Parental terminal cancer and dependent children: a systematic review

A Systematic Review of Educational Interventions to Equip Health and Social Care Professionals to Promote End-of-Life Supportive Care when a Parent with Dependent Children is Dying with Cancer

OBJECTIVES

This systematic review aimed to determine the content, mode of delivery, assessment, and outcomes of educational interventions to equip health and social care professionals when delivering end of life supportive care for parents dying with cancer who have dependent children.

DATA SOURCES

A mixed-methods systematic review was undertaken. Six electronic database were searched from their inception until September 2023 (Medline OVID, CINAHL, EMBASE, PsycINFO, Web of Science, and ERIC), supplemented by citation chaining, grey literature searches using Google Advanced Search and relevant professional bodies. Quality assessment was conducted independently by two researchers on the included studies. A convergent integrated approach was utilised for data synthesis.

CONCLUSION

The review identified two educational interventions; highlighting a dearth of training opportunities to equip health and social care professionals to provide supportive care to families when a parent is at end of life with cancer. Despite health and social care professionals reported need and desire for upskilling in this area of clinical practice, there is a severe lack of evidence-based educational interventions. It is imperative that effective educational interventions are made accessible to professionals.

IMPLICATIONS FOR NURSING PRACTICE

There is an imminent need for robust educational interventions to be developed, as health and social care professionals often lack the knowledge, skills and confidence on how best to support families when a parent of dependent children is at end of life. Health and social care professionals engagement with high-quality, evidence-based and theory-driven educational interventions has the potential to impact professionals' provision of family-centred cancer care at end of life. This could lead to better mental and physical outcomes for the whole family at end of life and in bereavement.

Parental death: a systematic review of support experiences and needs of children and parent survivors

BACKGROUND

Bereaved people need a supportive response from those around them. Knowing children's and surviving parents' needs following parental death is the first step to ensuring a supportive response. However, no systematic review has reported on this phenomenon.

AIM

To systematically identify and synthesise qualitative literature exploring support experiences of parentally bereaved children and surviving parents.

METHODS

Systematic review with thematic synthesis, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. MEDLINE, Embase, PsycINFO, CINAHL and the British Nursing Database were searched for relevant papers to September 2021. Included studies were appraised for quality and thematically synthesised using Thomas and Harden's thematic synthesis framework.

RESULTS

Fifteen qualitative studies from nine countries were included. There were four analytical themes from the children's perspectives (1) Openness of communication with children about death and dying, (2) Children's challenges of managing change, (3) Navigating emotions, and (4) Children's acceptability, access and engagement with support. There were three analytical themes from the parents' perspectives: (1) Adjusting as a parent, (2) Supporting their children, and (3) Parent's acceptability, access and engagement with support.

CONCLUSIONS

Following a parental death, open and honest communication and involvement in what is happening within the family will help children cope. Both children and parents suppress emotions and avoid conversations to protect each other and those around them. A taboo around death exists and constrains the support some families receive. Childhood bereavement is a public health issue, with a need for professionals and communities to better understand and respond to the needs of bereaved families.CRD42020166179.

VIVÊNCIA DO CANCRO PARENTAL: ESTUDO DE CASO COM APLICAÇÃO DO MODELO DE NEUMAN

RESUMO Objetivo compreender à luz do Modelo de Sistemas de Betty Neuman, a experiência de uma mulher-mãe a vivenciar uma situação de cancro; identificar as necessidades da mulher-mãe e prescrever intervenções de enfermagem em linguagem classificada. Método estudo de caso do tipo qualitativo, de uma mulher-mãe de um adolescente, a vivenciar cancro. Colheita de dados realizada em Coimbra, Portugal, em 2021, através de entrevista semiestruturada, apoiada por um guião fundamentado no Modelo de Betty Neuman. Tratamento de dados realizado com base na análise de conteúdo categorial. Resultados a análise do discurso da mãe possibilitou identificar categorias concordantes com as variáveis do modelo: fisiológicas, psicológicas, socioculturais, espirituais e desenvolvimentais. As dificuldades mais expressas pela mãe foram o medo, alterações provocadas pela doença e o desempenho do papel parental. Os diagnósticos de enfermagem foram definidos com base nos focos “aceitação do estado de saúde”, “medo”, “papel parental” e “coping familiar”, associando-os às respetivas intervenções de enfermagem. As intervenções focaram-se no apoio e na educação. Conclusão o modelo teórico contribuiu para compreender e identificar as necessidades da mãe a experienciar o cancro parental, facilitando a prescrição de intervenções de enfermagem em linguagem classificada. O modelo mostrou-se pertinente para futuras intervenções em pais a vivenciar situações semelhantes.

EXPERIENCING PARENTAL CANCER: A CASE STUDY WITH APPLICATION OF NEUMAN’S MODEL

ABSTRACT Objective to understand, in the light of Betty Neuman’s Systems Model, the experience of a woman-mother with cancer, and identify the woman-mother’s needs and prescribe nursing interventions in classified language. Method a qualitative case study of a woman-mother of a teenager experiencing cancer. Data collection carried out in Coimbra, Portugal, in 2021, through a semi-structured interview, supported by a script based on Betty Neuman’s Systems Model. Data processing performed based on categorical content analysis. Results the analysis of a mother’s speech made it possible to identify categories in agreement with the model variables: physiological, psychological, sociocultural, spiritual and developmental. The difficulties most expressed by the mother were fear, changes caused by the disease and parental role performance. The nursing diagnoses were defined based on the focuses “acceptance of health status”, “fear”, “parental role” and “family coping”, associating them with the respective nursing interventions. Interventions focused on support and education. Conclusion the theoretical model contributed to understanding and identifying the needs of a mother experiencing parental cancer, facilitating the prescription of nursing interventions in classified language. The model proved to be relevant for future interventions in parents experiencing similar situations.