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Kamaladasa DS, Sansom-Daly UM, Hetherington K, McGill BC, Ellis SJ, Kelada L, Donoghoe MW, Evans H, Anazodo A, Patterson P, Cohn RJ, Wakefield CE. How Are Families Faring? Perceived Family Functioning Among Adolescent and Young Adult Cancer Survivors in Comparison to Their Peers. J Adolesc Young Adult Oncol 2021; 10:711-719. [PMID: 33960837 DOI: 10.1089/jayao.2020.0215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Adolescent and young adult (AYA) cancer survivors' families can face ongoing challenges into survivorship. Families' adjustment and functioning as a unit can subsequently impact AYAs' mental health and quality of life. This study examined AYA cancer survivors' perceived family functioning, compared with their peers, and investigated factors associated with family functioning. Methods: Eligible participants were aged between 15 and 40 years, fluent in English, and cancer survivors who had completed treatment. AYA cancer survivors were recruited from hospital clinics, and the comparison group from an affiliated university campus. Participants completed the McMaster Family Assessment Device, Kidcope, and the Depression, Anxiety and Stress Scale-Short Form. We analyzed between-group differences in family functioning using multivariate analysis of covariance and used partial correlations to investigate associations between demographic cancer-related psychological coping variables and family functioning. Results: Ninety-three AYA cancer survivors and 141 comparison peers participated (ages: 15-32 years). AYA cancer survivors reported significantly better family functioning (p = 0.029), lower depression (p = 0.016), and anxiety symptoms (p = 0.008) compared with the comparison group. Approximately one-third of AYA survivors (34.4%) reported clinically significant maladaptive family functioning; however, this was more prevalent in the comparison group (50.4%). After adjusting for covariates, poorer family functioning was associated with AYA survivors using more avoidant escape-oriented coping strategies (p = 0.010). Conclusions: Our cancer survivor cohort reported better family functioning and psychological outcomes compared with their peers. Interventions targeting avoidant coping behaviors may support improved family functioning in some survivors. Further research disentangling the relationship between coping mechanisms and family functioning among AYA cancer survivors is needed.
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Affiliation(s)
- Dinuli S Kamaladasa
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Ursula M Sansom-Daly
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia
| | - Kate Hetherington
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Brittany C McGill
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Sarah J Ellis
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Lauren Kelada
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Mark W Donoghoe
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, Australia
| | - Holly Evans
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,School of Psychology, UNSW Sydney, Kensington, Australia
| | - Antoinette Anazodo
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Pandora Patterson
- Canteen Australia, Newtown, Australia.,Cancer Nursing Research Unit, Sydney Nursing School, The University of Sydney, Sydney, Australia
| | - Richard J Cohn
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
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Van Schoors M, De Mol J, Laeremans N, Verhofstadt LL, Goubert L, Van Parys H. Siblings’ Experiences of Everyday Life in a Family Where One Child Is Diagnosed With Blood Cancer: A Qualitative Study. J Pediatr Oncol Nurs 2018; 36:131-142. [DOI: 10.1177/1043454218818067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Childhood cancer not only presents challenges to the life of the child with cancer but also to the siblings’ daily family life. The aim of the current study was to gain a better understanding of siblings’ experiences of living in a family where one child has been diagnosed with blood cancer. Method: Ten siblings of children with leukemia or non-Hodgkin lymphoma completed a semistructured interview about their everyday family life experiences postdiagnosis. The verbatim transcripts of the interviews served as the data for an interpretative phenomenological analysis. Results: The results showed that overall the siblings experienced a continuity in many aspects of their family life: they still experienced their family as an important source of support and information/communication, as warm and loving and as a safe harbor where family members aim to protect each other. However, at the same time, the participating siblings also expressed that some things felt unmistakably different postdiagnosis: They felt that their family as a whole had been ripped apart, with a greater focus on the diagnosed child and changing responsibilities for each family member. Conclusion: This study informs parents and clinicians about the daily family life experiences from the siblings’ perspective, a perspective that is often overlooked. A focus on challenges as well as continuities within family life, the wish for connection expressed by the siblings, and the uniqueness of every sibling’s experiences is what can be taken away from this study by psychosocial workers in the field.
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Affiliation(s)
| | - Jan De Mol
- Université Catholic de Louvain, Louvain-la-Neuve, Belgium
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Cousino MK, Hazen R, Josie KL, Laschinger K, de Blank P, Taylor HG. Childhood Cancer and Brain Tumor Late Effects: Relationships with Family Burden and Survivor Psychological Outcomes. J Clin Psychol Med Settings 2018; 24:279-288. [PMID: 29147881 DOI: 10.1007/s10880-017-9519-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This study examines illness-specific family burden as a mediator of the association between late effects of childhood cancer and survivors' emotional and behavioral outcomes. Childhood cancer survivors (n = 65; ages 10-17) two or more years off-treatment completed measures assessing internalizing and PTSD symptoms. Parents reported on illness-specific family burden, late effects severity, and survivor internalizing/externalizing problems. Providers documented the number of late effects. Illness-specific family burden was correlated with provider-reported late effects (r = .29, p < .05) and parent report of severe late effects (r = .56, p < .01). Results supported an indirect effect of illness-specific family burden on number of late effects and parent-reported survivor internalizing problems, p < .05. Indirect effects were not found in models predicting PTSD and externalizing problems. Illness-specific family burden is an important intervention target for reducing internalizing problems in childhood cancer survivors with late effects.
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Affiliation(s)
- Melissa K Cousino
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA. .,Department of Pediatrics, C.S. Mott Children's Hospital, Michigan Medicine, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA. .,Department of Pediatrics and Communicable Diseases at Michigan Medicine and the University of Michigan Transplant Center, Ann Arbor, MI, USA.
| | - Rebecca Hazen
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA.,Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | | | - Kelly Laschinger
- Division of Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Peter de Blank
- Division of Oncology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - H Gerry Taylor
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA.,Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
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Van Schoors M, De Mol J, Morren H, Verhofstadt LL, Goubert L, Van Parys H. Parents' Perspectives of Changes Within the Family Functioning After a Pediatric Cancer Diagnosis: A Multi Family Member Interview Analysis. QUALITATIVE HEALTH RESEARCH 2018; 28:1229-1241. [PMID: 29357749 DOI: 10.1177/1049732317753587] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pediatric cancer is a life-threatening disease that challenges the life of the diagnosed child, the parents, and possible siblings. Moreover, it also places considerable demands on family life. The aim of this study was to explore changes in the family functioning after a pediatric cancer diagnosis. Ten couples who had a child with leukemia or non-Hodgkin lymphoma were interviewed individually about their experiences. Interviews were semistructured, and the data were analyzed using Multi Family Member Interview Analysis. Three themes emerged from the data: (a) Family Cohesion: Strengthened Versus Fragmented; (b) Educational Norms and Values: Overindulgence Versus Being Stricter, and (c) Normality: Loss Versus Preservation. The conflicting dynamics present in these emerging themes exemplify the complexity of this process of family adaptation. This study illustrates the need to take into account the family level, as well as the conflicting feelings parents may experience after a pediatric cancer diagnosis.
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Affiliation(s)
| | - Jan De Mol
- 2 Université Catholic de Louvain, Louvain-la-Neuve, Belgium
| | | | | | | | - Hanna Van Parys
- 1 Ghent University, Ghent, Belgium
- 3 Ghent University Hospital, Ghent, Belgium
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Kobylianskii A, Jegathesan T, Young E, Fung K, Huber J, Minhas RS. Experiences of Inner-City Fathers of Children With Chronic Illness. Clin Pediatr (Phila) 2018; 57:792-801. [PMID: 28969464 DOI: 10.1177/0009922817734361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aim to explore the experiences of fathers from inner-city families caring for children affected by chronic health conditions or disabilities. A systematic scoping review was conducted using the Arskey and O'Malley framework. Fourteen of the 5114 articles were included in the full review and were qualitatively evaluated in terms of stressors, resources, perception, coping, and adaptation according to the Double ABCX model. Stressors included financial strain and health care access barriers. Resources ranging from immediate to extended family members depended on ethnicity. Fathers' perceptions of their primary caregiver roles depended on ethnicity in the context of cultural gender norms. While inner-city fathers desired information about their children's health, some were uncomfortable asking physicians. They had a higher risk for coping difficulties and maladaptation, including depression. We highlight a need for pediatricians to advocate for additional resources to provide comprehensive care for inner-city fathers caring for their children with chronic health conditions or disabilities.
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Affiliation(s)
- Anna Kobylianskii
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada
| | - Thivia Jegathesan
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada
| | - Elizabeth Young
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada
| | - Kimmy Fung
- 2 St Michael's Hospital, Toronto, Ontario, Canada
| | - Joelene Huber
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada.,3 The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ripudaman S Minhas
- 1 University of Toronto, Toronto, Ontario, Canada.,2 St Michael's Hospital, Toronto, Ontario, Canada
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Van Schoors M, Caes L, Alderfer MA, Goubert L, Verhofstadt L. Couple functioning after pediatric cancer diagnosis: a systematic review. Psychooncology 2016; 26:608-616. [DOI: 10.1002/pon.4204] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/10/2016] [Accepted: 06/24/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology; Ghent University; Ghent Belgium
| | - Line Caes
- School of Psychology and Centre for Pain Research; National University of Ireland Galway; Galway Ireland
| | - Melissa A. Alderfer
- Center for Healthcare Delivery Science; Nemours Children's Health System; Wilmington Delaware
- Department of Pediatrics, Sidney Kimmel Medical College; Thomas Jefferson University; Philadelphia Pennsylvania
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology; Ghent University; Ghent Belgium
| | - Lesley Verhofstadt
- Department of Experimental Clinical and Health Psychology; Ghent University; Ghent Belgium
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7
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Leeman J, Crandell JL, Lee A, Bai J, Sandelowski M, Knafl K. Family Functioning and the Well-Being of Children With Chronic Conditions: A Meta-Analysis. Res Nurs Health 2016; 39:229-43. [PMID: 27128982 DOI: 10.1002/nur.21725] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2016] [Indexed: 11/11/2022]
Abstract
For children with chronic conditions, well-being is closely related to how well their families function. Most prior research syntheses on family functioning and child well-being have focused on children with a single condition, thereby limiting the potential to aggregate and build on what is known across conditions. To address this challenge, research reports were reviewed and meta-analyses conducted of findings on the relationship between family functioning and child well-being across a range of chronic physical conditions. The sample was derived from a larger systematic review study that included 1,028 reports published between January 1, 2000 and March 31, 2014. The current review includes 53 studies in which a relationship between family functioning and child well-being was analyzed using one of four family measures: Family Adaptability and Cohesion Evaluation Scales, Family Environment Scale, Family Relationship Index, or Family Assessment Device. Most studies were cross-sectional and observational (n = 43, 81%). The most frequently studied conditions were diabetes, cancer, sickle cell disease, and asthma. In 37 studies, findings were sufficiently comparable to conduct meta-analyses. Significant correlations were identified between children's psychological health and seven of nine dimensions of family functioning. Significant correlations also were found between dimensions of family functioning and children's problem behaviors, social competence, quality of life, and, to a lesser extent, adherence and physical health. Of the family dimensions, cohesion and conflict were associated most strongly with child outcomes. Understanding the specific family variables, such as conflict, linked to varied child outcomes is key for intervention development. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jennifer Leeman
- Assistant Professor, School of Nursing, University of North Carolina, 5004 Carrington Hall, CB 7460, Chapel Hill, NC, 27599-7460
| | - Jamie L Crandell
- Assistant Professor, School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Anna Lee
- Doctoral Candidate, School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Jinbing Bai
- Doctoral Candidate, School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Margarete Sandelowski
- Cary C. Boshamer Distinguished Professor, School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Kathleen Knafl
- Frances Hill Fox Distinguished Professor, School of Nursing, University of North Carolina, Chapel Hill, NC
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Van Schoors M, Caes L, Verhofstadt LL, Goubert L, Alderfer MA. Systematic Review: Family Resilience After Pediatric Cancer Diagnosis: Figure 1. J Pediatr Psychol 2015; 40:856-68. [DOI: 10.1093/jpepsy/jsv055] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 05/18/2015] [Indexed: 11/12/2022] Open
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