Poor Psychosocial Well-Being in the First Year-and-a-Half After Losing a Parent to Cancer - A Longitudinal Study Among Young Adults Participating in Support Groups

A Conceptual Model Depicting How Children Are Affected by Parental Cancer: A Constructivist Grounded Theory Approach

Cancer patients' children are vulnerable to psychosocial and behavioural issues. The mechanisms underlying how children are affected by their parent's diagnosis are unknown, warranting further research. This study investigated how children are affected by their parent's cancer diagnosis and provides a theoretical model conceptualising this experience. Informed by methods of grounded theory, embedded within a social constructivist framework, 38 informants (15 health professionals (HPs); 11 parents; 12 children (5 to 17 years)) were interviewed using a semi-structured format. Three themes were identified: (i) children were worried and distressed because they felt alone, (ii) parents were unable to tend to children's needs because they were overwhelmed by practical factors, and (iii) HPs were not detecting children due to barriers that affected their visibility in clinical settings. The proposed Alexander's Children's Cancer Communication (ACCC) Model and clinical recommendations made can be used to guide the clinical practice and development of future intervention research.

Posttraumatic Growth After Struggling With the Loss of a Parent in Young Adulthood

This study aims to examine posttraumatic growth and its associations with parental bereavement among adolescents and young adults. Fifty-five young adults who had lost a parent to cancer at least 2 months earlier and were about to attend a support group at a palliative care service were recruited. Data was collected through questionnaires before support group participation, about 5-8 months after the loss and at a 6-month follow-up, about 14-18 months after the loss. The result shows that the young adults experienced posttraumatic growth, mostly in the domains Personal strength and Appreciation of life. Posttraumatic growth was associated with bereavement outcomes, especially life satisfaction, a feeling of meaning in future life and psychological health. The result is of value for health care professionals as it adds information about the importance of supporting constructive rumination to enhance the possibility to positive psychological change after a parent's death.

Impact of expected parental death on the health of adolescent and young adult children: A systematic review of the literature

BACKGROUND

Few studies of health impacts of parental death focus on the developmental stage of adolescence and young adulthood and in particular, expected parental death from terminal illness.

AIM

To systematically review the health impact of expected parental death on adolescent and young adult children aged 15-25 years and provide a basis for further research and clinical practice.

DESIGN

Systematic review registered on PROSPERO (CRD42017080282).

DATA SOURCES

Pubmed, PsycINFO, CINAHL, MEDLINE and Cochrane databases were searched with no restrictions on publication date with the last search in March 2021. Eligible articles included studies of adolescent and young adult children (defined by age range of 15-25 years) exposed to parental death due to terminal illness, and with reported health outcomes (physical, psychological or social). Articles were reviewed using the QualSyst tool.

RESULTS

Ten articles met the inclusion criteria. Adolescent and young adult children reported poor family cohesion and communication with associated negative psychological outcomes. They reported distrust in the health care provided to their terminally ill parent, increased psychological distress and risk of unresolved grief, anxiety and self-harm. Some experience was positive with posttraumatic growth identified.

CONCLUSIONS

This review specifically analysed the health impact of expected parental death on adolescent and young adult children. It highlights their need for age-appropriate psychosocial support and clear information during parental illness, death and bereavement.