24)00207-0. [PMID: 38796359 DOI: 10.1016/j.pedn.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 05/19/2024] [Accepted: 05/19/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE A significant portion of parents of children diagnosed with sarcoma experience excessive stress and anxiety disorder. This quality improvement project aimed to implement a psychological support service program tailored for parents of children with sarcoma and evaluate its effects. DESIGN AND METHODS An interprofessional team was formed through a health-social partnership to deliver comprehensive psychological support service program involving multiple cognitive-behavioral components to parents of children with sarcoma. Parents who were identified as having excessive stress and/or anxiety disorder and voluntarily agreed to participate were enrolled. Pre- and post-intervention assessments were conducted, and previously recorded data from parents of children hospitalized in the year prior to this quality improvement project were included as historical controls. RESULTS A total of 48 parents, including 35 mothers and 13 fathers, participated in the quality improvement project. Results showed that participants achieved greater reduction in emotional, somatic, and behavioral stress when compared with historical controls (all p < .001). Significantly lower prevalence of moderate to severe anxiety disorder was also found (4.2% vs. 85.4%, p < .001). CONCLUSIONS The implementation of a psychological support service program, informed by cognitive-behavioral theory and delivered through a health-social partnership, effectively alleviated multiple facets of stress and anxiety disorder in parents of children newly diagnosed with sarcoma. PRACTICE IMPLICATIONS Nurses can facilitate and coordinate the collaboration among interprofessional team to deliver specialized psychological support services and ensure that parents of children with sarcoma have access to these services, ultimately enhancing their psychological well-being.
Collapse
Affiliation(s)
- Li Peng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Sha-Sha Xiong
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Juan Li
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Mian Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; Joint Research Centre for Primary Health Care, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Frances Kam Yuet Wong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; Joint Research Centre for Primary Health Care, The Hong Kong Polytechnic University, Hong Kong, China
| |
Collapse
|
3
|
Zhou T, Luo Y, Xiong W, Meng Z, Zhang H, Zhang J. Problem-Solving Skills Training for Parents of Children With Chronic Health Conditions: A Systematic Review and Meta-Analysis. JAMA Pediatr 2024; 178:226-236. [PMID: 38165710 PMCID: PMC10762633 DOI: 10.1001/jamapediatrics.2023.5753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/25/2023] [Indexed: 01/04/2024]
Abstract
Importance Problem-solving skills training (PSST) has a demonstrated potential to improve psychosocial well-being for parents of children with chronic health conditions (CHCs), but such evidence has not been fully systematically synthesized. Objective To evaluate the associations of PSST with parental, pediatric, and family psychosocial outcomes. Data Sources Six English-language databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Cochrane Library), 3 Chinese-language databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang), gray literature, and references were searched from inception to April 30, 2023. Study Selection Randomized clinical trials (RCTs) that performed PSST for parents of children with CHCs and reported at least 1 parental, pediatric, or family psychosocial outcome were included. Data Extraction and Synthesis Study selection, data extraction, and quality assessment were conducted independently by 2 reviewers. Data were pooled for meta-analysis using the standardized mean difference (SMD) by the inverse variance method or a random-effects model. Subgroup analyses of children- and intervention-level characteristics were conducted. Main Outcomes and Measures The psychosocial outcomes of the parents, their children, and their families, such as problem-solving skills, negative affectivity, quality of life (QOL), and family adaptation. Results The systematic review included 23 RCTs involving 3141 parents, and 21 of these trials were eligible for meta-analysis. There was a significant association between PSST and improvements in parental outcomes, including problem-solving skills (SMD, 0.43; 95% CI, 0.27-0.58), depression (SMD, -0.45; 95% CI, -0.66 to -0.23), distress (SMD, -0.61; 95% CI, -0.81 to -0.40), posttraumatic stress (SMD -0.39; 95% CI, -0.48 to -0.31), parenting stress (SMD, -0.62; 95% CI, -1.05 to -0.19), and QOL (SMD, 0.45; 95% CI, 0.15-0.74). For children, PSST was associated with better QOL (SMD, 0.76; 95% CI, 0.04-1.47) and fewer mental problems (SMD, -0.51; 95% CI, -0.68 to -0.34), as well as with less parent-child conflict (SMD, -0.38; 95% CI, -0.60 to -0.16). Subgroup analysis showed that PSST was more efficient for parents of children aged 10 years or younger or who were newly diagnosed with a CHC. Significant improvements in most outcomes were associated with PSST delivered online. Conclusions and Relevance These findings suggest that PSST for parents of children with CHCs may improve the psychosocial well-being of the parents, their children, and their families. Further high-quality RCTs with longer follow-up times and that explore physical and clinical outcomes are encouraged to generate adequate evidence.
Collapse
Affiliation(s)
- Tianji Zhou
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yuanhui Luo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wenjin Xiong
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Zhenyu Meng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hanyi Zhang
- Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jingping Zhang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| |
Collapse
|
4
|
McBride H, Jhawar N, Boucicaut L, Bearden CE, Kates WR, Woolf-King SE, Antshel KM. Mental health, coping, and protective factors in mothers of children with 22q11.2 deletion syndrome. Am J Med Genet B Neuropsychiatr Genet 2024:e32973. [PMID: 38409998 DOI: 10.1002/ajmg.b.32973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/29/2023] [Accepted: 02/07/2024] [Indexed: 02/28/2024]
Abstract
Compared to the large body of maternal mental health research for other pediatric disorders, we know far less about the experience of mothers of children with 22q11DS. This study investigates the coping methods, protective factors, and mental health of this population. These findings might lead to better support for 22q11DS maternal mental health. An international sample of 71 mothers (M = 40.5 years) of children with 22q11DS (M = 9.2 years) was recruited and completed an online survey assessing maternal mental health (symptoms of depression, anxiety, traumatic stress, general stress, and alcohol consumption), coping methods, and mental health protective factors (social support, dyadic adjustment, parenting competence). Maternal ratings of child mental health symptoms were also obtained. Mothers' self-report revealed a high percentage who screened positive for elevated levels of general stress (69%), hazardous alcohol consumption (30.9%), traumatic stress (33.8%), anxiety (26.8%), and depression (26.8%). After controlling for demographic variables and child mental health symptoms, maternal self-reported maladaptive coping methods were positively associated with maternal symptoms of depression, anxiety, stress, and traumatic stress. Reducing maladaptive coping methods may be a promising intervention for improving mental health in mothers of children with 22q11DS.
Collapse
Affiliation(s)
- Haley McBride
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Nandini Jhawar
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Laurie Boucicaut
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
- Department of Psychology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | - Wendy R Kates
- Department of Psychiatry and Behavioral Sciences, SUNY-Upstate Medical University, Syracuse, New York, USA
| | | | - Kevin M Antshel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
- Department of Psychiatry and Behavioral Sciences, SUNY-Upstate Medical University, Syracuse, New York, USA
| |
Collapse
|
5
|
Ayoub M, Udo C, Årestedt K, Kreicbergs U, Lövgren M. The Family Talk Intervention in Pediatric Oncology: Potential Effects Reported by Parents. CHILDREN (BASEL, SWITZERLAND) 2024; 11:95. [PMID: 38255408 PMCID: PMC10814711 DOI: 10.3390/children11010095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Childhood cancer impacts the family system and has psychosocial consequences for all family members. For the parents, the ill child, and the siblings to be able to adjust to this challenging situation, the whole family needs access to psychosocial support. However, only a few such family interventions in pediatric oncology have been evaluated. The aim of this study was to explore the potential effects of a family-centered intervention, the Family Talk Intervention (FTI), in pediatric oncology from the parents' perspectives. METHODS A concurrent mixed methods design was used for this study. Data were derived from a pilot study of 26 families recruited from one pediatric oncology center in Sweden. This study focused on questionnaire and interview data from 52 parents. RESULTS After participation in FTI, the parents felt more satisfied with the conversations within the family about the illness. FTI also contributed to strengthened family togetherness, including more open communication and improved family relations, as described by the parents. Parents further expressed that they felt more empowered in their parenting role following FTI. CONCLUSIONS The findings regarding FTI's ability to improve family communication and family relations, thus strengthening family togetherness in families with childhood cancer, are promising. This provides motivation for a large-scale study of FTIs in pediatric oncology.
Collapse
Affiliation(s)
- Maria Ayoub
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden;
| | - Camilla Udo
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden;
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, 116 28 Stockholm, Sweden; (U.K.); (M.L.)
- Center for Clinical Research Dalarna, Uppsala University, 791 82 Falun, Sweden
| | - Kristofer Årestedt
- Department of Health and Caring Sciences, Faculty of Health and Life Science, Linnaeus University, 352 52 Växjö, Sweden;
| | - Ulrika Kreicbergs
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, 116 28 Stockholm, Sweden; (U.K.); (M.L.)
- Department of Women’s and Children’s Health, Childhood Cancer Research Unit, Karolinska Institute, 171 77 Solna, Sweden
- Louis Dundas Center, Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Malin Lövgren
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, 116 28 Stockholm, Sweden; (U.K.); (M.L.)
- Advanced Pediatric Home Care, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, 171 64 Solna, Sweden
| |
Collapse
|
6
|
Joosten MMH, Maurice-Stam H, van Gorp M, Beek LR, Stremler-van Holten D, Scholten L, Grootenhuis MA. Efficacy of Op Koers Online, an online group intervention for parents of children with cancer: Results of a randomized controlled trial. Psychooncology 2024; 33:e6284. [PMID: 38282215 DOI: 10.1002/pon.6284] [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: 10/20/2023] [Revised: 11/29/2023] [Accepted: 12/19/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Parents of children with cancer are at risk for developing psychosocial problems. The present study aims to evaluate the effect of an online group intervention (Op Koers Online, in English: On Track Online) on psychosocial wellbeing and coping skills. METHODS Parents of a child with cancer (diagnosis <5 years ago) participated in a randomized controlled trial. In six consecutive (and one booster-) protocolled sessions in an online chatroom, trained psychologists and social workers taught coping skills using cognitive behavioral and acceptance and commitment techniques. Questionnaires assessed anxiety, depression, distress, situation-specific emotional reactions and coping skills (Op Koers Questionnaire/Cognitive Coping Strategies Scale Parent Form) and evaluated the intervention. Linear mixed-model analyses were performed to detect differences between the conditions in changes over time; T0-T1 and T0-T2 (6-week and 6-month follow-up), and to detect changes in scores T2-T3 (12-month follow-up) for the intervention group only. RESULTS 89 parents were included in analyses (mean age 41.9 years, 86% female, 62%/38% post/during treatment of their child). Beneficial intervention effects (p < 0.05) were found at T1 for anxiety, depression, distress, loneliness and relaxation, and at T2 for anxiety, uncertainty and relaxation. In the intervention condition, scores did not change from T2 to T3, except loneliness that decreased and relaxation that improved. All effect sizes were small to medium (β = -0.21 to 0.46). Parents were generally positive about the intervention. CONCLUSIONS Op Koers Online for parents of children with cancer has a positive effect on psychosocial wellbeing and the coping skill relaxation. Implementation is recommended to prevent psychosocial problems. CLINICAL TRIAL REGISTRATION Dutch Trial Register https://onderzoekmetmensen.nl/en NL73763.041.20.
Collapse
Affiliation(s)
- M M H Joosten
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - H Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - M van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - L R Beek
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - L Scholten
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| |
Collapse
|
7
|
Aljawadi MH, Alkhudair N, Alrasheed M, Alsuhaibani AS, Alotaibi BJ, Almuqbil M, Alhammad AM, Arafah A, AlGahtani FH, Rehman MU. Understanding the Quality of Life Among Patients With Cancer in Saudi Arabia: Insights From a Cross-Sectional Study. Cancer Control 2024; 31:10732748241263013. [PMID: 38870396 PMCID: PMC11179550 DOI: 10.1177/10732748241263013] [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: 11/26/2023] [Revised: 04/25/2024] [Accepted: 05/21/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Cancer patients' quality of life (QoL) significantly influences treatment response and mortality rates. Understanding QoL domains among patients with cancer and what affects it can help create interventions that improve QoL and ease patients' experience. This study measures the OoL among patients with cancer and influencing factors. METHODS A prospective cross-sectional questionnaire-based study included cancer patients aged >18 currently receiving treatment. The questionnaire collected social and economic data, followed by the validated Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30). Means and standard deviations for described numeric variables and frequencies and percentages described categorical variables. Analysis of variance, F-tests, and P-values were reported. RESULTS Among 182 cancer patients, 60% were female. Younger patients exhibited higher QoL in physical and role functioning (P = .016 and .03) and experienced more significant financial impact (P = .0144). Females reported more adverse effects from cancer symptoms, including fatigue, nausea, vomiting, and pain (36.7% vs 25.5%, P = .005; 20.6% vs 11.5%, P = .0186; 34.7% vs 25.1%, P = .0281). Single patients had superior QoL in physical functioning compared to others (P = .0127). Patients traveling long distances were more likely to face adverse financial consequences (P = .007). Asthmatic patients exhibited lower QoL in physical, role, and cognitive functioning (72.3 vs 37.8, P = .0147; 76.4 vs 22.2, P = .0024; 84.7 vs 44.4, P = .0038) and reported increased dyspnea and appetite loss (16 vs 55.6 and 26.1 vs 66.7, both P < .05). CONCLUSION Factors influencing QoL in Saudi cancer patients include age, marital status, gender, hospital distance, and chronic conditions. Thus emphasizing the necessity for personalized care strategies to enhance outcomes and alleviate the overall burden of cancer care.
Collapse
Affiliation(s)
- Mohammad H Aljawadi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Nora Alkhudair
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Marwan Alrasheed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz S Alsuhaibani
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Basil J Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mansour Almuqbil
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M Alhammad
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Azhar Arafah
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Farjah H AlGahtani
- Department of internal Medicine, King Saud University College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Muneeb U Rehman
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
8
|
Blundell L, Walker SKL, Ellenbogen S, Giwa S, Hatfield K. Factors that influence families' decision to send their children to a week-long pediatric oncology camp and thoughts about attending camp. Eur J Oncol Nurs 2023; 67:102429. [PMID: 37883908 DOI: 10.1016/j.ejon.2023.102429] [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: 05/22/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE We sought to understand: families' experience of an overnight pediatric oncology camp open to children with cancer and their siblings aged seven to seventeen (Camp Delight); the considerations that factor into families' decision to attend camp for the first time; and what motivates them to reattend. METHOD Eleven semi-structured interviews were conducted with families who attended Camp Delight during or before August 2020. Thematic analysis was performed using a framework developed by four coders and MaxQDA software. RESULT Six overarching themes were compiled: precipitating experiences, barriers to attending camp, facilitating factors, benefits of camp, pro-return factors, and activities to improve transitioning to camp and reduce uncertainty. CONCLUSION Child and parent hesitancy, travel cost, and distance to camp represent barriers to attendance. Organizers may mitigate these barriers by partnering with trusted health professionals, communicating safeness and benefits of camps, including siblings, implementing strategies for reducing uncertainty, and increasing accessibility.
Collapse
Affiliation(s)
- Lisa Blundell
- Janeway Children's Health and Rehabilitation Centre, St. John's, NL, Canada.
| | - Sarah-Kay L Walker
- DeGroote School of Business, Organizational Behaviour and Human Resource Management, McMaster University, Hamilton, ON, Canada.
| | - Stephen Ellenbogen
- School of Social Work, Memorial University of Newfoundland and Labrador, St. John's, NL, Canada.
| | - Sulaimon Giwa
- School of Social Work, Memorial University of Newfoundland and Labrador, St. John's, NL, Canada.
| | - Keeley Hatfield
- Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, NL, Canada.
| |
Collapse
|
9
|
Beeler D, Christensen V, Parker K, Cottrell E. "The place it puts us in emotionally and relationally with our child, it's damaging": understanding the real-world psychosocial needs of caregivers of childhood cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01461-7. [PMID: 37801177 DOI: 10.1007/s11764-023-01461-7] [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: 06/12/2023] [Accepted: 09/05/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE Understanding the lived experiences of childhood cancer caregivers can guide the development of effective psychosocial models of care. We conducted this qualitative study to understand triggers that impact the mental health, quality of life, and mental health supportive care needs of caregivers. METHODS A maximum variation sampling strategy was used to recruit study participants for semi-structured interviews. Using a grounded theory approach, transcripts were independently dual-coded using inductive thematic analysis. We conducted a secondary thematic analysis emphasizing the impact of pediatric oncology on caregiver mental health. RESULTS Our findings highlight caregiver experiences connected to their child's appearance, quality of life, or change in behavior. Caregivers reported the need to transition between the role of nurturer and protector and simultaneously be part of the care team, which increased trauma for caregivers and their children. Caregivers noted that the hardest part of being a caregiver is witnessing, participating, and forcing the child to comply with cancer treatment. Caregivers were left wishing there had been more support for these situations. CONCLUSION Our findings reveal real-world experiences that caregivers view as among the most stressful during their child's cancer journey. These events provide insight into the nuanced and most difficult experiences from the caregiver perspective in which emotional support services would be most useful. These insights will inform a future model for mental healthcare. IMPLICATIONS FOR CANCER SURVIVORS Caregivers' treatment-related stress is associated with the quality of life of pediatric cancer patients. Supporting the mental health, quality of life, and mental health supportive care needs of childhood cancer caregivers through supportive care guidelines may positively impact the caregiver-child relationship long into survivorship. Children's and their caregivers' treatment-related stress are indelibly connected to the quality of life concerns throughout the cancer journey. Supporting the mental health, quality of life, and mental health supportive care needs of childhood cancer caregivers through supportive care guidelines will positively impact the caregiver-child relationship long into survivorship.
Collapse
Affiliation(s)
- Dori Beeler
- Levine Cancer Atrium Health, Charlotte, NC, USA.
| | | | | | | |
Collapse
|
10
|
Rørbech JT, Dreyer P, Enskär K, Haslund-Thomsen H, Jensen CS. Nursing interventions for pediatric patients with cancer and their families: a scoping review protocol. JBI Evid Synth 2023; 21:1903-1909. [PMID: 37132377 DOI: 10.11124/jbies-22-00319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVE This scoping review will identify and map available nursing interventions provided by pediatric oncology hospital services to pediatric patients with cancer and/or their family members. The aim is to develop a comprehensive overview of the characteristics of nursing interventions and to identify potential knowledge gaps. INTRODUCTION Clinical nursing care is an essential part of pediatric oncology. In pediatric oncology nursing research, a shift from explanatory studies to intervention studies is recommended. The body of research on interventions for pediatric oncology patients and their families has grown in recent years. However, there are no reviews on nursing interventions currently available for pediatric oncology. INCLUSION CRITERIA Studies will be considered for inclusion if they refer to pediatric patients with cancer, and/or family members of a pediatric patient with cancer, who have received non-pharmacological and non-procedural nursing interventions provided by a pediatric oncology hospital service. Studies must also be peer-reviewed, published from the year 2000 onward, and written in English, Danish, Norwegian, or Swedish. METHODS The review will be conducted in accordance with the JBI guidelines for scoping reviews. A 3-step search strategy will be followed using the PCC mnemonic (Population, Concept, Context). The databases to be searched will include Scopus, PubMed, CINAHL, PsyclNFO, and Embase. The identified studies will be screened based on title and abstract, as well as full text, by 2 independent reviewers. Data will be extracted and managed in Covidence. A summary of the results will be presented as a narrative description, supported by tables.
Collapse
Affiliation(s)
- Josefine Tang Rørbech
- Department of Paediatrics and Adolescent Medicine, Unit for Research and Development in Nursing for Children and Young People, Aarhus University Hospital, Aarhus N, Denmark
| | - Pia Dreyer
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus N, Denmark
| | - Karin Enskär
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helle Haslund-Thomsen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Paediatrics, Aalborg University Hospital, Clinic for Anesthesiology, Child Diseases, Circulation and Women, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Claus Sixtus Jensen
- Department of Paediatrics and Adolescent Medicine, Unit for Research and Development in Nursing for Children and Young People, Aarhus University Hospital, Aarhus N, Denmark
- Research Centre for Emergency Medicine, Aarhus University Hospital, Aarhus N, Denmark
| |
Collapse
|
11
|
Lee ARYB, Low CE, Yau CE, Li J, Ho R, Ho CSH. Lifetime Burden of Psychological Symptoms, Disorders, and Suicide Due to Cancer in Childhood, Adolescent, and Young Adult Years: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:790-799. [PMID: 37345504 PMCID: PMC10288378 DOI: 10.1001/jamapediatrics.2023.2168] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/26/2023] [Indexed: 06/23/2023]
Abstract
Importance A cancer diagnosis and treatment may result in highly traumatic periods with lasting psychological consequences for children, adolescent, and young adult patients with cancer (CYACs). Early identification and management may prevent long-term psychological morbidity and suicide. Objective To analyze risk, severity, and risk factors for depression, anxiety, psychotic disorders, and suicide in CYACs and noncancer comparators. Data Sources Literature search of PubMed, MEDLINE, Embase, PsycINFO, CINAHL, and PubMed Central from January 1, 2000, to November 18, 2022. Study Selection Full-length articles in peer-reviewed journals that measured and reported risk and/or severity of depression, anxiety, psychotic disorders, and suicide mortality in CYACs and a noncancer comparator group. Data Extraction and Synthesis Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed with prospective PROSPERO registration. Main Outcomes and Measures Risk ratios (RRs) were used for dichotomous outcomes, and standardized mean differences (SMDs) were used for continuous outcomes. SMDs were defined as follows: 0.2, small; 0.5, medium; and 0.8, large. Sources of heterogeneity and risk factors were investigated using sensitivity, subgroup, and meta-regression analyses. Results From 7319 records, 52 studies were included. Meta-analyses revealed that CYACs were at increased lifetime risk of severe symptoms or a disorder of depression (RR, 1.57; 95% CI, 1.29-1.92), anxiety (RR, 1.29; 95% CI, 1.14-1.47), and psychotic disorders (RR, 1.56; 95% CI, 1.36-1.80) relative to both matched controls and their siblings. Overall suicide mortality was not significantly elevated (RR, 1.63; 95% CI, 0.78-3.40). The mean severity of depression was found to be elevated in CYACs receiving treatment (SMD, 0.44; 95% CI, 0.13-0.74) and long-term survivors (SMD, 0.18; 95% CI, 0.02-0.33). The mean severity of anxiety was found to be elevated only during treatment (SMD, 0.16; 95% CI, 0.03-0.20). Conclusions and Relevance Findings of this systematic review and meta-analysis suggest that CYACs may experience lasting psychological burden long into survivorship. Timely identification, preventive efforts, and psycho-oncological intervention for psychological comorbidity are recommended.
Collapse
Affiliation(s)
- Ainsley Ryan Yan Bin Lee
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chen Ee Low
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chun En Yau
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jiaqi Li
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| |
Collapse
|
12
|
Reuvers MJP, Gedik A, Way KM, Elbersen-van de Stadt SM, van der Graaf WTA, Husson O. Caring for Adolescents and Young Adults (AYA) with Cancer: A Scoping Review into Caregiver Burdens and Needs. Cancers (Basel) 2023; 15:3263. [PMID: 37370873 DOI: 10.3390/cancers15123263] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
AYAs with cancer (aged 15 to 39 at primary diagnosis) form a specific group within oncology, and there is limited information on the impact on their informal caregivers. This scoping review aimed to gain insight into the burden on caregivers of AYAs with cancer and identify the unmet needs they might have. Eligible articles focused on impacts in one of the domains of caregiver burden (physical, psychological, social, on schedule, financial) or unmet needs. In all domains of caregiver burden, impact was reported by caregivers. Caregiving leads to physical problems (such as sleep problems) and psychological symptoms (e.g., depression, anxiety, and negative emotions). Loneliness is reported, and little peer-support. Many different tasks and roles must be undertaken, which is perceived as challenging. In addition, there is a financial impact and there are unmet needs to be met. Several domains of the lives of caregivers of AYA cancer patients are negatively affected by the disease. Some of these are age-specific, and tailored to a particular group of caregivers (parents, partners, or friends). AYA cancer patients represent a wide age range, resulting in the engagement of many different caregivers. Future research will need to take this into account in order to adequately provide support.
Collapse
Affiliation(s)
- Milou J P Reuvers
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1006 BE Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Asiye Gedik
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Kirsty M Way
- School of Heath Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | | | - Winette T A van der Graaf
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1006 BE Amsterdam, The Netherlands
| | - Olga Husson
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| |
Collapse
|
13
|
Young K, Cashion C, Hassall T, Ekberg S, Bradford N. Supporting families through paediatric brain tumour: Unmet needs and suggestions for change. Psychooncology 2023; 32:942-950. [PMID: 37081572 PMCID: PMC10946516 DOI: 10.1002/pon.6136] [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] [Received: 03/06/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE From diagnosis and beyond, a paediatric brain tumour and its treatment impact the child and their family in a myriad of ways. While it is considered best practice to offer ongoing psychosocial support for all family members, there is little scholarly investigation of both families' experiences and the practical implications of offering such care. We aimed to explore families' experiences of paediatric brain tumour and their associated psychosocial health service needs. METHODS Families receiving care at the Queensland Children's Hospital in Brisbane, Australia, for a child (0-18 years) who had been diagnosed with a brain tumour between 2019 and 2022 were invited to be interviewed about their experiences. Using qualitative description, we analysed these interviews to identify families' unmet psychosocial health service needs and their suggestions for improvement. RESULTS Twenty-three clinically and socially diverse families were represented. While parents/carers expressed gratitude for the care their child had received, most also described unmet needs for the broader family. We identified three primary needs to be addressed: (1) parents want accessible psychological/emotional support for themselves; (2) parents/carers want additional guidance to navigate the hospital setting to reduce uncertainty and loss of control; and (3) parents want support to minimise treatment-associated trauma for their child. CONCLUSIONS Our findings evidence the need for improved family-centred psychosocial care within paediatric brain tumour care in Queensland, Australia. We propose a counselling and care coordination intervention to support parents/carers to care for themselves, their child, and their family through an extremely challenging experience.
Collapse
Affiliation(s)
- Kate Young
- Cancer and Palliative Care Outcomes CentreCentre for Healthcare TransformationQueensland University of TechnologyBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
| | - Christine Cashion
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
- Children's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
| | - Timothy Hassall
- Children's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
| | - Stuart Ekberg
- Children's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
- School of Psychology & CounsellingQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes CentreCentre for Healthcare TransformationQueensland University of TechnologyBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
| |
Collapse
|
14
|
Park M, Kim S, Lee H, Shin YJ, Lyu CJ, Choi EK. Development and effects of an internet-based family resilience-promoting program for parents of children with cancer: A randomized controlled trial. Eur J Oncol Nurs 2023; 64:102332. [PMID: 37146351 DOI: 10.1016/j.ejon.2023.102332] [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: 11/16/2022] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE The diagnosis of cancer in children can negatively impact their parents, owing to the complex treatment processes. Families with high levels of resilience can overcome these difficulties and thus perform higher family functions. We aimed to develop an internet-based family resilience-promoting program for parents of children with cancer and evaluate its effect on the levels of family resilience, depression, and family function. METHODS This prospective, parallel-group, randomized-controlled study that was conducted at Yonsei Cancer Center from June to October 2021 included 41 parents of children with cancer. In total, four sessions of the internet-based family resilience-promoting program, led by a nurse, were conducted individually for parents. Levels of family resilience, depression, and family function were measured before, immediately after, and 4 weeks after the program. The data were analyzed using the linear mixed-effect model, and program satisfaction was evaluated through an internet-based questionnaire and interview. RESULTS The experimental group (the family resilience-promoting program participants) differed more significantly from the control group in the level of change in family resilience (β = 13.214, p = 0.003, effect size = 0.374) and family function (β = 1.256, p = 0.018, effect size = 0.394). However, there was no significant difference between the groups in the level of depression (β = 2.133, p = 0.187, effect size = 0.416). All the program participants showed a high program satisfaction score of 4.75 out of 5.00 points overall. CONCLUSIONS The applicability of the internet-based family resilience-promoting program as an appropriate nursing intervention was verified. Its application can help the families of children with cancer adapt to the stressful situation of their children's cancer diagnosis and treatment.
Collapse
Affiliation(s)
- Mina Park
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Sunah Kim
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Hyejung Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Yoon Jung Shin
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - Chuhl Joo Lyu
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Kyoung Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
| |
Collapse
|
15
|
Davidson S, Contreras J, Santamaría CR, Alba-Suarez J, Patel P, Greenspahn E, Boucher L, Rodriguez EM. The Socioecology of Parental Adjustment to Pediatric Cancer: The Roles of Individual and Neighborhood Socioeconomic Status in Parental Social Support and Depressive Symptoms. J Pediatr Psychol 2023; 48:193-201. [PMID: 36644926 DOI: 10.1093/jpepsy/jsac089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Parents of children with cancer are at risk for depressive symptoms, and previous research has linked their level of distress to various demographic, social, and economic factors. However, little research has examined associations between parental depressive symptoms and multiple socioecological factors at once. The current study examined how socioeconomic status (SES) at the individual and neighborhood level is related to parental depressive symptoms and social support satisfaction in Latinx and non-Latinx parents of children recently diagnosed with cancer, and whether social support satisfaction mediated associations between SES and depressive symptoms. METHODS Parents (N = 115; 82% female; 30% Latinx) completed questionnaires reporting their demographic information, social support satisfaction, and depressive symptoms. Neighborhood SES was coded by block group level based on participants' home addresses. RESULTS Individual, but not neighborhood, SES was positively associated with social support satisfaction, and higher social support satisfaction was associated with lower depressive symptoms. There was a significant indirect effect of individual (but not neighborhood) SES on depressive symptoms through social support satisfaction. Latinx parents reported lower individual SES, but not lower social support satisfaction or depressive symptoms than non-Latinx parents. CONCLUSIONS These results highlight the important role of social support in the adjustment of parents who have a child with pediatric cancer. Findings suggest that families may benefit from services that target multiple levels of their social ecology.
Collapse
Affiliation(s)
- Savannah Davidson
- Department of Educational Psychology, The University of Texas at Austin, USA
| | - Janie Contreras
- Department of Educational Psychology, The University of Texas at Austin, USA
| | | | - Juliana Alba-Suarez
- Department of Educational Psychology, The University of Texas at Austin, USA
| | - Puja Patel
- Department of Educational Psychology, The University of Texas at Austin, USA
- Children's Blood and Cancer Center, Dell Children's Medical Center, USA
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, USA
| | - Emily Greenspahn
- Department of Educational Psychology, The University of Texas at Austin, USA
- Children's Blood and Cancer Center, Dell Children's Medical Center, USA
- Department of Neurology, Dell Medical School, USA
| | - Lori Boucher
- Children's Blood and Cancer Center, Dell Children's Medical Center, USA
| | - Erin M Rodriguez
- Department of Educational Psychology, The University of Texas at Austin, USA
| |
Collapse
|
16
|
Adamkovič M, Fedáková D, Kentoš M, Bozogáňová M, Havrillová D, Baník G, Dědová M, Piterová I. Relationships between satisfaction with life, posttraumatic growth, coping strategies, and resilience in cancer survivors: A network analysis approach. Psychooncology 2022; 31:1913-1921. [PMID: 35524705 PMCID: PMC9790334 DOI: 10.1002/pon.5948] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/24/2022] [Accepted: 04/30/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Cancer survivors' satisfaction with life should be seen through the psychological factors related to a person's capabilities to face and handle the situation. This study aimed to (1) examine the relationships of satisfaction with life, posttraumatic growth, resilience and coping strategies in a global network model, (2) find the bridge indicators between satisfaction with life and the other constructs, and (3) test for the invariance of the network structures across several moderating variables. METHODS In a heterogeneous sample of 696 cancer survivors (69% female; mean age = 53.1 ± 15.44 years; median time from being diagnosed = 4 years; breast cancer was the most frequent type of cancer) their satisfaction with life, resilience, coping strategies and posttraumatic growth was measured. In order to account for their complexity, the relationships between the constructs were explored using a network analysis approach. RESULTS The network analysis shows that satisfaction with life is strongly connected to resilience, moderately connected to coping strategies, and has a weak connection with posttraumatic growth. In the separate networks, the relationships between the psychological constructs were examined in greater detail. Besides some exceptions observed in the degree of disability, the networks were invariant across gender, age, years since being diagnosed, cancer type and treatment type. CONCLUSION The findings suggest that interventions focused on cancer survivors' coping strategies and resilience could help increase their satisfaction with life. However, further replication of the proposed and/or modified model is needed.
Collapse
Affiliation(s)
- Matúš Adamkovič
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
- Institute of PsychologyFaculty of ArtsUniversity of PrešovPrešovSlovakia
- Faculty of Humanities and Social SciencesUniversity of JyväskyläJyväskyläFinland
| | - Denisa Fedáková
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
| | - Michal Kentoš
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
| | - Miroslava Bozogáňová
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
| | - Dominika Havrillová
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
- Department of PsychologyFaculty of ArtsPavol Jozef Šafárik UniversityKošiceSlovakia
| | - Gabriel Baník
- Institute of PsychologyFaculty of ArtsUniversity of PrešovPrešovSlovakia
| | - Mária Dědová
- Department of PsychologyFaculty of ArtsUniversity of TrnavaTrnavaSlovakia
| | - Ivana Piterová
- Institute of Social SciencesCentre of Social and Psychological Sciences SASKošiceSlovakia
| |
Collapse
|
17
|
Tan CE, Lau SCD, Tan KA, Latiff ZA, Teh KH, Lee CC, Mohd Sidik S. Development and Validation of a Caregiving Knowledge Questionnaire for Parents of Pediatric Leukemia and Lymphoma Patients in Malaysia. Cureus 2022; 14:e30903. [PMID: 36465778 PMCID: PMC9710185 DOI: 10.7759/cureus.30903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 06/17/2023] Open
Abstract
Introduction Validated tools to measure caregiving knowledge among parents of children with hematological cancers are needed to measure the clinical outcome of caregiver interventions. This study reports the development and validation of the Hematological Oncology Parents Education Caregiving Knowledge Questionnaire (HOPE-CKQ) among Malaysian parents of pediatric leukemia and lymphoma patients. Methods Initially, 60 items on caregiving knowledge were developed based on a qualitative needs assessment study. Content validity was evaluated using item content validity index (I-CVI) and scale content validity index (S-CVI/Ave). Parents of pediatric leukemia and lymphoma patients were invited to complete the 60-item version of the HOPE-CKQ. Exploratory factor analysis (EFA) using polychoric correlation resulted in an 18-item version of HOPE-CKQ. Confirmatory factor analysis (CFA) was used to verify the factor structure. Known-group validity was tested by comparing the scores among different levels of parent education. Results The I-CVI ranged from 0.83 to 1.00 whereas the S-CVI/Ave was 0.99, indicating good content validity. A total of 167 complete responses were analyzed for factor analysis. EFA using polychoric correlations resulted in a single-factor structure consisting of 18 items. CFA confirmed that the 18-item single-factor HOPE-CKQ model had a good fit for the data. The internal consistency reliability was good (α=0.80). Parents with tertiary education level had higher caregiving knowledge (M=12.61, SD=3.37) compared to parents with secondary education and below (M=10.33, SD=3.80) (t=3.58, p<0.001). Conclusions The 18-item HOPE-CKQ is valid and reliable for use to measure caregiving knowledge among pediatric leukemia and lymphoma parents. This tool may be considered to measure caregiving knowledge in future preventive and intervention programs.
Collapse
Affiliation(s)
- Chai-Eng Tan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
- Department of Psychiatry, Universiti Putra Malaysia, Serdang, MYS
| | - Sie Chong Doris Lau
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Kit Aun Tan
- Department of Psychiatry, Universiti Putra Malaysia, Serdang, MYS
| | - Zarina Abdul Latiff
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Kok Hoi Teh
- Department of Pediatrics, Hospital Tunku Azizah (Ministry of Health Malaysia), Kuala Lumpur, MYS
| | - Chee Chan Lee
- Department of Pediatrics, Hospital Tunku Azizah (Ministry of Health Malaysia), Kuala Lumpur, MYS
| | | |
Collapse
|
18
|
Lövgren M, Udo C, Kreicbergs U. Is the family talk intervention feasible in paediatric oncology? An evaluation of a family-based psychosocial intervention. Acta Paediatr 2022; 111:684-692. [PMID: 34787928 DOI: 10.1111/apa.16190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/19/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022]
Abstract
AIM To examine the feasibility of a family-based psychosocial intervention, Family Talk Intervention (FTI), in paediatric oncology in terms of recruitment, retention, delivery, response rate and acceptability from the parents' perspective. METHODS This study involved 26 families affected by childhood cancer. FTI encompasses six family meetings, with the main goal being to facilitate family communication about illness-related subjects. Meeting 5 is preferably moderated by the parents. Extra meetings (7-11) can be held if needed. This paper includes observational data and surveys, and interviews with parents. RESULTS All families who started FTI underwent the full intervention and the survey response rate varied between 100% and 71% over time. Extra meetings were held with most families. The parents stated that FTI filled a gap of support to the family as a unit and described FTI as a map they could follow. Since FTI was conducted at home, this created a safe environment, which contributed to their participation. The parents valued the children's perspectives being considered, but some felt uncomfortable moderating 'the family talk' (meeting 5). CONCLUSION Family talk intervention was valued by parents, but it would benefit from being slightly modified before a large trial can be developed.
Collapse
Affiliation(s)
- Malin Lövgren
- Palliative Research Centre Department of Health Care Sciences Ersta Sköndal Bräcke University College Stockholm Sweden
- Advanced Pediatric Home Care Karolinska University Hospital Stockholm Sweden
| | - Camilla Udo
- Palliative Research Centre Department of Health Care Sciences Ersta Sköndal Bräcke University College Stockholm Sweden
- School of Education, Health and Society Dalarna University College Falun Sweden
- Center for Clinical Research Dalarna‐Uppsala University Falun Sweden
| | - Ulrika Kreicbergs
- Palliative Research Centre Department of Health Care Sciences Ersta Sköndal Bräcke University College Stockholm Sweden
- Department of Women's and Children's Health Childhood Cancer Research Unit Karolinska Institute Stockholm Sweden
| |
Collapse
|
19
|
Eche IJ, Yusufov M, Isibor DA, Wolfe J. A systematic review and meta-analytic evaluation of psychosocial interventions in parents of children with cancer with an exploratory focus on minority outcomes. Pediatr Blood Cancer 2021; 68:e29328. [PMID: 34523798 DOI: 10.1002/pbc.29328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/28/2021] [Accepted: 08/13/2021] [Indexed: 11/11/2022]
Abstract
Parents of children with cancer are prone to psychosocial distress, yet little is known about intervention response among diverse parents. Our systematic review and meta-analysis evaluated the efficacy of psychosocial interventions on anxiety and depression among parents of children with cancer and explored race and/or ethnicity differences in the efficacy of these interventions. Twenty articles met inclusion. The aggregate effect size on anxiety (-0.01, 95% CI: -0.95, 0.93, p = .97) and depression (-0.56, 95% CI: -1.65, 0.54, p = .32) showed micro to medium effects, with larger negative effect sizes indicating that anxiety and depression scores after treatment were lower for parents in intervention group as compared to control group. Neither aggregate effect size was statistically significantly different from zero. Due to underrepresentation of minorities, we could not perform subgroup or moderator analyses. Several efficacious psychosocial interventions were found to reduce parental anxiety. Future studies to examine psychosocial interventions in minority parents are warranted.
Collapse
Affiliation(s)
- Ijeoma Julie Eche
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Miryam Yusufov
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
20
|
Ellawindi MI, Shoman TH, Taher E, Gohar S, Shehata S. Effectiveness of Psychosocial Supportive Care Trial on Quality of Life among Breast Cancer Patients: An Interventional Study at the National Cancer Institute, Egypt. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Breast cancer (BC) patients suffer from many psychosocial problems due to their health condition and treatment side effects so they are in great need for psychosocial supportive care.
AIM: The aim of the study was to provide a comprehensive psych-social supportive health-care model for BC patients a step toward improving their quality of life (QOL).
PATIENTS AND METHODS: Random assignment was done for 185 patients with primary operated BC to a control or an intervention group. The researcher offered five daily successive psychosocial supportive care sessions for the patients in the intervention group. All patients were followed up for coping ability, mood and QOL 8 weeks after the intervention.
RESULTS: The intervention had statistically significant effects on psychological distress, depression, problem focused, and active emotional coping domain, while had not any statistically significant effects on avoidant emotional coping domain.
CONCLUSION: Psychosocial supportive developed health-care model decreased psychological distress, depression, and improved QOL among patients with primary BC.
Collapse
|
21
|
Quast LF, Williamson Lewis R, Lee JL, Blount RL, Gilleland Marchak J. Psychosocial Functioning Among Caregivers of Childhood Cancer Survivors Following Treatment Completion. J Pediatr Psychol 2021; 46:1238-1248. [PMID: 34363683 DOI: 10.1093/jpepsy/jsab061] [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: 07/17/2020] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To inform efforts to better support caregivers of children with cancer during the transition from treatment to survivorship, this study sought to characterize caregiver mental health-related quality of life (HRQOL) and anxiety, and examine the influence of family psychosocial risk and caregiver problem-solving on these outcomes. METHOD Participants included 124 caregivers (child age M = 10.05 years; SD = 4.78), 12-19 months from the conclusion of cancer-directed treatment. Participants' self-reported mental HRQOL, anxiety, and problem-solving were compared with community norms using t-tests. Correlations and hierarchical multiple regressions examined the influence of psychosocial risk and problem-solving on caregiver mental HRQOL and anxiety. RESULTS Overall, caregivers reported HRQOL and anxiety within normal limits. Caregivers also reported more adaptive patterns of problem-solving than community norms. Subsets of caregivers reported clinical levels of psychosocial risk (11%) and at-risk levels of mental HRQOL (2.5%) and anxiety (5.7%). Females reported greater anxiety than males. Psychosocial risk and negative problem orientation (NPO) were both related to poorer mental HRQOL and greater anxiety (r = .40-.51, p's < .001). Positive problem orientation related to better mental HRQOL and lower anxiety (r = .18-.21, p's < .05). Impulsivity/carelessness and avoidance were associated with greater anxiety (r = .19-.25, p's < .05). Only NPO accounted for additional variance in mental HRQOL and anxiety, over and above psychosocial risk and demographic characteristics. CONCLUSIONS The majority of caregivers appear to be resilient and experience limited distress during the off therapy period. Targeting negative cognitive appraisals (NPO) through cognitive-behavioral therapy or problem-solving skills training may further improve caregiver psychosocial functioning.
Collapse
Affiliation(s)
| | | | - Jennifer L Lee
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta.,Emory University School of Medicine.,Evidation Health, Inc
| | | | - Jordan Gilleland Marchak
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta.,Emory University School of Medicine
| |
Collapse
|
22
|
Lewandowska A. Influence of a Child's Cancer on the Functioning of Their Family. CHILDREN-BASEL 2021; 8:children8070592. [PMID: 34356571 PMCID: PMC8306515 DOI: 10.3390/children8070592] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 11/17/2022]
Abstract
Background—A child’s cancer affects their entire family and is a source of chronic stress for a sick child, as well as for their parents and siblings. It deprives them of the feeling of security; introduces uncertainty, fear and anxiety; and destabilises their life. It mobilises the family since they have to reconcile the treatment and frequent appointments at the hospital with the hardships of everyday life. The emotional burden they have to deal with is enormous. Recognition of the needs of such a family allows for the implementation of support, psychosocial care and psychoeducation, as well as the provision of reliable information. Patients and Methods—A population survey was conducted between 2015 and 2020. Caregivers of children diagnosed with cancer were invited to participate in the study to assess their problems and needs. Results—All respondents in their legal status were parents of children with cancer. The study included 800 people, where women accounted for 85% and men accounted for 15%. The mean age of the mother was 38.09, SD = 7.25, and the mean age of the father was 41.11, SD = 7.03. The occurrence of problems negatively correlated with both the age of the parents (p < 0.0001) and the level of education (p < 0.0001). Parents who admitted having financial problems more often reported problems of a different kind; moreover, financial problems were more often reported by parents of children who were ill for a longer time (p = 0.01). Conclusions—Parents of children suffering from cancer reported numerous psychological, social and somatic problems. The identification of problems through screening should translate into specific interventions, thus creating support for the families of children with cancer. Promoting coping with difficult emotions and the ability to solve problems when a child is ill has a positive effect on the functioning of the family.
Collapse
Affiliation(s)
- Anna Lewandowska
- Institute of Healthcare, State School of Technology and Economics, 37-500 Jaroslaw, Poland
| |
Collapse
|
23
|
Khosrobeigi M, Hafezi F, Naderi F, Ehteshamzadeh P. Effectiveness of self-compassion training on hopelessness and resilience in parents of children with cancer. Explore (NY) 2021; 18:357-361. [PMID: 33906814 DOI: 10.1016/j.explore.2021.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/31/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES the psychological state of parents, who are considered the primary caregivers of a sick child, can affect the child's behavior and emotions. This study analyzed the effectiveness of self-compassion training on hopelessness and resilience in the parents of children with cancer. METHODS this was an experimental study with a pre-test and post-test design and a control group. The statistical population included all parents of children with cancer hospitalized in Amir Kabir Hospital of Arak in 2020. The research sample consisted of 30 parents of children with cancer selected through convenience sampling. The participants were equally divided into experimental (n = 15) and control (n = 15) groups at random. The research instruments were the Connor-Davidson Resilience Scale (CD-RISC) and the Beck Hopelessness Scale (BHS). The experimental group underwent eight 90 min sessions of self-compassion training on a weekly basis. Finally, the multivariate analysis of covariance (MANCOVA) was employed for data analysis. RESULTS the mean (±SD) of the post-test scores of hopelessness and resilience were reported 10.20 (±4.95) and 43.33 (±4.27), respectively, in the experimental group, whereas they were reported 13.78 (±4.94) and 38.73 (±4.07), respectively, in the control group. According to the results, self-compassion training had significant effects on the resilience and hopelessness of the parents of children with cancer (p < 0.01). Self-compassion training had a positive, significant effect on their resilience. It was also efficient in decreasing their hopelessness. CONCLUSIONS self-compassion training improved resilience and mitigated hopelessness in the parents of children with cancer.
Collapse
Affiliation(s)
- Mostafa Khosrobeigi
- Department of Health Psychology, Khorramshahr-Persian Gulf International Branch, Islamic Azad University, Khorramshahr, Iran
| | - Fariba Hafezi
- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran.
| | - Farah Naderi
- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | | |
Collapse
|