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Neves MC, Bártolo A, Prins JB, Sales CMD, Monteiro S. Taking Care of an Adolescent and Young Adult Cancer Survivor: A Systematic Review of the Impact of Cancer on Family Caregivers. Int J Environ Res Public Health 2023; 20:ijerph20085488. [PMID: 37107768 PMCID: PMC10138338 DOI: 10.3390/ijerph20085488] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/15/2023] [Accepted: 04/07/2023] [Indexed: 05/11/2023]
Abstract
Research usually investigates adolescents and young adults (AYA) with cancer in combination with younger and older cancer patients and survivors. However, AYAs with cancer are a unique group, and their caregivers' experience may also differ from other caregivers of cancer survivors. This systematic review aims to understand the impact of a cancer diagnosis on family caregivers, comparing the experience of caregivers of AYA childhood cancer survivors (AYA CCS) and caregivers of AYA with cancer. Relevant studies were identified through PubMed, Scopus, and Web of Science databases, and their quality was assessed using the Joanna Briggs Institute's critical appraisal checklists. Sixteen studies (17 reports) met the inclusion criteria. Findings were synthesized separately for caregivers of AYA CCS and caregivers of AYA with cancer. Results showed that caregivers in both groups experienced high distress after the diagnosis. Partners of AYAs with cancer experienced diminished quality of life (QoL) and over half reported moderate to high fear of cancer recurrence (FCR). Findings indicated that cancer negatively impacts family caregivers, regardless of the patient's age at diagnosis. However, findings are heterogeneous, and most do not focus on QoL or FCR. More research is needed on the impact of cancer among these family caregivers.
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Affiliation(s)
- Maria Carolina Neves
- Center for Psychology at the University of Porto, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
- Correspondence:
| | - Ana Bártolo
- I2P—Portucalense Institute of Psychology, 4200-072 Porto, Portugal
- RECI—Research in Education and Community Intervention, Piaget Institute—ISEIT/Viseu, 3515-776 Viseu, Portugal
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Judith B. Prins
- Department of Medical Psychology, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands
| | - Célia M. D. Sales
- Center for Psychology at the University of Porto, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
| | - Sara Monteiro
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal
- Departament of Social Sciences and Management, Open University, 1269-001 Lisboa, Portugal
- Center for Global Studies, Open University, 1269-001 Lisboa, Portugal
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Chen JJ, Roldan CS, Nichipor AN, Balboni TA, Krishnan MS, Revette AC, Chen AB, Hertan LM. Prognostic Understanding and Goals of Palliative Radiotherapy: A Qualitative Study. J Pain Symptom Manage 2022; 64:567-576. [PMID: 36007684 DOI: 10.1016/j.jpainsymman.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 01/04/2023]
Abstract
CONTEXT There is a paucity of data describing patients' expectations of goals of palliative radiotherapy (RT) and overall prognosis. OBJECTIVES To explore patients' perceptions of and preferences for communication surrounding goals of palliative RT and cancer prognosis. METHODS We conducted a qualitative study utilizing semi-structured interviews with seventeen patients with either bone or lung metastases receiving their first course of palliative RT at a comprehensive cancer center. All patient interviews were recorded, transcribed verbatim, and thematically analyzed. RESULTS Themes of goals of palliative RT centered on either restoration, such as through improving quality of life or minimizing pain, or on a desire to combat cancer by eliminating tumor. While most patients perceived that palliative RT would palliate symptoms but not cure their cancer, some patients believed that the goal of palliative RT was to cure. Themes that emerged surrounding patients' understanding of prognosis and what lies ahead included uncertainty and apprehension about the future, a focus on additional treatment, and confronting mortality. Most patients preferred to receive information about goals of treatment and prognosis from their doctors, including radiation oncologists, rather than other members of the medical team. Patients also expressed a desire for written patient education materials on palliative RT. CONCLUSION Unclear perceptions of goals of treatment and prognosis may motivate some patients to pursue unnecessarily aggressive cancer treatments. Patients desire prognostic information from their doctors, including radiation oncologists, who are important contributors to goals of care discussions and may improve patient understanding and well-being by using restorative rather than combat-oriented language.
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Affiliation(s)
- Jie Jane Chen
- Department of Radiation Oncology (J.J.C.), University of San Francisco, San Francisco, California, USA
| | - Claudia S Roldan
- Northwestern Feinberg School of Medicine (C.S.R.), Chicago, Illinois, USA
| | - Alexandra N Nichipor
- Psychosocial Oncology and Palliative Care (A.N.N.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Tracy A Balboni
- Department of Radiation Oncology (T.A.B., M.S.K.), Dana-Farber Cancer Institute/ Brigham and Women's Cancer Center, Boston, Massachusetts, USA
| | - Monica S Krishnan
- Department of Radiation Oncology (T.A.B., M.S.K.), Dana-Farber Cancer Institute/ Brigham and Women's Cancer Center, Boston, Massachusetts, USA
| | - Anna C Revette
- Survey and Data Management Core (A.C.R.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Aileen B Chen
- Department of Radiation Oncology (A.B.C.), MD Anderson Cancer Center, Houston, Texas, USA
| | - Lauren M Hertan
- Department of Radiation Oncology (L.M.H.), Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
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Petersen NN, Larsen HB, Pouplier A, Schmidt‐Andersen P, Thorsteinsson T, Schmiegelow K, Fridh MK. Childhood cancer survivors' and their parents' experiences with participation in a physical and social intervention during cancer treatment: A RESPECT study. J Adv Nurs 2022; 78:3806-3816. [PMID: 35942568 PMCID: PMC9804908 DOI: 10.1111/jan.15381] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/21/2022] [Accepted: 07/09/2022] [Indexed: 01/09/2023]
Abstract
AIMS This study explores experiences of childhood cancer survivors and their parents with a combined physical and social activity intervention during treatment, including how the survivors and their parents perceive physical activity post-treatment. DESIGN A process evaluation using semi-structured interviews. METHODS Using a criterion-sampling strategy, 18 Danish childhood cancer survivors (aged 11-18 years) and their parents were interviewed from September 2019 through May 2020. Data analysis used an inductive thematic approach focused on meaning. RESULTS Three themes emerged: (1) being physically active during hospitalization; (2) peers as motivators and (3) physical activity post-treatment. During hospitalization, daily motivation to do physical activity was dependent on the daily well-being, that is, presence of the side effects from the child's treatment. Healthy classmates provided distraction, reduced loneliness and promoted normality for those hospitalized. For most of the survivors, their healthy peers provided motivation for being physically active during treatment. When surplus energy was lacking, some survivors preferred doing physical activity alone with a professional. Those who were physically active in the hospital sustained being physically active post-treatment while their parents continued seeking advice about appropriate activity levels. CONCLUSION Childhood cancer survivors and their parents benefited from the intervention which also provided guidance to remaining physically active post-treatment. This was particularly true for the participants with leukaemia. IMPACT Healthcare professionals should support children with cancer to be physically active during hospitalization. Including social and physical components in their care plan and being aware of individual preferences is pivotal to improving the survivors' level of physical and social well-being during and post-treatment. PATIENT OR PUBLIC CONTRIBUTION The participants were involved in designing the interview guides to ensure that the interview guides were understandable for the participants to provide rich descriptions of their experiences with a physical and social activity intervention during hospitalization.
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Affiliation(s)
- Natasha Nybro Petersen
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark,Faculty of Health SciencesUniversity of Copenhagen and The Pediatric Clinic, Juliane Marie Centre, University Hospital (Rigshospitalet)CopenhagenDenmark
| | - Anna Pouplier
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Peter Schmidt‐Andersen
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Troels Thorsteinsson
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark,Faculty of Health SciencesUniversity of Copenhagen and The Pediatric Clinic, Juliane Marie Centre, University Hospital (Rigshospitalet)CopenhagenDenmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
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Petersen NN, Hansson H, Lie HC, Brinkkjaer M, Graungaard B, Hamilton Larsen M, Hamilton Larsen E, Schmiegelow K, Fridh MK, Baekgaard Larsen H. A qualitative study of young childhood cancer survivors and their parents' experiences with treatment-related late effects in everyday life post-treatment. J Adv Nurs 2021; 78:858-868. [PMID: 34636441 DOI: 10.1111/jan.15073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/17/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022]
Abstract
AIMS The purpose of this secondary analysis was to explore how young cancer survivors and their parents experience and manage treatment-related late effects in daily life post-treatment. DESIGN A phenomenological-hermeneutic explorative study. METHODS Using purposive sampling, we included 15 childhood cancer survivors (aged 11-18 years) and their parents who participated in semi-structured interviews from September 2019 through May 2020. We analysed the interviews paired using a thematic approach focused on meaning. RESULTS The central theme, 'Negotiation daily life', emerged as well as three interrelated sub-themes, that is 'A changed everyday life', 'Physical activity as a tool' and 'Friends as a tool'. The childhood cancer survivors and their parents experienced, understood and interpreted the late effects differently. The difference between the survivors' perceptions and those of their parents in managing treatment-related late effects in everyday life resulted in a continuous negotiation process between the parties. Parents highlighted the negative impact of late effects on their child's daily life in relation to physical activity, school and socialization while the survivors wished to leave the cancer experience behind and 'move on' with their friends. As a result, most of the survivors developed strategies to manage their social activities while their parents felt that the survivors neglected the late effects. CONCLUSION The ongoing negotiation process between the childhood cancer survivors and their parents show the complexity of the new family dynamics on returning to everyday life post-treatment. For clinical nurses, that means that there should be focus on family dynamics and how the childhood cancer survivors and parents, respectively, manage the childhood cancer survivors' late effects. IMPACT Healthcare providers should distinguish between the needs of the survivors and those of their parents as they transition from treatment to everyday life, and especially in the management of late effects caused by the treatment.
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Affiliation(s)
- Natasha Nybro Petersen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Helena Hansson
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Faculty of Health Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Hanne C Lie
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Maria Brinkkjaer
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Benjamin Graungaard
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Marie Hamilton Larsen
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elna Hamilton Larsen
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Faculty of Health Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Faculty of Health Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Barrett PM, Mullen L, McCarthy T. Enduring psychological impact of childhood cancer on survivors and their families in Ireland: A national qualitative study. Eur J Cancer Care (Engl) 2020; 29:e13257. [PMID: 32537764 PMCID: PMC7988562 DOI: 10.1111/ecc.13257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 01/30/2020] [Accepted: 04/16/2020] [Indexed: 12/12/2022]
Abstract
Objective To establish the major expressed psychological needs of adult survivors of childhood cancer living in Ireland. Methods Seven focus groups were conducted with adult survivors of childhood cancer and their parents in 2018. Survivors were invited to participate if they were diagnosed with cancer before age 18. Results Thirty‐three participants (15 survivors, 18 parents; 27 female, 6 male) were included. They had experienced a range of haematological and solid tumours. Five themes were generated: (a) Enduring psychological impact on survivors; many survivors experience delayed trauma and mental health crises in adulthood. (b) Enduring psychological impact on family members; parents and siblings have unmet psychological needs relating to the family's experience of cancer. (c) Enduring impact on family dynamics; survivors and parents expressed fear and guilt relating to cancer which impacted on family interactions. (d) Challenges accessing support; psychological support services are inadequate to meet expressed needs. (e) Desired model of care; no single service model appeals to all survivors, and flexibility is required in the delivery of psychological support. Conclusion Adult survivors of childhood cancer and their family members experience enduring psychological effects relating to their diagnosis and treatment. Psychological support services are inadequate to meet the expressed needs of this growing population.
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Affiliation(s)
- Peter M Barrett
- HSE National Cancer Control Programme, Dublin 1, Ireland.,School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland.,Wellcome Trust/HRB Irish Clinical Academic Training (ICAT) Programme, University College Cork, Cork, Ireland
| | - Louise Mullen
- HSE National Cancer Control Programme, Dublin 1, Ireland
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