1
|
Holmbom M, Andréasson F, Grundström H, Bernild C, Fålun N, Norekvål TM, Kikkenborg Berg S, Strömberg A. Young Spouses' Experiences of Having a Partner With Heart Disease and Adolescents Living at Home. Health Expect 2024; 27:e14129. [PMID: 38970211 PMCID: PMC11226407 DOI: 10.1111/hex.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 06/02/2024] [Accepted: 06/19/2024] [Indexed: 07/08/2024] Open
Abstract
AIM To describe the life situation of spouses having a partner with heart disease and adolescents living at home. DESIGN Qualitative inductive design. METHOD Participants (n = 22) were included from three Scandinavian countries. Semi-structured interviews were analysed using thematic analysis with an inductive and latent approach. RESULTS Three themes were derived. 'Being in spousal and parental role transition' described how daily life had been affected and parental responsibilities had been doubled due to their partner's heart disease. 'Living with unpredictability and insecurity' included how the unpredictable illness trajectory caused worries and affected the well-being of the family. 'Managing a challenging life situation' highlights how spouses coped with their partners' heart disease and adapted to a new life situation. CONCLUSION Young spouses' life situation was greatly affected by their partner's heart disease, resulting in increased responsibilities and double parenthood. Having a positive attitude and mindset towards life was used as a strategy to cope with the changed life situation and find a new way of life. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE All family members are affected by heart disease. Spouses needed additional professional support and guidance on how to involve the children when a parent is ill. IMPACTS This study highlights how young spouses, with adolescents living at home, experience their life situation. The life situation is unpredictable due to the partner's heart disease, as they must handle both caring for their partner and taking on double parenthood. Research involving family members can improve person- and family-centred care and treatment outcomes in health care and society. REPORTING METHOD COREQ checklist was used preparing the manuscript. PATIENT OR PUBLIC CONTRIBUTION Data collection included interviews with spouse. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: By highlighting the spouses changed life situation due to heart disease and the importance of including them in health care.
Collapse
Affiliation(s)
- Matilda Holmbom
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | | | - Hanna Grundström
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Obstetrics and GynecologyNorrkopingSweden
- Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Camilla Bernild
- The Heart Center, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Nina Fålun
- Haukeland University HospitalBergenNorway
| | - Tone Merete Norekvål
- Haukeland University HospitalBergenNorway
- Department of Clinical ScienceUniversity of BergenBergenNorway
| | | | - Anna Strömberg
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of CardiologyLinköping UniversityLinköpingSweden
| |
Collapse
|
2
|
Ljungman L, Romare Strandh M, Gustafsson N, Muriel AC, Moore CW, Enebrink P, Wikman A. Psychometric properties of the Swedish version of the Parenting Concerns Questionnaire in parents with cancer. Acta Oncol 2024; 63:592-599. [PMID: 39037078 PMCID: PMC11332499 DOI: 10.2340/1651-226x.2024.40728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 07/04/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND AND PURPOSE Parenting concerns can be a major source of distress for patients with cancer who are parents of dependent children; however, these are often not addressed in health care. The Parenting Concerns Questionnaire (PCQ) is an instrument designed to assess parents' worries about the impact of cancer on their children and their ability to parent during this time. The Swedish version of the PCQ has, however, not been evaluated. This study therefore aimed to examine the psychometric properties of the PCQ in a sample of Swedish parents with cancer. MATERIAL AND METHODS A sample of 336 patients with cancer having dependent children (≤18 years) were included in a cross-sectional web-based survey. Participants completed questionnaires assessing parenting concerns, depression, anxiety, and stress symptoms (DASS); self-efficacy, family functioning (FAD-GF); and sociodemographic and clinical characteristics. Descriptive analyses, as well as reliability and validity analyses, were conducted followed by a confirmatory factor analysis of the factor structure proposed by the authors of the original version of the PCQ. RESULTS The majority were mothers (94.9%) with breast cancer (66.4%) aged 40-50 years (59.5%). The results showed evidence for convergent, criterion, and known group's validity, but the original three-factor structure of the PCQ was not fully supported by confirmatory factor analysis. INTERPRETATION Evaluating parenting concerns may be an important step towards identifying patients who could benefit from targeted psychosocial interventions. However, the PCQ may require some further refinement to fully capture the breadth of parenting concerns in parents with cancer in different settings.
Collapse
Affiliation(s)
- Lisa Ljungman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Romare Strandh
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER), Uppsala University, Uppsala, Sweden
| | - Niklas Gustafsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anna C Muriel
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA
| | - Cynthia W Moore
- Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Pia Enebrink
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anna Wikman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| |
Collapse
|
3
|
Romare Strandh M, Enebrink P, Stålberg K, Sörensdotter R, Ljungman L, Wikman A. Parenting under pressure: a cross-sectional questionnaire study of psychological distress, parenting concerns, self-efficacy, and emotion regulation in parents with cancer. Acta Oncol 2024; 63:468-476. [PMID: 38910314 PMCID: PMC11332455 DOI: 10.2340/1651-226x.2024.40404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/31/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND AND PURPOSE As many as one in four adults with cancer have children under 18 years. Balancing parenting and cancer is challenging and can be a source of psychological distress. This study aimed to examine psychological distress in parents with cancer and its associations with parenting concerns, self-efficacy, and emotion regulation. MATERIALS AND METHODS This was a cross-sectional questionnaire study of 406 parents (aged 25-60 years) diagnosed with cancer within the last 5 years, with at least one dependent child (≤ 18 years). Parents completed questionnaires on psychological distress (DASS-21), parenting concerns (PCQ), self-efficacy (GSE), emotion regulation (ERQ), mental and physical health, and sociodemographics. Data were analysed using multiple logistic regressions on depression (yes/no), anxiety (yes/no), and stress (yes/no). RESULTS Higher parenting concerns were associated with greater odds of depression (OR = 2.33, 95% CI: 1.64-3.31), anxiety (OR = 2.30, 95% CI: 1.64-3.20), and stress (OR = 3.21, 95% CI: 2.20-4.69) when adjusting for health and sociodemographic factors. Poorer self-efficacy was associated with increased odds of anxiety (OR = 0.94, 95% CI: 0.89-0.99, p < 0.05), whereas lower use of cognitive reappraisal and higher use of expressive suppression increased the odds of depression (OR = 0.76, 95% CI: 0.59-0.98 | OR = 1.46, 95% CI: 1.18-1.80). INTERPRETATION The findings highlight the complexity of parental well-being in relation to parenthood and cancer, stressing the need for interventions that address relevant psychological factors to improve overall mental health in this population.
Collapse
Affiliation(s)
- Maria Romare Strandh
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER), Uppsala University, Uppsala, Sweden.
| | - Pia Enebrink
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Karin Stålberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Lisa Ljungman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anna Wikman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER), Uppsala University, Uppsala, Sweden
| |
Collapse
|
4
|
Tulpin M, Scherrens AL, Van Driessche A, Verhofstadt LL, Kreicbergs U, Goubert L, Beernaert K. "A sincere 'how are you?' is already a sign of acknowledgement that you're there too." - Interview study on the support needs of adolescents and young adults (AYAs) living with a parent with cancer. Eur J Oncol Nurs 2024; 70:102602. [PMID: 38810585 DOI: 10.1016/j.ejon.2024.102602] [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: 09/24/2023] [Revised: 04/04/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE Parental cancer brings changes and challenges which affect the whole family. Evidence shows heightened psychosocial risk among the offspring. Research among adolescents and young adults (AYAs) facing parental cancer has mainly focused on these psychosocial problems. As a reaction, there has been an increase in research on the needs of this population, since this knowledge is crucial for developing appropriate support. Despite this increase, some AYAs are still underrepresented, namely those over eighteen years old and those who have a parent with incurable cancer. Moreover, the factors hampering or fostering access to and receipt of support addressing their needs are under-investigated. Increasing our understanding of these issues is crucial to developing more effective support interventions for these young people. Our aim was therefore to gain insight into the perceived support needs of AYAs who have a parent with cancer, including the mentioned underrepresented subgroups, and the perceived factors facilitating or hindering their use of support. METHODS We conducted semi-structured interviews with 17 AYAs who have a parent with cancer of any type and stage, which were analyzed using conventional Qualitative Content Analysis (QCA). RESULTS Six main categories emerged from the data, encompassing various subcategories: 1) Needs surrounding the time of disclosure, 2) Information needs, 3) Informal support needs, 4) Need for effective personal coping strategies, 5) Formal support needs, and 6) Contextual and medical factors affecting support needs. AYAs perceived family members, friends and teachers as important sources of informal support, but lacked contact with peers who also have a parent with cancer. They expressed a need for formal informational and emotional support from their parent's medical team, (onco)psychologists, and their general practitioner. AYAs faced barriers in accessing formal support. A proactive attitude from healthcare providers and information about available support would help them meet their needs. Furthermore, we shed new light on needs and issues in post-secondary education. CONCLUSIONS AYAs who are living with their parent with cancer experience informational, emotional, and practical needs in multiple contexts, such as the home, school, leisure and hospital environment. They identify their informal and formal network as important key figures in addressing these needs.
Collapse
Affiliation(s)
- Marthe Tulpin
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium; End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium & Ghent University, Ghent, Belgium.
| | - Anne-Lore Scherrens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium & Ghent University, Ghent, Belgium
| | - Anne Van Driessche
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium & Ghent University, Ghent, Belgium
| | - Lesley L Verhofstadt
- Family Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ulrika Kreicbergs
- Population, Policy & Practice Department, University College London, London, United Kingdom
| | - Liesbet Goubert
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Kim Beernaert
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium & Ghent University, Ghent, Belgium
| |
Collapse
|
5
|
Johannsen L, Frerichs W, Inhestern L, Bergelt C. Exploring the perspectives of cancer patients parenting minor children: A qualitative study on family-centered cancer care experiences. PATIENT EDUCATION AND COUNSELING 2023; 117:107989. [PMID: 37812964 DOI: 10.1016/j.pec.2023.107989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVES Parents with cancer experience not only disease-related burden but also child- and family-related concerns. According to the German guidelines, all professionals working in oncology are responsible for addressing these burdens and needs and for involving the patient's relatives. This study aims to explore patients' perspectives on their experiences regarding family-centeredness in cancer care. METHODS We conducted interviews with 18 cancer patients parenting at least one minor child (< 18). The interviews were audio-recorded, transcribed verbatim and analyzed using qualitative content analysis. RESULTS Most parents reported that their healthcare professionals (HCPs) rarely or not routinely discussed family issues. There was a wide range of ways in which HCPs communicated about family issues. Parents often felt unsure about professionals' responsibilities and many of them expressed a desire for more proactive communication. CONCLUSIONS The findings suggest that the majority of patients have unmet needs related to comprehensive care as parents. PRACTICE IMPLICATIONS HCPs need to be sensitized to identify parents facing additional burdens and needs. It is essential that HCPs clarify parents' preferences regarding the extent of involvement of family issues in cancer care.
Collapse
Affiliation(s)
- Lene Johannsen
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany.
| | - Wiebke Frerichs
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Germany; Department of Medical Psychology, University Medicine Greifswald, Germany
| |
Collapse
|
6
|
Taneja S, Vanstone M, Lysecki DL, McKean H, Bainbridge D, Sussman J, Molinaro M. "There's So Much More Support We Could Have Provided": Child Life Specialists' Stories of the Challenges Working in Adult Oncology. QUALITATIVE HEALTH RESEARCH 2023:10497323231215950. [PMID: 38035631 DOI: 10.1177/10497323231215950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
A cancer diagnosis in patients who are parents of minor children is uniquely stressful for both parents and children. Children need developmentally appropriate information and support to help reduce their fears and worries. Child life specialists (CLSs) are health professionals who work in pediatric environments to support children and families with the stress and uncertainty of illnesses. Increasingly, CLSs have been called upon to support children of patients in adult clinical environments. Our objective was to elucidate CLS caregiving narratives related to working with children of adult cancer patients. We used narrative inquiry to interview four CLSs working in adult oncology. Canadian CLSs who have experience providing care for children and families affected by parental cancer were recruited via convenience sampling. We used narrative analysis methods that included multiple close reads of the data, generating narrative themes, and noting conflicts or tensions in the data. CLSs' caregiving stories often highlighted the complexities of working in an adult oncology environment. Their narratives included challenges in providing optimal care to the children, including family-level barriers (such as parental wishes to withhold information from their children) and systemic barriers (such as late referrals and limited options for bereavement support). CLS participants identified several challenges of working with families in adult oncology. The CLSs highlighted a desire for additional institutional support for children of adult oncology patients and for themselves working in these environments in order to achieve what they believed to be optimal care.
Collapse
Affiliation(s)
- Shipra Taneja
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - David L Lysecki
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Heather McKean
- Hamilton Health Sciences, McMaster Children's Hospital, Hamilton, ON, Canada
| | - Daryl Bainbridge
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Jonathan Sussman
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Monica Molinaro
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- Institute of Health Sciences Education, McGill University, Montreal, QC, Canada
| |
Collapse
|
7
|
Kamp MA, von Sass C, Januzi D, Dibué M, Libourius K, Lawson McLean AC, Baumgarten P, Lawson McLean A, Dinc N, Senft CA. Frequency of social burden and underage children in neuro-oncological patients. J Cancer Res Clin Oncol 2023; 149:15911-15922. [PMID: 37679652 PMCID: PMC10620259 DOI: 10.1007/s00432-023-05338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Brain tumours can cause significant burden for patients and their families, including physical, psychological, and social challenges. This burden can be particularly difficult for patients with malignant brain tumours and those with underage children. However, the frequency of social burden among neuro-oncological patients and the proportion of patients with underaged children is currently unknown. The aim of this retrospective study is to determine the frequency of social and family dysfunction among neuro-oncological patients, the percentage of such patients who have underage children, and to assess their associated burden. METHODS During a 22-month period, all brain tumour patients were asked to complete a short questionnaire that included epidemiological data, the EORTC-qlq-C30 and -BN20 questionnaire, and the distress thermometer. Data were collected and analysed using Prism 9 for macOS (version 9, GraphPad Prism). RESULTS Our analysis included 881 brain tumour patients, of which 540 were female. Median age was 61 years (ranging from 16 to 88 years). Of all patients, 228 suffered from malignant intracranial tumours. More than half of all patients and more than 65% of patients with malignant tumours reported that their illness or medical treatment interfered with their social activities and family life. Almost 30% of patients reported moderate or severe complaints. About 27% of all patients (and 31% of patients with malignancies) expressed moderate or major concerns that their family life could be disrupted. Among the patients with malignancies, 83.5% of patients had a total of 318 children at the time of tumour diagnosis, with a mean age of 33 ± 0.9. Of these patients with malignancies, 38 (17.9%) had a total of 56 underage children at the time of tumour diagnosis, and currently have 53 underage children. Patients with minor children had more financial worries but less interference of their disease with social activities, less psycho-oncological distress, and a more positive outlook into the future (each, p < 0.0001). They evaluated their general health status and quality of life in the week prior to their current appointment significantly better (each p < 0.0001). CONCLUSION Our study found that 17.9% of patients with malignant brain tumours have underage children. However, having underage children may actually be a positive resource for these patients, as they show lower distress values and better quality of life.
Collapse
Affiliation(s)
- Marcel A Kamp
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany.
| | - Christiane von Sass
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Donjetë Januzi
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Maxine Dibué
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Katharina Libourius
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Anna C Lawson McLean
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Peter Baumgarten
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Aaron Lawson McLean
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Nazife Dinc
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Christian A Senft
- Centre of Neuro-Oncology, Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| |
Collapse
|
8
|
Romare Strandh M, Hovén E, Sörensdotter R, Stålberg K, Enebrink P, Ljungman L, Wikman A. Psychosocial interventions targeting parenting distress among parents with cancer - A systematic review and narrative synthesis of available interventions. Crit Rev Oncol Hematol 2023; 191:104119. [PMID: 37683815 DOI: 10.1016/j.critrevonc.2023.104119] [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: 06/22/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Balancing having cancer and parenting a major stressor, and may result in parenting distress, negatively affecting the whole family. To provide adequate support, knowledge of existing psychosocial interventions are crucial to guide future interventions. This study aimed to describe available psychosocial interventions for parents with cancer and dependent children (<18 years). METHOD We conducted a systematic review, and four databases were searched from January 2000 to March 2023. RESULTS Thirty studies were included, reporting on 22 psychosocial interventions for parents with cancer. They aimed to improve different aspects of parenting distress, and included psychoeducation and communication strategies. Interventions were beneficial to and acceptable among parents, but only a few had been evaluated. The study quality was, overall, assessed as moderate. CONCLUSIONS The results of this review highlight the diversity of available psychosocial interventions for parents with cancer and the outcomes on parenting distress, as well as methodological challenges.
Collapse
Affiliation(s)
- Maria Romare Strandh
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER), Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden.
| | - Emma Hovén
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
| | - Renita Sörensdotter
- Centre for Gender Research, Uppsala University, Engelska parken, Humanistiskt centrum, Thunbergsvägen 3G, Box 527, SE-751 20 Uppsala, Sweden
| | - Karin Stålberg
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
| | - Pia Enebrink
- Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A 5th floor, SE-171 77 Stockholm, Sweden
| | - Lisa Ljungman
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
| | - Anna Wikman
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden; Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER), Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
| |
Collapse
|
9
|
Fernandes DCR, Nelson D, Siriwardena AN, Law G, Andreyev HJN. Understanding colorectal cancer patient follow-up: a qualitative interview study. Support Care Cancer 2023; 31:634. [PMID: 37843671 DOI: 10.1007/s00520-023-08108-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/06/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE There are increasing numbers of patients who have been treated for colorectal cancer (CRC) who struggle with ongoing physical and psychological symptoms. 'Cancer survivor' is often used to describe these patients but this terminology remains controversial. This study sought to understand the follow-up experience of CRC patients in the UK and identify the terminology they prefer following diagnosis and treatment. METHODS Purposeful sampling of patients from specialist CRC follow-up clinics was performed until data saturation was achieved. Two 1:1 semi-structured qualitative interviews were performed for each participant. Data were analysed thematically. RESULTS Seventeen participants, median age = 62, 53% male were interviewed. Several themes were identified. Of note, fear of cancer recurrence dominates patients' agendas at follow-up appointments. There are also clinical and administrative barriers to discussing symptoms including being embarrassed, feeling that their symptoms were not relevant or not having enough time to discuss issues. However, there are several methods which may improve this, such as through the use of video consultations and questionnaires. In addition, patients identified inadequate holistic support despite significant psychological and social distress. Our data suggest that labelling a diverse group of patients as 'cancer survivors' can be problematic. CONCLUSION It is important that clinicians systematically screen patients for symptoms that are known to occur following treatment. Clinicians and patients should have routine access to pathways and programmes that can support patients in navigating their life after cancer therapy.
Collapse
Affiliation(s)
- Darren C R Fernandes
- The Department of Gastroenterology, United Lincolnshire NHS Trust, Lincoln County Hospital, Lincoln, UK.
- Community and Health Research Unit, University of Lincoln, Lincoln, UK.
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
- Macmillan Cancer Support, London, UK
| | | | - Graham Law
- Lincoln Clinical Trials Unit, University of Lincoln, Lincoln, UK
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - H Jervoise N Andreyev
- The Department of Gastroenterology, United Lincolnshire NHS Trust, Lincoln County Hospital, Lincoln, UK
- The Biomedical Research Centre, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
10
|
Romare Strandh M, Hovén E, Sörensdotter R, Stålberg K, Enebrink P, Ljungman L, Wikman A. The Complexity of Being a Parent in the Hospital and a Patient at Home: A Qualitative Study on Parenting Concerns and Challenges Among Parents With Cancer. Cancer Nurs 2023:00002820-990000000-00168. [PMID: 37731179 DOI: 10.1097/ncc.0000000000001276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
BACKGROUND Parents given a diagnosis of cancer must balance the demands of their illness and caregiving responsibilities. This can result in parental stress and have a negative impact on the well-being of the whole family. A greater understanding of the experiences of parents with cancer is necessary to provide adequate support. OBJECTIVE The aim of this study was to explore parenting concerns and challenges among parents with cancer who were caring for dependent children younger than 18 years. METHODS Semistructured interviews were carried out with 22 parents with cancer. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. RESULTS Parental concerns and challenges affected parents in their parental role and their everyday family life. Three overarching themes described the struggles in balancing life as a parent and as a patient: navigating dual roles as a parent with cancer, impact of cancer on parenting, and impact on family life. Parents' primary focus was on their children's well-being, and they struggled to manage their own expectations of parenting and the demands on their role in the family. CONCLUSION The results highlight the complexity of being a parent with cancer while caring for dependent children. To support parents during the cancer journey, it is important to understand the consequences of their illness on their parental role and the family. IMPLICATIONS FOR PRACTICE Supporting parents to feel secure in their parental role and providing support to them during their cancer journey should be integrated into routine cancer care, where parenting concerns and challenges are addressed.
Collapse
Affiliation(s)
- Maria Romare Strandh
- Author Affiliations: Department of Women's and Children's Health (Ms Romare Strandh, and Drs Hovén, Stålberg, Ljungman, and Wikman), Centre for Women's Mental Health during the Reproductive Lifespan (WOMHER) (Ms Romare Strandh and Dr Wikman), and Centre for Gender Research (Dr Sörensdotter), Uppsala University; and Department of Clinical Neuroscience, Karolinska Institutet (Dr Enebrink), Stockholm, Sweden
| | | | | | | | | | | | | |
Collapse
|
11
|
Mota-George G, Martinez A, Dains JE. Quality of Life in Adult Cancer Patients With Underage Children: An Integrative Review. J Adv Pract Oncol 2023; 14:390-402. [PMID: 37576361 PMCID: PMC10414533 DOI: 10.6004/jadpro.2023.14.5.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
As many as 24.7% of cancer patients are also parents to children younger than 18 years of age. This population faces unique challenges, and quality of life in parental cancer patients has not been well studied. This integrative review assessed parental cancer patients' quality of life. PubMed and Scopus were searched using the following terms: quality of life, distress, anxiety, coping, emotion, social support, employment, work, psychosocial, physical, function, parental cancer, and parents with cancer. English publications conducted within the past 15 years that used an objective instrument to measure quality of life in adult cancer patients with children 18 years of age or younger were included. Studies with an intervention focus were excluded. After review of 672 articles, nine studies met the criteria for inclusion. Several instruments were utilized to measure quality of life. Some parental cancer patients reported decreased quality of life when compared with other cancer patients and the general population at diagnosis and years after. Parental cancer patients may be at an increased risk of decreased quality of life. With this understanding, health-care providers should complete comprehensive assessments routinely so that these patients' unique needs may be more adequately addressed.
Collapse
Affiliation(s)
| | - Ashley Martinez
- From The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joyce E Dains
- From The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
12
|
Geertz W, Frerichs W, Inhestern L, Bergelt C. Supportive and psychosocial peer-group interventions for children and adolescents of parents with cancer: A systematic review. PATIENT EDUCATION AND COUNSELING 2023; 114:107844. [PMID: 37331281 DOI: 10.1016/j.pec.2023.107844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Children and adolescents are highly affected by their parents` cancer disease. This review aims to summarize peer-group interventions for children and adolescents of cancer patients, where those affected have the opportunity to exchange and normalize their feelings among equals. METHODS A systematic review searching four different databases (MEDLINE, PsycInfo, CINAHL and Web of Science) was conducted. We included studies investigating psychosocial peer-group interventions for offspring of cancer patients. A narrative synthesis summarised the characteristics of the interventions and the findings on effects and evaluation. RESULTS Ten articles on seven different peer-group interventions were analysed. Research designs and intervention concepts were heterogeneous. Overall, high acceptance, feasibility and positive effects of peer-group support were reported. Significant effects were found in six studies, e.g. in relation to psychological well-being, quality of life and coping skills. CONCLUSION Peer-group interventions are an accepted and helpful form of support. Providing children and adolescents of cancer patients for example with psychoeducation, community and coping strategies, thereby impacting on psychological well-being. PRACTICE IMPLICATIONS For comprehensive care, it seems to be important to offer support throughout the parent's cancer journey and to offer support flexibly as needed through group services as well as individual sessions.
Collapse
Affiliation(s)
- Wiebke Geertz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Wiebke Frerichs
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - 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; Department of Medical Psychology, University Medicine Greifswald, Germany
| |
Collapse
|
13
|
Skrabal Ross X, McDonald FEJ, Konings S, Schiena E, Phipps-Nelson J, Hodgson F, Patterson P. Cancer patients as parents: implementation of a cross sector service for families with adolescent and young adult children. BMC Health Serv Res 2023; 23:472. [PMID: 37165404 PMCID: PMC10173515 DOI: 10.1186/s12913-023-09413-8] [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: 01/30/2023] [Accepted: 04/18/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Cancer patients who are parents show concerns about their ability to parent following diagnosis, and their adolescent and young adult (AYA) children have a need for improved cancer communication within the family. However, psychosocial support for families affected by parental cancer is not routinely available. This study explores the implementation of the Parent Support Worker (PSW) role, as part of a new cross sector model of care to support parent patients, their partners, and AYA children. METHODS Two PSWs, social workers and healthcare staff (n = 26) from three hospitals participated in audio-recorded, semi-structured interviews about implementation of the PSW role. Template Analysis and Normalization Process Theory were used to analyze the interviews. Data on PSW service activity and referrals of AYA to support from a community organization were analyzed using descriptive statistics. RESULTS Eleven themes categorized into enablers and barriers of implementation were identified. Regarding acceptability of the role, three enablers (social workers' understanding of the PSW role increasing, easy and prompt access of staff and parent patients to PSWs, satisfaction with the PSW role) and one barrier (communication related confusion and frustration about the PSW role) were identified. Additionally, three enablers (the PSW role fills gaps in parenting-focused support and continuity of care, the PSW role alleviates social workers' workload, negotiation helped to define responsibilities) and one barrier (fear of social work roles to be overtaken by PSWs) for appropriateness of the role were found. Finally, two enablers of feasibility of the role (PSWs and social workers co-managing the work, higher confidence from hospital staff to talk about children in the family) and one barrier (lack of systematic identification and referral processes) were identified. Across hospitals, the number of referrals of AYA children to the community organization increased between 2.7 and 12 times nine months post-introduction of the service. CONCLUSIONS Established in response to identified gaps in oncology care for parents with cancer, their partners and AYA children, a novel cross-sector model of care was acceptable, appropriate, and feasible. Barriers and enablers to implementation identified in this study need to be considered when designing and implementing similar services.
Collapse
Affiliation(s)
- X Skrabal Ross
- Policy and Patient Department, Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia.
| | - F E J McDonald
- Policy and Patient Department, Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - S Konings
- Psycho-Oncology Department, Clinique Saint-Jean, Brussels, Belgium
| | - E Schiena
- Department of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Phipps-Nelson
- Department of Oncology, University of Melbourne, Melbourne, Australia
- Office of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - F Hodgson
- John Hunter Hospital, New Lambton Heights, Australia
| | - P Patterson
- Policy and Patient Department, Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
14
|
Allison KR, Patterson P, McDonald FE, Bibby K, Ciarrochi J, Tracey D, Hayes LL, Wright A, Konings S, Davis E, Hulbert-Williams NJ, Wakefield CE, White K. Truce: Feasibility and acceptability of an Acceptance and Commitment Therapy-based intervention for adolescents and young adults impacted by parental cancer. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
|
15
|
Liénard A, Lamal S, Merckaert I, Razavi D. Efficacy of a support intervention designed to improve parents’ communication with children dealing with parental cancer: a randomized pilot trial. Support Care Cancer 2022; 30:9823-9832. [DOI: 10.1007/s00520-022-07380-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 09/26/2022] [Indexed: 11/09/2022]
|
16
|
How to support parenting in patients with cancer and co-parents? From research to practice. Curr Opin Oncol 2022; 34:285-293. [PMID: 35703229 DOI: 10.1097/cco.0000000000000839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW When a parent is diagnosed with cancer, the entire family is impacted. Patients with cancer and co-parents may no longer feel able to fulfill their parenting roles. The aims of this article are to describe interventions designed to support parenting in the oncological context and to make suggestions for the development and assessment of such interventions. RECENT FINDINGS Ten parenting support interventions published in the last 10 years in oncology were identified, among which four randomized controlled trials (RCTs). The therapeutic aims, techniques, and modalities of these interventions were heterogeneous. Five main therapeutic aims were addressed to: increase parents' knowledge, promote parents' emotion regulation, enhance parents' self-efficacy related to parenting, promote parents' support of their children's reactions and coping strategies, and promote open and appropriate parent-child communication. Few studies have combined informational resources with experiential techniques. SUMMARY Very few studies examining the efficacy of parenting support interventions have been published. There is still a need to develop, test, and compare interventions that meet the many needs of parents and their children. Suggestions are made about the contents and formats of parenting support interventions in oncology.
Collapse
|