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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.
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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
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Delemere E, Gitonga I, Maguire R. "A Really Really Almost Impossible Journey" Perceived Needs and Challenges of Families Impacted by Pediatric Cancer: A Qualitative Analysis. Compr Child Adolesc Nurs 2023; 46:277-294. [PMID: 37409984 DOI: 10.1080/24694193.2023.2229429] [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: 09/01/2022] [Accepted: 06/16/2023] [Indexed: 07/07/2023]
Abstract
Caring for a child with cancer can place a number of burdens on families, however it is unclear the extent to which health-care professionals (HCPs) and other personnel supporting families are aware of these burdens. This study sought to explore the needs and challenges encountered by families impacted by pediatric cancer in Ireland from the perspectives of both parents and the personnel who support them. Twenty-one participants, comprising seven parents (one male, six females), and 14 supportive personnel (nine hospital-based volunteers and five HCPs) took part in in-depth semi-structured interviews via Microsoft Teams (December 2020 to April 2021) to obtain a perspective of the needs, challenges, and currently available support for families. A reflexive thematic approach to analysis was employed. The need to navigate a new normal, a sense of riding the wave and reliance on others were perceived to be the primary challenges encountered by families. Participants reported a need for community service provision, connectivity across the health-care system and more accessible psychological support. High levels of overlap across themes were found for parents and supportive personnel, particularly HCPs. Results highlight the significant challenges encountered by families impacted by pediatric cancer. Themes voiced by parents were frequently echoed by HCPs, suggesting this group is attuned to broader family needs. As such, they may be capable of providing insight where parent perspectives are unavailable. While further analysis including children's voices is needed, findings highlight key areas toward which support for families should be directed.
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Affiliation(s)
- Emma Delemere
- Department of Psychology, Maynooth University Co., Kildare, Ireland
| | - Isaiah Gitonga
- Department of Psychology, Maynooth University Co., Kildare, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University Co., Kildare, Ireland
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3
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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.
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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
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4
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Vasilopoulou K, Skoutari A, Siomos K, Christodoulou N. "The effects of family therapeutic interventions on mental health and quality of life of children with cancer: A systematic review". Clin Child Psychol Psychiatry 2022; 27:911-928. [PMID: 34979818 DOI: 10.1177/13591045211061812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The diagnosis of a childhood malignancy and the following period are very stressful for the little patient and the whole family. Depression, anxiety, and poor quality of life (QoL) are some of the negative effects of pediatric cancer to the children and their parents. Family therapeutic interventions aim to improve mental health and QoL of these children. METHODS A systematic search of the electronic database PubMed was conducted for articles that studied the effect of family therapeutic interventions on mental health and QoL of children with cancer. RESULTS A total of 634 articles were evaluated, of which 10 articles met the inclusion criteria. A percentage of 70% of the studies, representing seven different types of interventions, seemed to be beneficial for the participant's mental health and QoL. The remaining three studies did not significantly improve mental health and QoL. CONCLUSION The results of our review indicate that family psychosocial interventions are beneficial for children with cancer. These children and their families are a growing population requiring more patient-centered, time flexible interventions which may enhance family bonding and patients' positive emotions.
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Affiliation(s)
| | | | - Konstantinos Siomos
- Faculty of Medicine, 37787University of Thessaly, Larissa, Greece.,Department of Psychiatry, 37787University of Thessaly, Larissa, Greece
| | - Nikolaos Christodoulou
- Faculty of Medicine, 37787University of Thessaly, Larissa, Greece.,Department of Psychiatry, 37787University of Thessaly, Larissa, Greece
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Eklund R, Lövgren M. The Family Talk Intervention in Pediatric Oncology: Ill Children's Descriptions of Feasibility and Potential Effects. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:143-154. [PMID: 35467434 DOI: 10.1177/27527530221068423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: There are few scientifically evaluated psychosocial interventions in pediatric oncology, despite the needs for families. The family-based psychosocial intervention "The Family Talk Intervention" (FTI) has shown promising results in other care contexts and was therefore pilot-tested in pediatric oncology. In this study, we examined the experiences of participating in FTI from ill children's perspectives regarding feasibility and potential effects. Methods: This pilot study involved 26 families in pediatric oncology that had participated in FTI. The paper is focused on those ill children who answered surveys (n = 19) and/or participated in interviews (n = 11) when FTI had ended. Data were analyzed with descriptive statistics and thematic analysis. Results: For most ill children, FTI came at the right time, included a reasonable number of meetings, and the length of the meetings was appropriate. The children felt listened to and understood by the interventionists and almost all children reported that FTI had helped them in some way. The children's perceptions indicated that FTI improved communication within the family and strengthened family relations. Children reported that the parents and their siblings seemed to feel better after participation and became more understanding. Discussion: The findings of this pilot study indicated that a full-scale study could be valuable from the ill children's perspective, as FTI was reported as feasible and had positive effects. The findings showed that FTI gave families an opportunity to open up communication about the illness, adjust their behaviors, and strengthen family relationships. Trial registration: ClinicalTrials.gov Identifier NCT03650530.
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Affiliation(s)
- Rakel Eklund
- 7643Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, Stockholm, Sweden
- Department of Neuroscience, National Centre for Disaster Psychiatry, 8097Uppsala University, Uppsala, Sweden
| | - Malin Lövgren
- 7643Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, Stockholm, Sweden
- Advanced Pediatric Home Care, Astrid Lindgren Children's Hospital, 59562Karolinska University Hospital, Stockholm, Sweden
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Espinoza-Salgado FS, Robles García R, Wakefield CE, Kelada L, Sansom-Daly UM, McGill BC, Zentella Tusie A, Juárez García L, Cárdenas Cardos RDS, Zapata-Tarrés M. Adaptación cultural mexicana del programa de intervención CASCAdE para padres de supervivientes de cáncer infantil. PSICOONCOLOGIA 2022. [DOI: 10.5209/psic.80798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo: Describir el proceso de adaptación cultural del programa CASCAdE en línea para padres de supervivientes de cáncer infantil mexicanos. Método: Se utilizó el Modelo Ecológico de Validación (MEV), en dos fases: la primera consistió en la traducción (inglés-español) y adaptación cultural de los contenidos del programa; la segunda fue la evaluación del contenido e integridad del tratamiento. Resultados: Se realizaron cambios en la redacción del texto, se modificó el uso de la segunda persona del singular por la tercera persona del singular “usted”. Del MEV se eligieron para adaptación de materiales: Lenguaje, Personas, Metáforas o dichos, Narrativa y Conceptos. Entre los cambios más relevantes se encuentran el uso de la tercera persona del singular (aceptabilidad) y la adaptación de metáforas que fueran entendibles en este contexto (relevancia). Para la intervención se adaptaron: Métodos, contexto y objetivos, dando como resultado la aplicación individual, cambios en el diseño gráfico e inclusión de iconografías llamativas y amigables para los padres (aceptabilidad). En la evaluación del contenido por jueces expertos se obtuvieron porcentajes del 50% de acuerdo en redacción de las sesiones de introducción del manual para el facilitador y 75% en redacción de la sesión cuatro del manual para padres. Conclusión: Este estudio muestra el proceso de adaptación cultural desde el MEV a fin de contar con los materiales necesarios para que la aplicación del programa CASCAdE en un contexto mexicano.
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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.
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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
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Lamson AL, Hodgson JL, Pratt KJ, Mendenhall TJ, Wong AG, Sesemann EM, Brown BJ, Taylor ES, Williams-Reade JM, Blocker DJ, Harsh Caspari J, Zubatsky M, Martin MP. Couple and family interventions for high mortality health conditions: A strategic review (2010-2019). JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:307-345. [PMID: 34741539 DOI: 10.1111/jmft.12564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
The earliest publications in the field of marriage and family therapy introduced interventions conducted with families experiencing complex health conditions. This strategic review captures an evaluation of efficacy for 87 couple and family interventions published between 2010 and 2019 with a focus on the leading causes of mortality in the United States. These health conditions include chromosomal anomalies and accidents with infants aged 0-4 years; accidents and cancer among children aged 5-14; accidents among adolescents aged 15-24; and heart disease, cancer, accidents, chronic lower respiratory diseases, stroke, Alzheimer's disease, diabetes, influenza/pneumonia, and nephritis/nephrosis among adults 25 and older. Results support the need for greater inclusion of couples and families in assessments and interventions. The greatest chasm in efficacy research was with minoritized couples and families. Implications include ways to initiate couple and family interventions in the context of health conditions with attention given to accessibility, recruitment, retention, and evaluation.
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Affiliation(s)
- Angela L Lamson
- Department of Human Development & Family Science, College of Health and Human Performance, Greenville, North Carolina, USA
| | - Jennifer L Hodgson
- Department of Human Development & Family Science, College of Health and Human Performance, Greenville, North Carolina, USA
| | - Keeley J Pratt
- Department of Human Services, Human Development and Family Science Program, Couple and Family Therapy Specialization, College of Education & Human Ecology, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Tai J Mendenhall
- Department of Family Social Science, University of Minnesota, Saint Paul, Minnesota, USA
| | - Alison G Wong
- Department of Marriage and Family Therapy, Fuller School of Psychology and Marriage and Family Therapy, Pasadena, California, USA
| | | | - Braden J Brown
- Department of Family Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Athletics Department, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Erika S Taylor
- Department of Family Medicine, Behavioral Medicine Section, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | | | - Daniel J Blocker
- Pomona Valley Family Medicine Residency, Pomona Valley Hospital Medical Center, Pomona, California, USA
| | - Jennifer Harsh Caspari
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Max Zubatsky
- Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri, USA
| | - Matthew P Martin
- Doctor of Behavioral Health Program, College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
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Wakefield CE, Sansom-Daly UM, McGill BC, Hetherington K, Ellis SJ, Robertson EG, Donoghoe MW, McCarthy M, Kelada L, Girgis A, King M, Grootenhuis M, Anazodo A, Patterson P, Lowe C, Dalla-Pozza L, Miles G, Cohn RJ. Providing Psychological Support to Parents of Childhood Cancer Survivors: ' Cascade' Intervention Trial Results and Lessons for the Future. Cancers (Basel) 2021; 13:cancers13225597. [PMID: 34830752 PMCID: PMC8615912 DOI: 10.3390/cancers13225597] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary We assessed a new group-based cognitive behavior therapy videoconferencing program to support parents of childhood cancer survivors. The trial allocated parents to three groups: Cascade, peer-support, waitlist. Cascade achieved good parent engagement. We successfully delivered Cascade to participants who lived >3200 km apart. Any technical difficulties caused only minor disruptions. Most Cascade parents were satisfied and reported experiencing benefits from the program. However, Cascade did not improve our main outcomes, including parents’ quality of life, depression and anxiety. Cascade parents reported a short-term improvement in their confidence to use the skills they learnt, but this did not translate into actual use. After six months, Cascade parents felt their child survivor had lower psychological health than waitlisted parents. Our findings show that while some parents find Cascade helpful, it may not suit everyone. We used these findings to further improve Cascade and will trial the new version in future. Abstract We conducted a three-armed trial to assess Cascade, a four-module group videoconferencing cognitive behavior therapy (CBT) intervention for parents of childhood cancer survivors currently aged <18 years. We allocated parents to Cascade, an attention control (peer-support group), or a waitlist. The primary outcome was parents’ health-related quality of life (PedsQL-Family Impact/EQ-5D-5L) six months post-intervention. Parents also reported their anxiety/depression, parenting self-agency, fear of recurrence, health service and psychotropic medication use, engagement in productive activities, confidence to use, and actual use of, CBT skills, and their child’s quality of life. Seventy-six parents opted in; 56 commenced the trial. Cascade achieved good parent engagement and most Cascade parents were satisfied and reported benefits. Some parents expressed concerns about the time burden and the group format. Most outcomes did not differ across trial arms. Cascade parents felt more confident to use more CBT skills than peer-support and waitlisted parents, but this did not lead to more use of CBT. Cascade parents reported lower psychosocial health scores for their child than waitlisted parents. Cascade parents’ health service use, psychotropic medication use, and days engaged in productive activities did not improve, despite some improvements in waitlisted parents. Our trial was difficult to implement, but participants were largely satisfied. Cascade did not improve most outcomes, possibly because many parents were functioning well pre-enrolment. We used these findings to improve Cascade and will trial the new version in future.
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Affiliation(s)
- Claire E. Wakefield
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Correspondence: ; Tel.: +61-(2)-9382-3113; Fax: +61-(2)-9382-1789
| | - Ursula M. Sansom-Daly
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Brittany C. McGill
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Kate Hetherington
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Sarah J. Ellis
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia;
| | - Eden G. Robertson
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Mark W. Donoghoe
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Maria McCarthy
- Clinical Sciences, Brain and Mind, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia;
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 2052, Australia
| | - Lauren Kelada
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Afaf Girgis
- South West Sydney Clinical Campuses, UNSW Medicine and Health, Sydney, NSW 2052, Australia;
| | - Madeleine King
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia;
| | - Martha Grootenhuis
- Princess Máxima Center for Pediatric Oncology, 3584 CT Utrecht, The Netherlands;
| | - Antoinette Anazodo
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Pandora Patterson
- Research, Evaluation and Social Policy Unit, Canteen, Newtown, NSW 2042, Australia;
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Cherie Lowe
- Queensland Children’s Cancer Centre, Queensland Children’s Hospital, South Brisbane, QLD 4101, Australia;
| | - Luciano Dalla-Pozza
- Cancer Centre for Children, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia;
| | - Gordon Miles
- Child and Adolescent Mental Health Service, Perth Children’s Hospital, Perth, WA 6009, Australia;
| | - Richard J. Cohn
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
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10
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Schepers SA, Schulte FSM, Patel SK, Vannatta K. Cognitive Impairment and Family Functioning of Survivors of Pediatric Cancer: A Systematic Review. J Clin Oncol 2021; 39:1795-1812. [PMID: 33886349 DOI: 10.1200/jco.20.02516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sasja A Schepers
- Department of Psycho-Oncology Research and Care, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Fiona S M Schulte
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Sunita K Patel
- Departments of Population Sciences and Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Kathryn Vannatta
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH.,Departments of Pediatrics and Psychology, The Ohio State University, Columbus, OH
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11
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Mulligan S, Guerin S, McKiernan A, Brown A, Hartnett M, Gray D, Kiernan G. The core features and outcomes of a specialised camp programme for children with life-limiting conditions and their families: A qualitative multi-perspective approach. J Child Health Care 2020; 24:515-528. [PMID: 31594387 DOI: 10.1177/1367493519875593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous research has reported that the families of children with enduring and life-limiting health conditions are at risk of negative psychosocial effects. Adjunct to medical interventions, specialist camp programmes have been developed to promote familial adjustment. However, limited research has been carried out in this area. The aim of this study was to describe the core features and outcomes of a specialised camp programme for children with life-limiting conditions (LLC) and their family. Semi-structured interviews were conducted with four professionals, three volunteers involved in facilitating the programme and two mothers representing families that attended the programme. Multiple perspectives were sought to gain a detailed understanding of the programme and outcomes. Data were analysed through an inductive thematic approach. There was considerable overlap among participant groups on the core features and outcomes of the programme. Thematically, core features are described in terms of familial togetherness, peer interaction, safety and positive experiences. Noted outcomes include lasting memories, continued peer relations for parents and siblings and enhancement of relationships between family members and professionals. Findings suggest that specialised camp programmes may provide families of children with LLC with positive experiences that support adjustment, although further research is required.
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Affiliation(s)
- Shane Mulligan
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Suzanne Guerin
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | | | - Anna Brown
- LauraLynn, Ireland's Children's Hospice, Dublin, Ireland
| | | | - Dee Gray
- LauraLynn, Ireland's Children's Hospice, Dublin, Ireland
| | - Gemma Kiernan
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
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12
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Delemere E, Maguire R. The role of Connected Health technologies in supporting families affected by paediatric cancer: A systematic review. Psychooncology 2020; 30:3-15. [PMID: 32893415 DOI: 10.1002/pon.5542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/06/2020] [Accepted: 08/31/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Families impacted by paediatric cancer are met with logistical, financial and psychological impacts, with severe acute respiratory syndrome coronavirus two creating additional barriers and stressors for these families. Connected Health (CH) may facilitate cancer care. The objective of the present study was to systematically review CH for families/informal caregivers affected by paediatric cancer. METHODS Using search terms relating to: (1) paediatric cancer, (2) family/caregivers and (3) CH, the databases of PsycINFO, Pubmed, EMBASE and Web of Science were searched. Inclusion criteria included an evaluation of CH technologies for supportive care for families/caregivers affected by paediatric cancer at any stage of treatment or survivorship. RESULTS Sixteen studies met inclusion criteria. CH was primarily web-based (n = 6), however smartphone applications (n = 5), telehealth (n = 2) and online groups (n = 3) were utilised. Intervention areas included psycho-social (n = 6), health and information provision (n = 8) and palliative care (n = 2). CONCLUSIONS While limited studies have evaluated the impact of CH on families living with paediatric cancer, emerging evidence suggests potential benefits. More evidenced-based interventions are required.
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Affiliation(s)
- Emma Delemere
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
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13
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A review of psychosocial interventions targeting families of children with cancer. Palliat Support Care 2020; 19:103-118. [DOI: 10.1017/s1478951520000449] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AbstractObjectivePsychosocial interventions in families of children with cancer are considered an effective way of empowering family members to tackle the complex hurdles they face. The ability of parents to develop adaptive coping strategies during the child's treatment is not only important to their own mental and physical health, but also to their child's well-being and long-term adjustment with the disease.MethodsThe aim of this review was to evaluate the existing literature for the period from 2009 to 2017 on psychosocial interventions targeting families of children with cancer. We searched the PubMed database using the following combination of keywords: “cancer AND children AND (intervention OR training) AND (mothers OR primary caregivers OR parents OR fathers OR siblings).”ResultsAfter careful evaluation of 995 papers, 17 full-text papers were found to match our criteria (12 randomized controlled trials and 5 quasi-experimental studies). The quality of the studies was assessed using the Delphi score questionnaire, and the score of the reviewed studies ranged from 3 to 5. The findings suggest that most interventions reduced distress and improved coping strategies among participants. Interventions, mainly cognitive behavioral therapy and problem-solving skills training targeting maternal distress, were associated with improved adjustment outcomes in mothers of children with cancer.Significance of resultsPsychosocial interventions are helpful, and efforts should be made to promote them in a larger scale. Protocols should be implemented to ensure that all parents benefit. Computer-assisted methods may provide additional benefit by improving cancer-related knowledge and cancer-related communication.
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14
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The concept of “emotional distress” as a possible indicator of maladaptation in children/adolescents with oncological and oncohematological diseases and their caregivers. ACTA ACUST UNITED AC 2020. [DOI: 10.21682/2311-1267-2019-6-4-76-82] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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15
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Salvador Á, Crespo C, Barros L. Family Management of Pediatric Cancer: Links with Parenting Satisfaction and Psychological Distress. FAMILY PROCESS 2019; 58:761-777. [PMID: 30063085 DOI: 10.1111/famp.12379] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Research has long acknowledged the disruptions posed by pediatric cancer diagnosis and treatment to family life. Nonetheless, the mechanisms through which the family response influences parents' mental health in this adverse context are not fully understood. The main goal of the present study was to examine the direct and indirect links, via parenting satisfaction, between family condition management and psychological distress of parents of children with cancer. Participants were 201 parents (86.6% mothers) of children/adolescents diagnosed with cancer who completed self-report questionnaires assessing family condition management (family life difficulty and parental mutuality), parenting satisfaction, and psychological distress (anxiety and depression). Structural equation modeling was used to test the proposed mediation model. The results showed that parenting satisfaction mediated the association between both the family condition management dimensions (family life difficulty and parental mutuality) and depression. Specifically, greater family life difficulties and lower parental mutuality were associated with lower parenting satisfaction, which, in turn, was associated with higher levels of depression. Additionally, greater family life difficulties and lower parental mutuality were directly linked to higher levels of anxiety. Multigroup analyses suggested that the model was valid across patient age groups (children vs. adolescents) and treatment status (on vs. off-treatment). These findings reinforce the need for family- and parent-based interventions in the pediatric oncology field. Interventions that target families' difficulties and promote their resources are likely to foster parenting satisfaction and psychological adjustment.
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Affiliation(s)
- Ágata Salvador
- Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
| | - Carla Crespo
- Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
| | - Luísa Barros
- Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
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16
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Schepers SA. Commentary: Fifty Years of Development in Pediatric Psycho-Oncology Research and Practice: How Far Have we Come? J Pediatr Psychol 2019; 44:761-763. [DOI: 10.1093/jpepsy/jsz043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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17
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Psychological treatment for family members of children with cancer: A systematic review and meta‐analysis. Psychooncology 2019; 28:960-969. [DOI: 10.1002/pon.5052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/14/2019] [Accepted: 03/01/2019] [Indexed: 01/11/2023]
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18
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Lövgren M, Kreicbergs U, Udo C. Family talk intervention in paediatric oncology: a pilot study protocol. BMJ Paediatr Open 2019; 3:e000417. [PMID: 30815590 PMCID: PMC6361369 DOI: 10.1136/bmjpo-2018-000417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION There is evidence that families with a child diagnosed with cancer need psychosocial support throughout the illness trajectory. Unfortunately, there is little research into psychosocial interventions for such families, especially interventions where the entire family is involved. The aim of this pilot study is therefore to evaluate a psychosocial intervention, the family talk intervention (FTI), in paediatric oncology in terms of study feasibility and potential effects. METHODS AND ANALYSIS This pretest/post-test intervention pilot study is based on families with a child diagnosed with cancer. All families that include at least one child aged 6-19 years (ill child and/or sibling) at one of the six paediatric oncology centres in Sweden between September 2018 and September 2019 will be asked about participation. The intervention consists of six meetings with the family (part of the family or the entire family), led by two interventionists. The core elements in the intervention are to support the families in talking about the illness and related subjects, support the parents in understanding the needs of their children and how to support them and support the families in identifying their strengths and how to use them best. Mixed methods are used to evaluate the intervention (web-based questionnaires, interviews, field notes and observations). Self-reported data from all family members are collected at baseline, directly after the intervention and 6 months later. Study outcomes are family communication, knowledge about the illness, resilience, quality of life and grief. ETHICS AND DISSEMINATION The study has been approved by the Regional Ethical Review Board in Stockholm (Dnr 2018/250-31/2 and 2018/1852-32). Data are processed in coded form, accessible only to the research team and stored at Ersta Sköndal Bräcke University College in a secure server. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03650530, registered in August 2018.
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Affiliation(s)
- Malin Lövgren
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,The Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Kreicbergs
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,The Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
| | - Camilla Udo
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,School of Education, Health and Society, Dalarna University, Falun, Sweden
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19
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Gutiérrez-Colina AM, Lee JL, VanDellen M, Mertens A, Marchak JG. Family Functioning and Depressive Symptoms in Adolescent and Young Adult Cancer Survivors and Their Families: A Dyadic Analytic Approach. J Pediatr Psychol 2018; 42:19-27. [PMID: 28173209 DOI: 10.1093/jpepsy/jsw041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/09/2016] [Accepted: 04/15/2016] [Indexed: 11/14/2022] Open
Abstract
Background To examine dyadic relationships between depressive symptoms and family functioning in families of pediatric cancer survivors. Methods Sixty-four adolescent and young adult (AYA) cancer survivors and their caregivers self-reported on depressive symptoms and family functioning. Multilevel modeling analyses were used to test actor–partner interdependence models. Results Significant actor effects of depressive symptoms on domains of family functioning were found for AYAs and their caregivers. Only caregivers’ depressive symptoms exerted a significant effect on AYAs’ report of family cohesion, indicating the presence of significant partner effects for AYAs. Conclusions AYAs’ and caregivers’ depressive symptoms are related to poorer family functioning. Caregivers’ perceptions of depressive symptoms relate not only to their own perceptions of family functioning but also to that of their children. These findings begin to map the complex relationships that exist between AYAs and their caregivers and elucidate some of the mechanisms through which caregiver-related variables affect AYA outcomes.
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Affiliation(s)
| | - Jennifer L Lee
- Children's Healthcare of Atlanta.,Emory University School of Medicine
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20
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Peikert ML, Inhestern L, Bergelt C. Psychosocial interventions for rehabilitation and reintegration into daily life of pediatric cancer survivors and their families: A systematic review. PLoS One 2018; 13:e0196151. [PMID: 29672608 PMCID: PMC5908186 DOI: 10.1371/journal.pone.0196151] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/07/2018] [Indexed: 11/18/2022] Open
Abstract
Background The survival rate of childhood cancer patients increased over the past decades. However, even after successful treatment the transition back to normalcy is often a major challenge for the whole family. Therefore, this study aims to provide an overview of psychosocial interventions for childhood cancer survivors and their families in the first years after the end of cancer treatment. Methods We conducted a systematic review following the PRISMA Checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PROSPERO registration number: CRD42017059782). In November 2016 and September 2017, we searched the databases CINAHL, MEDLINE, PSYNDEX, and Web of Science. We included studies investigating psychosocial interventions for childhood cancer survivors diagnosed under the age of 21, their family members or the family as a whole. Further, we summarized the study characteristics and conducted a narrative synthesis of the results. Finally, we assessed the study quality with the Effective Public Health Practice Project Quality Assessment Tool. Results We identified a total of 8215 records based on our database searches and 17 additional records through hand searches. We included 33 articles in the qualitative synthesis. Most of the studies described interventions for the cancer survivor (n = 15). Nine studies investigated interventions for the whole family, and two studies interventions for siblings. The interventions mainly take place in an outpatient group setting (n = 15). Overall, most of the studies reported a significant psychosocial benefit of the interventions. However, the quality of the included studies was limited. Conclusion In summary, we identified a broad range of different interventions and thus could give a comprehensive overview of existing interventions for childhood cancer survivors and their families. However, there is a necessity for high quality studies. The results may help to optimize health care services that support families with the re-entry into daily life.
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Affiliation(s)
- Mona Leandra Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Agnew F, Higgins A, Casey M, McCarthy A. The experience of fatherhood following childhood cancer survival. J Health Psychol 2017; 25:340-349. [DOI: 10.1177/1359105317717598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study explored the experience of becoming a father following childhood cancer survival. Semi-structured interviews were conducted with five fathers and analysed using interpretative phenomenological analysis. Three superordinate themes emerged: ‘moving away from and revisiting the experience of cancer’, ‘making sense of fortune and loss following a life-threatening illness’ and ‘valuing the opportunity to be a father’. The transition to fatherhood brought unique and specific challenges to fathers. Nevertheless, all appeared to have positively adjusted to this transition. Findings recommended providing information and support to childhood survivors who wish to or who are about to become fathers.
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Affiliation(s)
- Francis Agnew
- Belfast Health and Social Care Trust, UK
- Queen’s University Belfast, UK
| | - Aiveen Higgins
- Queen’s University Belfast, UK
- Antrim Area Hospital, Northern Health & Social Care Trust
| | - Maureen Casey
- Royal Belfast Hospital for Sick Children, UK
- Brothers of Charity, Lota, Glanmire, Co Cork, Ireland
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22
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Salem H, Johansen C, Schmiegelow K, Winther JF, Wehner PS, Hasle H, Rosthøj S, Kazak AE, E. Bidstrup P. FAMily-Oriented Support (FAMOS): development and feasibility of a psychosocial intervention for families of childhood cancer survivors. Acta Oncol 2017; 56:367-374. [PMID: 28080169 DOI: 10.1080/0284186x.2016.1269194] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND We developed and tested the feasibility of a manualized psychosocial intervention, FAMily-Oriented Support (FAMOS), a home-based psychosocial intervention for families of childhood cancer survivors. The aim of the intervention is to support families in adopting healthy strategies to cope with the psychological consequences of childhood cancer. The intervention is now being evaluated in a nationwide randomized controlled trial (RCT). METHODS AND DESIGN FAMOS is based on principles of family systems therapy and cognitive behavioral therapy, and is delivered in six sessions at home. Families were recruited from all four pediatric oncology departments in Denmark after the end of intensive cancer treatment. We evaluated the feasibility of the intervention and of a RCT design for comparing the intervention with usual care. The evaluation was conducted among families enrolled in the study by tracking procedures and parents' evaluations. RESULTS A total of 68 families (68 mothers, 60 fathers, 68 children with cancer and 73 siblings) were enrolled, with a participation rate of 62% of families. Fathers were highly represented (88% of families); also families with single parents (12%) and parents with basic education (7-12 years of primary, secondary, and grammar school education) were represented (12%). The dropout rate was 12% of families (all in the control group), and two families did not complete the intervention because of relapse. Evaluation by parents in the intervention group showed overall satisfaction with the format, timing, and content of the intervention. CONCLUSION The results indicate that the FAMOS intervention is feasible in terms of recruitment, retention, and acceptability. The effects of the intervention on post-traumatic stress, depression, anxiety, family functioning, and quality of life will be reported after the nationwide RCT has been completed.
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Affiliation(s)
- Hanin Salem
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christoffer Johansen
- Department of Oncology, Finsen Centre, Rigshospitalet, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- University Hospital Rigshospitalet, Institute of Clinical Medicine, Medical Faculty, University of Copenhagen, Copenhagen, Denmark
| | | | - Peder Skov Wehner
- Department of Pediatric Hematology and Oncology, H.C. Andersen Children’s Hospital, Odense University Hospital, Denmark
| | - Henrik Hasle
- Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Steen Rosthøj
- Department of Pediatrics, Aalborg Hospital, Aalborg, Denmark
| | - Anne E. Kazak
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, USA
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23
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Knafl KA, Havill NL, Leeman J, Fleming L, Crandell JL, Sandelowski M. The Nature of Family Engagement in Interventions for Children With Chronic Conditions. West J Nurs Res 2016; 39:690-723. [PMID: 27596106 DOI: 10.1177/0193945916664700] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recognizing the bi-directional relationship between family functioning and child well-being in the context of childhood chronic conditions, researchers have tested family-focused interventions aimed at promoting both child and family well-being through improving the family's condition management capacity. Based on a sample of 70 interventions for families in which there was a child with a chronic physical condition, this analysis examined the nature of family engagement in the interventions. Data were extracted from the intervention reports using a standardized template; conventional content analysis was used to describe family engagement. Interventions varied in focus, structure, and level of family engagement. Investigators most often sought to improve condition control or management, with parent engagement focused on improving capacity to manage the treatment regimen. Few investigators addressed capacity building in the context of family functioning. Recommendations are made for reporting standards for family-focused interventions and for enhancing the family systems grounding of interventions.
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Affiliation(s)
| | - Nancy L Havill
- 1 The University of North Carolina at Chapel Hill, NC, USA
| | | | - Louise Fleming
- 1 The University of North Carolina at Chapel Hill, NC, USA
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24
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Sultan S, Leclair T, Rondeau É, Burns W, Abate C. A systematic review on factors and consequences of parental distress as related to childhood cancer. Eur J Cancer Care (Engl) 2016; 25:616-37. [PMID: 26354003 PMCID: PMC5049674 DOI: 10.1111/ecc.12361] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2015] [Indexed: 01/08/2023]
Abstract
The literature including correlates of parental distress as related to childhood cancer is abundant. It is important to identify predictive factors and outcomes of this distress in parents. The objective of this review was to update previous syntheses on factors of distress and to identify outcomes of parents' distress in the recent literature (2007-2012). We performed a systematic review to identify all quantitative studies including measures of parental distress and associated factors during the study period. We found 56 eligible studies, of which 43 had a Low risk of bias (Cochrane guidelines). Forty-two reports included potential predictive factors. Significant relationships were found with clinical history of the child, sex of the parent, coping response and personal resources, pre-diagnosis family functioning, but not education/income or marital status. Twenty-five reports studied potential consequences of distress and focused on psychological adjustment in parents and children. Compared to past periods, a higher proportion of studies included fathers. Measures used to evaluate distress were also more homogeneous in certain domains of distress. This review underscores the need for appropriate methods for selecting participants and reporting results in future studies. Appropriate methods should be used to demonstrate causality between factors/consequences and distress.
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Affiliation(s)
- S Sultan
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Centre de cancérologie Charles-Bruneau, Hôpital Sainte-Justine, CHU Sainte-Justine, Montreal, QC, Canada
| | - T Leclair
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - É Rondeau
- Centre de cancérologie Charles-Bruneau, Hôpital Sainte-Justine, CHU Sainte-Justine, Montreal, QC, Canada
| | - W Burns
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - C Abate
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
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25
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Safarabadi-Farahani A, Maarefvand M, Biglarian A, Khubchandani J. Effectiveness of a Brief Psychosocial Intervention on Quality of Life of Primary Caregivers of Iranian Children With Cancer: A Randomized Controlled Trial. J Pediatr Nurs 2016; 31:e262-70. [PMID: 26860879 DOI: 10.1016/j.pedn.2016.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 12/17/2022]
Abstract
UNLABELLED Cancer in children has a great impact on primary caregiver quality of life (QOL). OBJECTIVE This study examined the effectiveness of a brief psychosocial intervention (BPI) on QOL of Primary Caregivers of Children with Cancer (PCCCs). METHODS Sixty-five PCCCs participated in a randomized controlled trial in Mahak Hospital and Rehabilitation Complex in Tehran, Iran. A 5-week long BPI (which comprised of counseling sessions and telephone follow-up) was delivered to the intervention group in addition to usual service, while the control group was provided with usual service. Data were collected using the Caregiver Quality of Life Index-Cancer-Persian version (CQOLC-P) prior to intervention, post-intervention, and at follow-up (i.e. 30days after the intervention). Repeated measures analysis of variance analysis (ANOVA) was used to evaluate outcomes. RESULTS Majority of the participants were mothers (95%), between ages of 24-47 years (95%) with children between ages of 2-12 years. Most child cancer diagnoses were for brain tumors (n=31) and blood cancers (n=17). Significant improvement was found within the intervention group on QOL (p<0.001) including improvements on subscale measures of mental/emotional burden (p<0.001), disruption (p<0.001), and positive adaptation (p<0.001), compared with the control group over time. There was no difference between the intervention and control groups on the financial subscale measure after intervention (p>0.05). CONCLUSION BPI was an effective strategy to improve the quality of life of PCCCs. Similar interventions can be planned by practitioners to reduce the burden of childhood cancer on PCCCs.
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Affiliation(s)
| | - Masoomeh Maarefvand
- Substance Abuse and Dependence Research Center, Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Akbar Biglarian
- Biostatistics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Jagdish Khubchandani
- Department of Physiology and Health Science, Ball State University, Muncie, IN, USA
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26
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Wakefield CE, Sansom-Daly UM, McGill BC, Ellis SJ, Doolan EL, Robertson EG, Mathur S, Cohn RJ. Acceptability and feasibility of an e-mental health intervention for parents of childhood cancer survivors: "Cascade". Support Care Cancer 2016; 24:2685-94. [PMID: 26781620 DOI: 10.1007/s00520-016-3077-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/03/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to evaluate the feasibility and acceptability of "Cascade": an online, group-based, cognitive behavioral therapy intervention, delivered "live" by a psychologist, to assist parents of children who have completed cancer treatment. METHODS Forty-seven parents were randomized to Cascade (n = 25) or a 6-month waitlist (n = 22). Parents completed questionnaires at baseline, 1-2 weeks and 6 months post-intervention. Thirty parents completed full evaluations of the Cascade program (n = 21 randomized to Cascade, n = 9 completed Cascade post-waitlist). RESULTS Ninety-six percent of Cascade participants completed the intervention (n = 24/25). Eighty percent of parents completed every questionnaire (mean completion time 25 min (SD = 12)). Cascade was described as at least "somewhat" helpful by all parents. None rated Cascade as "very/quite" burdensome. Parents reported that the "online format was easy to use" (n = 28, 93.3 %), "I learnt new skills" (n = 28, 93.3 %), and "I enjoyed talking to others" (n = 29, 96.7 %). Peer-to-peer benefits were highlighted by good group cohesion scores. CONCLUSIONS Cascade is highly acceptable and feasible. Its online delivery mechanism may address inequities in post-treatment support for parents, a particularly acute concern for rural/remote families. Future research needs to establish the efficacy of the intervention. TRIAL REGISTRATION ACTRN12613000270718, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12613000270718.
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Affiliation(s)
- Claire E Wakefield
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Ursula M Sansom-Daly
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
- Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, Randwick, NSW, Australia
| | - Brittany C McGill
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Sarah J Ellis
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Emma L Doolan
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Eden G Robertson
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Sanaa Mathur
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Richard J Cohn
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
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A review of supportive care interventions to manage distress in young children with cancer and parents. Cancer Nurs 2015; 37:E1-26. [PMID: 24936752 DOI: 10.1097/ncc.0000000000000095] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a positive relationship between parent and young child distress during cancer treatment. Dimensions of parent/child distress are multifaceted and associated with family function and quality of life outcomes. A critical examination of intervention research is needed to identify how dimensions of parent/child distress and related outcomes are being addressed. OBJECTIVE The aims of this study were to summarize and describe supportive care intervention research for young children with cancer and parents and to discuss implications for family-based intervention research. METHODS This systematic review examined supportive care intervention studies with randomized and nonrandomized designs for young children with cancer (aged 3-8 years) and/or their parents published between 1991 and 2011. Twenty-two studies that met specific inclusion criteria were reviewed to determine intervention type, intervention components, targeted outcomes and findings, and whether interventions addressed child, parent, or parent/child needs. RESULTS Most interventions focused primarily on procedural support, followed by parent education/counseling. Most studies targeted the child or the parent alone; very few targeted parent/child dyads. Outcomes focused primarily on child distress, anxiety, and pain. Quality of life and coping were rarely measured, and no studies examined family function. This body of research is emerging, with most interventions in the developmental pilot phase and few efficacy trials. CONCLUSIONS Findings confirm underrepresentation of young children in supportive care intervention research and the need for more complex, family-based interventions to advance young child intervention research beyond acute, procedural distress. IMPLICATIONS FOR PRACTICE The authors discuss the implications of review findings for clinical practice.
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Thompson AL, Young-Saleme TK. Anticipatory Guidance and Psychoeducation as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S684-93. [PMID: 26700925 DOI: 10.1002/pbc.25721] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/03/2015] [Indexed: 01/24/2023]
Abstract
The aim of this review was to critically evaluate the literature on anticipatory guidance and psychoeducation for youth with cancer and their caregivers. Twenty-one publications were identified. Overall, psychoeducation efforts and interventions were well-liked and accepted by patients and caregivers, improved patient and family knowledge about childhood cancer, and increased patient's health locus of control. A number of modalities are effective in giving families anticipatory guidance, provided the content and delivery are matched to the needs and preferences of individual patients and caregivers. Evidence supports a strong recommendation for psychoeducation for youth with cancer and their families.
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Affiliation(s)
- Amanda L Thompson
- Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC
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Gerhardt CA, Lehmann V, Long KA, Alderfer MA. Supporting Siblings as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S750-804. [PMID: 26700924 DOI: 10.1002/pbc.25821] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 09/27/2015] [Indexed: 11/09/2022]
Abstract
In this study, evidence is provided for supporting siblings as a standard of care in pediatric oncology. Using Medline, PsycInfo, and CINAHL, a systematic search of articles published over the past two decades about siblings of children with cancer was conducted. A total of 125 articles, which were primarily descriptive studies, were evaluated by the four investigators using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. There is moderate-quality evidence, as well as support from community stakeholders, to justify a strong recommendation that siblings of children with cancer should be provided with psychosocial services and that parents and professionals are advised about how to meet siblings' needs.
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Affiliation(s)
- Cynthia A Gerhardt
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio
| | - Vicky Lehmann
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio
| | - Kristin A Long
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Melissa A Alderfer
- Nemours Children's Health System, Wilmington DE and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
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Polizzi C, Fontana V, Perricone G, D’Angelo P, Jankovic M, Taormina C, Nichelli F, Burgio S. Coping Strategies and Locus of Control in Childhood Leukemia: A Multi-Center Research. Pediatr Rep 2015; 7:5703. [PMID: 26266029 PMCID: PMC4508620 DOI: 10.4081/pr.2015.5703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 04/16/2015] [Accepted: 04/18/2015] [Indexed: 11/23/2022] Open
Abstract
Acute lymphoblastic leukemia (ALL) is a very distressing experience for children and requires a special effort of adjustment. Therefore, it seems to be crucial to explore coping resources for the experienced risk condition. In this sense, the study focuses on coping strategies and locus of control in children with ALL during the treatment phase, and on their possible relation. The correlation between children and maternal coping strategies is also investigated. The participants involved were an experimental group of 40 children with ALL and their mothers, and 30 healthy children as the control group. The tools used were: the Child Behavioral Style Scale and the Monitor-Blunter Style Scale to assess the coping strategies of children and mothers; the locus of Control Scale for Children to analyze the children's perception of controlling the events. Both children with ALL and their mothers resorted to monitoring coping strategies with a statistically significant rate of occurrence (children: M=17.8, SD=3.8; mothers: M=10.48, SD=3.4). The data concerning the locus of control show this tendency towards internal causes (M=53.1, SD=4.7). There were statistically significant correlations between monitoring coping strategies and external locus of control (r=0.400, P<0.05). The results gained from the control group are almost equivalent. The outcomes show several interesting resources of the psychological functioning of children as well as of their mothers.
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Affiliation(s)
- Concetta Polizzi
- Department of Psychological, Educational and Training Sciences, University of Palermo, Italy
| | - Valentina Fontana
- Department of Psychological, Educational and Training Sciences, University of Palermo, Italy
| | - Giovanna Perricone
- Department of Psychological, Educational and Training Sciences, University of Palermo, Italy
| | - Paolo D’Angelo
- Onco-Hematology Unit, A.R.N.A.S. Civico-Di Cristina Benfratelli Hospital of Palermo, Italy
| | | | - Calogero Taormina
- Onco-Hematology Unit, A.R.N.A.S. Civico-Di Cristina Benfratelli Hospital of Palermo, Italy
| | | | - Sofia Burgio
- Clinical Psychology of the Life Span, University of Palermo, Italy
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Wakefield CE, Sansom-Daly UM, McGill BC, McCarthy M, Girgis A, Grootenhuis M, Barton B, Patterson P, Osborn M, Lowe C, Anazodo A, Miles G, Cohn RJ. Online parent-targeted cognitive-behavioural therapy intervention to improve quality of life in families of young cancer survivors: study protocol for a randomised controlled trial. Trials 2015; 16:153. [PMID: 25872773 PMCID: PMC4395969 DOI: 10.1186/s13063-015-0681-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 03/26/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Due to advances in multimodal therapies, most children survive cancer. In addition to the stresses of diagnosis and treatment, many families are now navigating the challenges of survivorship. Without sufficient support, the ongoing distress that parents experience after their child's cancer treatment can negatively impact the quality of life and psychological wellbeing of all family members. METHODS/DESIGN The 'Cascade' (Cope, Adapt, Survive: Life after C AncEr) study is a three-arm randomised controlled trial to evaluate the feasibility and efficacy of a new intervention to improve the quality of life of parents of young cancer survivors. Cascade will be compared to a peer-support group control and a 6-month waitlist control. Parents (n = 120) whose child (under 16 years of age) has completed cancer treatment in the past 1 to 12 months will be recruited from hospitals across Australia. Those randomised to receive Cascade will participate in four, weekly, 90-minute online group sessions led live by a psychologist. Cascade involves peer discussion on cognitive-behavioural coping skills, including behavioural activation, thought challenging, mindfulness and acceptance, communication and assertiveness skills training, problem-solving and goal-setting. Participants randomised to peer support will receive four, weekly, 90-minute, live, sessions of non-directive peer support. Participants will complete measures at baseline, directly post-intervention, one month post-intervention, and 6 months post-intervention. The primary outcome will be parents' quality of life. Secondary outcomes include parent depression, anxiety, parenting self-agency, and the quality of life of children in the family. The child cancer survivor and all siblings aged 7 to 15 years will be invited to complete self-report quality of life measures covering physical, emotional, social and school-related domains. DISCUSSION This article reviews the empirical rationale for group-based, online cognitive-behavioural therapy in parents of children who have recently finished cancer treatment. The potential challenges of delivering skills-based programs online are highlighted. Cascade's videoconferencing technology has the potential to address the geographic and psychological isolation of families after cancer treatment. Teaching parents coping skills as they resume their normal lives after their child's cancer may see long-term benefits for the quality of life of the family as a whole. TRIAL REGISTRATION ACTRN12613000270718 (registered 6 March 2013).
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Affiliation(s)
- Claire E Wakefield
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Level 3, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
| | - Ursula M Sansom-Daly
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Level 3, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
- Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
| | - Brittany C McGill
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Level 3, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
| | - Maria McCarthy
- The Royal Children's Hospital Melbourne, Flemington Road, Parkville, VIC, 3052, Australia.
- Murdoch Childrens Research Institute, Melbourne, Flemington Road, Parkville, 3052, Australia.
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, The University of New South Wales, Campbell Street, Liverpool, NSW, 2170, Australia.
| | - Martha Grootenhuis
- Pediatric Psychosocial Department G8-224, Academic Medical Center, Emma Kinderziekenhuis Meibergdreef 9, 1105, AZ, Amsterdam, Netherlands.
| | - Belinda Barton
- Children's Hospital Education Research Institute, The Children's Hospital at Westmead, Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia.
- Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, The Children's Hospital at Westmead, Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia.
| | - Pandora Patterson
- CanTeen, Level 11, 130 Elizabeth Street, Sydney, NSW, 2000, Australia.
- Cancer Nursing Research Unit (CNRU), University of Sydney, Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Michael Osborn
- Youth Cancer Service South Australia/Northern Territory, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia.
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, King William Road, North Adelaide, SA, 5006, Australia.
| | - Cherie Lowe
- Queensland Children's Cancer Centre, Lady Cilento Children's Hospital, Stanley Street, South, Brisbane, QLD, 4101, Australia.
| | - Antoinette Anazodo
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
- Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
| | - Gordon Miles
- Acute Services: Paediatric Consultation Liaison, Princess Margaret Hospital, Roberts Road, Subiaco, Perth, WA, 6008, Australia.
| | - Richard J Cohn
- Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Level 3, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
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Myers RM, Balsamo L, Lu X, Devidas M, Hunger SP, Carroll WL, Winick NJ, Maloney KW, Kadan-Lottick NS. A prospective study of anxiety, depression, and behavioral changes in the first year after a diagnosis of childhood acute lymphoblastic leukemia: a report from the Children's Oncology Group. Cancer 2014; 120:1417-25. [PMID: 24473774 PMCID: PMC4319360 DOI: 10.1002/cncr.28578] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 10/16/2013] [Accepted: 11/18/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND The authors prospectively assessed anxiety, depression, and behavior in children with standard-risk acute lymphoblastic leukemia (SR-ALL) during the first year of therapy and identified associated risk factors. METHODS A cohort study was performed of 159 children (aged 2 years-9.99 years) with SR-ALL who were enrolled on Children's Oncology Group protocol AALL0331 at 31 sites. Parents completed the Behavior Assessment System for Children, the General Functioning Scale of the Family Assessment Device, and the Coping Health Inventory for Parents at approximately 1, 6, and 12 months after diagnosis. RESULTS Overall, mean scores for anxiety, depression, aggression, and hyperactivity were similar to population norms. However, more children scored in the at-risk/clinical range for depression than the expected 15% at 1 month (21.7%; P= .022), 6 months (28.6%; P< .001), and 12 months (21.1%; P= .032). For anxiety, more children scored in the at-risk/clinical range at 1 month (25.2% vs 15%; P= .001), but then reverted to expected levels. On adjusted analysis, unhealthy family functioning was found to be predictive of anxiety (odds ratio [OR], 2.24; P= .033) and depression (OR, 2.40; P= .008). Hispanic ethnicity was associated with anxiety (OR, 3.35; P= .009). Worse physical functioning (P= .049), unmarried parents (P= .017), and less reliance on social support (P= .004) were found to be associated with depression. Emotional distress at 1 month predicted anxiety (OR, 7.11; P= .002) and depression (OR, 3.31; P= .023) at 12 months. CONCLUSIONS Anxiety is a significant problem in a subpopulation of patients with SR-ALL immediately after diagnosis, whereas depression remains a significant problem for at least 1 year. Children of Hispanic ethnicity or those with unhealthy family functioning may be particularly vulnerable. These data suggest that clinicians should screen for anxiety and depression throughout the first year of therapy.
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Affiliation(s)
- Regina M Myers
- Section of Pediatric Hematology/Oncology, Yale University School of Medicine and Yale Comprehensive Cancer Center, New Haven, Connecticut
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Howard AF, Tan de Bibiana J, Smillie K, Goddard K, Pritchard S, Olson R, Kazanjian A. Trajectories of social isolation in adult survivors of childhood cancer. J Cancer Surviv 2014; 8:80-93. [PMID: 24202698 PMCID: PMC3923114 DOI: 10.1007/s11764-013-0321-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 10/15/2013] [Indexed: 01/14/2023]
Abstract
PURPOSE Long-term childhood cancer survivors may be at increased risk for poor social outcomes as a result of their cancer treatment, as well as physical and psychological health problems. Yet, important challenges, namely social isolation, are not well understood. Moreover, survivors' perspectives of social isolation as well as the ways in which this might evolve through young adulthood have yet to be investigated. The purpose of this research was to describe the trajectories of social isolation experienced by adult survivors of a childhood cancer. METHODS Data from 30 in-depth interviews with survivors (9 to 38 years after diagnosis, currently 22 to 43 years of age, 60 % women) were analyzed using qualitative, constant comparative methods. RESULTS Experiences of social isolation evolved over time as survivors grew through childhood, adolescence and young adulthood. Eleven survivors never experienced social isolation after their cancer treatment, nor to the present day. Social isolation among 19 survivors followed one of three trajectories; (1) diminishing social isolation: it got somewhat better, (2) persistent social isolation: it never got better or (3) delayed social isolation: it hit me later on. CONCLUSIONS Knowledge of when social isolation begins and how it evolves over time for different survivors is an important consideration for the development of interventions that prevent or mitigate this challenge. IMPLICATIONS FOR CANCER SURVIVORS Assessing and addressing social outcomes, including isolation, might promote comprehensive long-term follow-up care for childhood cancer survivors.
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Affiliation(s)
- A Fuchsia Howard
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada,
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Rosenberg AR, Baker KS, Syrjala KL, Back AL, Wolfe J. Promoting resilience among parents and caregivers of children with cancer. J Palliat Med 2013; 16:645-52. [PMID: 23646887 PMCID: PMC3719479 DOI: 10.1089/jpm.2012.0494] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Promoting resilience is an aspect of psychosocial care that affects patient and whole-family well-being. There is little consensus about how to define or promote resilience during and after pediatric cancer. OBJECTIVES The aims of this study were (1) to review the resilience literature in pediatric cancer settings; (2) to qualitatively ascertain caregiver-reported perceptions of resilience; and (3) to develop an integrative model of fixed and mutable factors of resilience among family members of children with cancer, with the goal of enabling better study and promotion of resilience among pediatric cancer families. METHODS The study entailed qualitative analysis of small group interviews with eighteen bereaved parents and family members of children with cancer treated at Seattle Children's Hospital. Small-group interviews were conducted with members of each bereaved family. Participant statements were coded for thematic analysis. An integrative, comprehensive framework was then developed. RESULTS Caregivers' personal appraisals of the cancer experience and their child's legacy shape their definitions of resilience. Described factors of resilience include baseline characteristics (i.e., inherent traits, prior expectations of cancer), processes that evolve over time (i.e., coping strategies, social support, provider interactions), and psychosocial outcomes (i.e., post-traumatic growth and lack of psychological distress). These elements were used to develop a testable model of resilience among family members of children with cancer. CONCLUSIONS Resilience is a complex construct that may be modifiable. Once validated, the proposed framework will not only serve as a model for clinicians, but may also facilitate the development of interventions aimed at promoting resilience in family members of children with cancer.
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Affiliation(s)
- Abby R Rosenberg
- Division of Pediatric Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington, USA.
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35
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George SM, Smith AW. Commentary: understanding risk behavior among adolescent cancer survivors--are they more like healthy adolescents or is cancer a teachable moment? A commentary on Klosky and colleagues' article on health behaviors in survivors of childhood cancer and their siblings. J Pediatr Psychol 2012; 37:647-9. [PMID: 22586152 DOI: 10.1093/jpepsy/jss064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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McQuaid EL, Spirito A. Integrating research into clinical internship training bridging the science/practice gap in pediatric psychology. J Pediatr Psychol 2012; 37:149-57. [PMID: 22286345 DOI: 10.1093/jpepsy/jsr114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Existing literature highlights a critical gap between science and practice in clinical psychology. The internship year is a "capstone experience"; training in methods of scientific evaluation should be integrated with the development of advanced clinical competencies. We provide a rationale for continued exposure to research during the clinical internship year, including, (a) critical examination and integration of the literature regarding evidence-based treatment and assessment, (b) participation in faculty-based and independent research, and (c) orientation to the science and strategy of grantsmanship. Participation in research provides exposure to new empirical models and can foster the development of applied research questions. Orientation to grantsmanship can yield an initial sense of the "business of science." Internship provides an important opportunity to examine the challenges to integrating the clinical evidence base into professional practice; for that reason, providing research exposure on internship is an important strategy in training the next generation of pediatric psychologists.
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Affiliation(s)
- Elizabeth L McQuaid
- Brown Clinical Psychology Training Consortium, Alpert Medical School, Brown University, Providence, RI 02912, USA.
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