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Ozturk CS, Katikol E. Effect of mHealth-based relaxation program on stress coping and anxiety levels in mothers of children with cancer: A randomized controlled study. PATIENT EDUCATION AND COUNSELING 2024; 123:108247. [PMID: 38471311 DOI: 10.1016/j.pec.2024.108247] [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: 08/01/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE This study aimed to explore the effects of a mHealth-based relaxation program on anxiety and stress coping levels in mothers of children with cancer. METHODS This randomized controlled, single-blind, parallel-group trial was conducted in the pediatric hematology-oncology unit of a university hospital. The study was completed by 50 mothers (intervention group: n = 25; control group: n = 25). The mothers in the intervention group participated in a mHealth-based relaxation program for eight weeks (including progressive muscle relaxation, guided imagery, and the four-leaf clover of mindfulness). Videos of the relaxation program were sent to mothers' WhatsApp accounts. The mothers in the control group received routine care. The State-Trait Anxiety and Stress Coping Scales were administered during the first and eighth weeks. The registration number of this study on ClinicalTrials.gov is NCT05807295. RESULTS Mothers who participated in the relaxation program had lower anxiety levels and higher stress-coping scores than those in the control group (p < 0.05). CONCLUSION Progressive muscle relaxation exercises, guided imagery, and cognitive-based therapeutic approaches were effective in reducing mothers' anxiety and stress coping. PRACTICE IMPLICATIONS Pediatric oncology nurses can apply mHealth-based relaxation programs to support caregivers, particularly mothers. In this way, ensuring the continuity and integrity of care is easy.
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Affiliation(s)
- Cigdem Sari Ozturk
- Gazi University Nursing Faculty Pediatric Nursing Department, Emek, Ankara, Turkey.
| | - Emine Katikol
- Gazi University Health Research and Application Center, Pediatric Hematology and Oncology Service, Yenimahalle, Ankara, Turkey.
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Keller MC, Needham A, Holden E, Engelke K, Foy K, Hart L, Hinderer K. We Are Done! Now What? Exploring End of Treatment Needs of Childhood Cancer Survivors and Their Parents. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:96-106. [PMID: 38238967 DOI: 10.1177/27527530231194598] [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: 04/16/2024]
Abstract
Background: Increased childhood cancer survival rates have spurred a new body of research pertaining to the cancer-survivorship continuum. Literature suggests a lack of research and guidelines for care at the end of treatment (EOT). To improve the transition to survivorship and determine any posttreatment challenges, this study explored the experiences of childhood cancer survivors (CCSs), parents/caregivers, and pediatric oncology health care professionals (HCPs) at EOT. Method: This study employed a mixed methods design. EOT Questionnaires were completed by CCSs and parents/caregivers within 6 months of completing treatment, and by pediatric oncology HCPs. Results: A total of 75 CCSs and parents/caregivers and 21 HCPs completed the study. The majority of parents/caregivers (78%) and older CCSs (94%) recalled having an EOT "meeting." Most were satisfied with the meeting, but described unexpected worries/problems following EOT. Family members stating they were "very satisfied" with the EOT meeting increased significantly relative to the number of EOT topics addressed. In contrast, the omission of certain psychosocial discussion topics negatively correlated with satisfaction. Oncologists provided the majority of EOT services, with infrequent provision by other HCPs. Less than 20% of HCPs characterized families as "very satisfied" with EOT services and suggested improvements to meet families' needs. Discussion: This study found unmet psychosocial and anticipatory guidance needs, indicating a lack of preparedness. The results suggest that end of cancer treatment requires a more standardized, comprehensive, and multidisciplinary approach. Enhanced education and support services are needed to promote the successful navigation of all families through this period of transition.
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Affiliation(s)
- Mary Conway Keller
- Division of Hematology/Oncology, Connecticut Children's, Hartford, CT, USA
| | - Andrew Needham
- Center for Cancer and Blood Disorders, Connecticut Children's, Hartford, CT, USA
| | - Elizabeth Holden
- Center for Cancer and Blood Disorders, Connecticut Children's, Hartford, CT, USA
| | - Karina Engelke
- Division of Hematology/Oncology, Connecticut Children's, Hartford, CT, USA
| | - Kelly Foy
- Child and Family Support Services, Connecticut Children's, Hartford, CT, USA
| | - Leigh Hart
- Center for Cancer and Blood Disorders, Connecticut Children's, Hartford, CT, USA
| | - Katherine Hinderer
- Institute of Nursing Research and Evidence-Based Practice, Connecticut Children's, Hartford, CT, USA
- Department of Pediatrics, UCONN School of Medicine, Farmington, CT, USA
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Woodford J, Reuther C, Ljungberg JL, von Essen L. Involving parents of children treated for cancer in Sweden as public contributors to inform the design and conduct of an evaluation of internet-administered self-help for parents of children treated for cancer: a protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:2. [PMID: 38167254 PMCID: PMC10759441 DOI: 10.1186/s40900-023-00532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Public contribution in research can facilitate the design and conduct of meaningful research, resulting in feasible and sustainable solutions to healthcare challenges. However, the evidence concerning the acceptability, feasibility, and impact of public contribution in research is limited. We will embed a mixed-method examination of public contribution activities into the CHANGE trial. The overall aim of the CHANGE trial is to evaluate the efficacy and cost-effectiveness of an internet-administered, guided, low-intensity cognitive behavioral therapy-based self-help intervention (EJDeR) plus treatment as usual (TAU) versus TAU for symptoms of depression and/or Generalized Anxiety Disorder in a superiority randomized controlled trial with an internal pilot phase. In this protocol we describe how we aim to: (1) involve parents of children treated for cancer in the managing and undertaking, analysis and interpretation, and dissemination phases of the CHANGE trial; and (2) examine the acceptability, feasibility, and perceived impact of Parent Advisory Board contribution to the trial from the perspective of board members and public contribution coordinators. METHODS We will recruit around six parents of children treated for cancer to the Parent Advisory Board. Board members will contribute throughout the trial during online workshops and steering group meetings. An impact log will be used during workshops to record activities and examine the perceived impact of activities according to board members and public contribution coordinators, including anticipated and unanticipated changes to the research process and potential benefits and harms. Activities will be reported using the Guidance for Reporting Involvement of Patients and the Public checklist. We will conduct semi-structured interviews with board members and public contribution coordinators 6 months after the board is established and at the end of the trial to examine the acceptability, feasibility, and perceived impact of public contribution activities. We will also conduct interviews with board members and public contribution coordinators who withdraw participation. Findings will be reported in accordance with the Standards for Reporting Qualitative Research checklist. DISCUSSION We hope adding public contribution to the CHANGE trial will provide guidance on how to embed public contribution in research and add to the evidence base concerning the impact of public contribution.
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Affiliation(s)
- Joanne Woodford
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Christina Reuther
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Johan Lars Ljungberg
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden.
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Joosten MMH, Maurice-Stam H, van Gorp M, Beek LR, Stremler-van Holten D, Scholten L, Grootenhuis MA. Efficacy of Op Koers Online, an online group intervention for parents of children with cancer: Results of a randomized controlled trial. Psychooncology 2024; 33:e6284. [PMID: 38282215 DOI: 10.1002/pon.6284] [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: 10/20/2023] [Revised: 11/29/2023] [Accepted: 12/19/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Parents of children with cancer are at risk for developing psychosocial problems. The present study aims to evaluate the effect of an online group intervention (Op Koers Online, in English: On Track Online) on psychosocial wellbeing and coping skills. METHODS Parents of a child with cancer (diagnosis <5 years ago) participated in a randomized controlled trial. In six consecutive (and one booster-) protocolled sessions in an online chatroom, trained psychologists and social workers taught coping skills using cognitive behavioral and acceptance and commitment techniques. Questionnaires assessed anxiety, depression, distress, situation-specific emotional reactions and coping skills (Op Koers Questionnaire/Cognitive Coping Strategies Scale Parent Form) and evaluated the intervention. Linear mixed-model analyses were performed to detect differences between the conditions in changes over time; T0-T1 and T0-T2 (6-week and 6-month follow-up), and to detect changes in scores T2-T3 (12-month follow-up) for the intervention group only. RESULTS 89 parents were included in analyses (mean age 41.9 years, 86% female, 62%/38% post/during treatment of their child). Beneficial intervention effects (p < 0.05) were found at T1 for anxiety, depression, distress, loneliness and relaxation, and at T2 for anxiety, uncertainty and relaxation. In the intervention condition, scores did not change from T2 to T3, except loneliness that decreased and relaxation that improved. All effect sizes were small to medium (β = -0.21 to 0.46). Parents were generally positive about the intervention. CONCLUSIONS Op Koers Online for parents of children with cancer has a positive effect on psychosocial wellbeing and the coping skill relaxation. Implementation is recommended to prevent psychosocial problems. CLINICAL TRIAL REGISTRATION Dutch Trial Register https://onderzoekmetmensen.nl/en NL73763.041.20.
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Affiliation(s)
- M M H Joosten
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - H Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - M van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - L R Beek
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - L Scholten
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Vaagan A, Haaland-Øverby M, Eriksen AA, Fredriksen K, Stenov V, Varsi C, Ingadóttir B, Cleal BR, Alvheim AR, Westermann KF, Strømme H, Kristjansdottir OB. Group-based patient education via videoconference: A scoping review. PATIENT EDUCATION AND COUNSELING 2024; 118:108026. [PMID: 37939596 DOI: 10.1016/j.pec.2023.108026] [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: 05/09/2023] [Revised: 10/12/2023] [Accepted: 10/15/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To summarize recent evidence on the feasibility, acceptability, and effectiveness of videoconference (VC) group-based patient and caregiver education. METHODS Systematic searches of the literature were conducted. Data was extracted on the characteristics of the studies and interventions and on the feasibility, acceptability, and effectiveness of the interventions. RESULTS From 12,570 hits, 65 studies were eligible for inclusion. Their results confirmed previously identified tendencies of high feasibility and acceptability of VC group patient education, and improved health outcomes. However, evidence of effectiveness is limited, and the quality of studies is varied. Several patient and caregiver groups also remain under-researched. Only four studies stated that facilitators were trained in using VC-technology. CONCLUSION VC group-based patient and caregiver education is feasible and acceptable and may improve health outcomes for participant patients and caregivers. However future research should increase the number of high-quality randomized controlled trials to establish the effectiveness of VC group-based education for several groups of patients and caregivers. Studies of the training of facilitators is also warranted. PRACTICE IMPLICATIONS The results suggest that interventions should be more accessible. An overview of the recent evidence may also stimulate the development and evaluation of VC group-based patient and caregiver education.
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Affiliation(s)
- André Vaagan
- Norwegian National Advisory Unit on Learning and Mastery in Health, Postbox 4959 Nydalen, 0424 Oslo, Norway.
| | - Mette Haaland-Øverby
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway; Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Kari Fredriksen
- Learning and Mastery Center, Stavanger University Hospital, Stavanger, Norway
| | - Vibeke Stenov
- Health Promotion Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Cecilie Varsi
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway,; Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Brynja Ingadóttir
- Faculty of Nursing and Midwifery, University of Iceland, Reykjavik, Iceland
| | - Bryan Richard Cleal
- Health Promotion Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Anita Røyneberg Alvheim
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Karl Fredrik Westermann
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Hilde Strømme
- Library of Medicine and Science, University of Oslo, Oslo, Norway
| | - Olöf Birna Kristjansdottir
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway; Mental health team West, Primary care of the capital area, Reykjavik, Iceland
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Thiblin E, Woodford J, Reuther C, Lundgren J, Lutvica N, von Essen L. Internet-administered, low-intensity cognitive behavioral therapy for parents of children treated for cancer: A feasibility trial (ENGAGE). Cancer Med 2023; 12:6225-6243. [PMID: 36404407 PMCID: PMC10028033 DOI: 10.1002/cam4.5377] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/05/2022] [Accepted: 10/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Parents of children treated for cancer may experience mental health difficulties, such as depression and anxiety. There is a lack of evidence-based psychological interventions for parents, with psychological support needs unmet. An internet-administered, guided, low-intensity cognitive behavioral therapy-based (LICBT) self-help intervention may provide a solution. METHODS The feasibility and acceptability of such an intervention was examined using a single-arm feasibility trial (ENGAGE). Primary objectives examined: (1) estimates of recruitment and retention rates; (2) feasibility and acceptability of data collection instruments and procedures; and (3) intervention feasibility and acceptability. Clinical outcomes were collected at baseline, post-treatment (12 weeks), and follow-up (6 months). RESULTS The following progression criteria were met: sample size was exceeded within 5 months, with 11.0% enrolled of total population invited, study dropout rate was 24.0%, intervention dropout was 23.6%, missing data remained at ≤10% per measure, and no substantial negative consequences related to participation were reported. Intervention adherence was slightly lower than progression criteria (47.9%). CONCLUSION Findings suggest an internet-administered, guided, LICBT self-help intervention may represent a feasible and acceptable solution for parents of children treated for cancer. With minor study protocol and intervention modifications, progression to a pilot randomized controlled trial (RCT) and subsequent superiority RCT is warranted.
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Affiliation(s)
- Ella Thiblin
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Christina Reuther
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Johan Lundgren
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Nina Lutvica
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Chow WK, Hetherington K, McGill BC, Sansom-Daly UM, Daly R, Miles G, Cohn RJ, Wakefield CE. 'Like ships in the night': A qualitative investigation of the impact of childhood cancer on parents' emotional and sexual intimacy. Pediatr Blood Cancer 2022; 69:e30015. [PMID: 36200485 DOI: 10.1002/pbc.30015] [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: 04/04/2022] [Revised: 08/19/2022] [Accepted: 08/29/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Childhood cancer is highly distressing for families and can place strain on parents' relationships. Parental functioning and cohesiveness are important predictors of family functioning and adaptation to stress. This qualitative study investigated the perceived impact of childhood cancer on parents' relationship with their partner, with a focus on emotional and sexual intimacy. METHODS We conducted semi-structured interviews with 48 parents (42 mothers, six fathers) of children under the age of 18 who had completed curative cancer treatment. We analysed the interviews using thematic analysis. RESULTS At interview, parents were on average 40.7 years old (SD = 5.5, range: 29-55 years), and had a child who had completed cancer treatment between 3 months and 10.8 years previously (M = 22.1 months). All participants were living with their partner in a married/de facto relationship. Most parents reported that their child's cancer treatment had a negative impact on emotional and sexual intimacy with their partner, with some impacts extending to the post-treatment period. Reasons for compromised intimacy included exhaustion and physical constraints, having a shifted focus, and discord arising from different coping styles. Some parents reported that their relationship strengthened. Parents also discussed the impact of additional stressors unrelated to the child's cancer experience. CONCLUSIONS Parents reported that childhood cancer had a negative impact on aspects of emotional and sexual intimacy, although relationship strengthening was also evident. It is important to identify and offer support to couples who experience ongoing relationship stress, which may have adverse effects on family functioning and psychological wellbeing into survivorship.
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Affiliation(s)
- Wan Ka Chow
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Kate Hetherington
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Brittany C McGill
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Ursula M Sansom-Daly
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Rebecca Daly
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Gordon Miles
- Acute Services: Paediatric Consultation Liaison, Princess Margaret Hospital, Subiaco, Western Australia, Australia
| | - Richard J Cohn
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Claire E Wakefield
- School of Clinical Medicine, Discipline of Paediatrics, UNSW Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
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Sansom-Daly UM, McLoone JK, Touyz L, Signorelli C. New Frontiers in Child, Adolescent and Young Adult Psycho-Oncology Survivorship Care. Cancers (Basel) 2022; 14:4335. [PMID: 36139504 PMCID: PMC9496797 DOI: 10.3390/cancers14184335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/31/2022] [Indexed: 12/03/2022] Open
Abstract
The landscape of cancer survivorship has changed considerably from Fitzhugh Mullan's conceptualization of the three sequential phases or 'seasons of survival' that an individual might expect to pass through, from the acute (cancer diagnosis and treatment), extended (the period following treatment), and permanent (survivorship, aligned with cure) survivorship phases [...].
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Affiliation(s)
- Ursula M. Sansom-Daly
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, Randwick Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Jordana K. McLoone
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, Randwick Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Kensington, NSW 2052, Australia
| | - Lauren Touyz
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, Randwick Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Kensington, NSW 2052, Australia
| | - Christina Signorelli
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, Randwick Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Kensington, NSW 2052, Australia
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