When a parent has cancer: a community based program for school personnel

Discussion Surrounding Theory, Knowledge, and Practical Applications for Clinical Nurse Specialists to Aid Them in Caring for Parents with Cancer Who Have Young Children

PURPOSE

To identify the theory, knowledge, and practical applications that clinical nurse specialists should consider adding to their "toolkit" to support them in caring for people affected by cancer with young children.

DATA SOURCES

Expert opinion and relevant studies on the topic formed the basis of this article.

CONCLUSION

A conversation with experts identified five key areas of knowledge important to supporting clinical nurse specialists in caring for people affected by cancer with young children: family-centered and systemic practice, nursing responsibilities and competencies, trauma-informed practice, adult life stages, and stages of child development. Key areas identified have relevance to all healthcare professionals working in cancer care.

IMPLICATIONS FOR NURSING PRACTICE

This article provides a useful overview of psychological theories important to supporting healthcare professionals in caring for people affected by cancer. A discussion on the boundaries and competencies of the nursing role led to agreement about practical advice rooted in theory and knowledge that could benefit clinical practice. Concepts of emotional labor and the wounded healer were identified as important to inform reflection and supervision when caring for a parent affected by cancer who has a young family.

Professionals' Awareness of Young Carers in Schools: Results from a French Survey

Few studies have investigated professionals' awareness of young carers (YCs). Therefore, the main aim of this study was to explore school professionals' awareness of YCs. The secondary aim was to compare professionals' responses according to their occupation. A total of 2658 professionals took part in this study by completing an online questionnaire. The results indicated that the mean for the perceived age for care beginning was 10.3 years old, with parents being perceived as the most frequent care recipient. The main caring activities reported were domestic chores, emotional support and sibling care, while care provided directly to the care recipient was perceived as less frequent. Many suggestions for improving the identification, referral and support of YCs were seen as relevant, but professionals were less supportive of suggestions for adjustments within schools. The key training needs centered around better identifying YCs and developing better knowledge of their difficulties. Differences were observed according to occupation, with administrative staff and teachers having less accurate perceptions than school counsellors as well as social and health professionals. This study shows that it can be difficult for school professionals to imagine a child providing care. Specific training, therefore, needs to be proposed according to school professionals' occupations.

The Impact of Cancer on the Mental Health of Patients Parenting Minor Children: A Systematic Review of Quantitative Evidence

OBJECTIVE

To provide an overview of quantitative data on the impact of cancer on the mental health of patients parenting minor children. We focused on mental health outcomes, their levels and prevalence and applied measurement tools.

METHODS

MEDLINE, CINAHL, PsycInfo and Web of Science were searched up to March 2021. We included quantitative studies, published in a peer-reviewed journal and reporting outcomes on the mental health (e.g., depression, anxiety) of cancer patients parenting minor children (≤ 21 years). Study quality was assessed based on the NIH assessment tool for observational studies. This study is registered on PROSPERO (CRD42019141954).

RESULTS

A total of 54 articles based on 36 different studies were included in this systematic review. Studies differ markedly regarding study and sample characteristics (e.g., outcome measures, sample size, parental health status). Depression and anxiety levels range from normal to abnormal, according to applied measurement tools. 7%-83% of parents with cancer have depression scores indicating probable depression and 19%-88% have anxiety scores indicating anxiety disorder.

CONCLUSIONS

This review reveals the dimension of mental burden affecting cancer patients parenting minor children. To identify, address and timely treat potentially arising mental health problems and support needs, affected parents should be closely monitored by healthcare professionals and referred to specialized support offers, if necessary. In the context of a comprehensive patient- and family-oriented care, it is highly relevant to integrate mental health (including parental) issues routinely into oncological care by proactively asking for the patient's psychosocial situation and the family status. This article is protected by copyright. All rights reserved.

Families Affected by Parental Cancer: Quality of Life, Impact on Children and Psychosocial Care Needs

Parental cancer poses major challenges for families with minor children. Due to diagnosis and treatment family life is disrupted. To prevent long-term consequences in all family members and to design needs-oriented family-centered interventions, further understanding of the family's situation including the impact on the children, quality of life levels and the parental psychosocial needs is necessary. This study aims at investigating the impact of parental cancer on the minor children, family-specific psychosocial needs and quality of life levels of parents and children. Cancer patients parenting at least 1 minor child (<18 years) were eligible for study participation. In total, n=86 cancer patients under treatment participated in the study. After excluding participants without a minor child, 78 patients remained for analyses. We assessed children's quality of life using the parent proxy version of the KIDSCREEN-10 and parental quality of life using the EORTC QLQ C30 quality of life questionnaire. Additionally, the questionnaire comprised open questions about positive and negative changes parents perceived in their children as well as questions on specific family- and child-related psychosocial needs. The majority of participants were mothers (91%), mainly diagnosed with breast cancer (59%). The participating parents provided data on 117 minor children. Parents mentioned positive changes in 38% of the children (e.g., being more attentive and helpful). Negative changes were reported in 37% of the children (e.g., being more anxious and clingy). Parents reported family-specific psychosocial supportive care needs for themselves as a parent (e.g., support regarding parenting concerns), support needs for the partner or the children. Moreover, parents expressed family-related information needs and needs regarding practical aspects (e.g., childcare, household help). Global quality of life was M = 55.7 (SD = 23.4) for parents and M = 57.5 (SD = 15.5) for children. Pearson's correlation coefficient between parental and children's quality of life was 0.377 (p < 0.001). To identify parents with cancer and children in need for additional support, health care providers should proactively inquire about the impact of the disease on the children. In terms of a comprehensive cancer care, the direct assessment of family impact and family-specific support needs in cancer patients with minor children allows for needs-based allocation to support offers.

Contributing to making the school a safe place for the child: School nurses' perceptions of their assignment when caring for children having parents with serious physical illness

Aim

To explore how school nurses perceive their assignment when caring for children having parents with serious physical illness.

Design

An explorative inductive qualitative design.

Method

The study is based on interviews with 16 school nurses. The interviews were subjected to qualitative content analysis.

Results

The main category, “Contribute in making the school a safe place for the child”, reveals how the school nurses try to contribute to making the school a safe place for a child when his/her parent has a serious physical illness. They support children through individual support, as well as at an overall level in the school health team to make the school, as an organization, a safe place. Routines and collaboration to recognize the child when his/her parent has become ill is described as crucial to accomplishing this assignment.

Padres diagnosticados de cáncer: malestar emocional y recursos para comunicarse con sus hijos meno

Objetivo: Conocer los recursos que poseen los padres afectados por cáncer al comunicar la enfermedad a sus hijos menores y su relación con el malestar emocional de estos pacientes. Método: Se evaluó el estilo de comunicación familiar mediante una subescala del FAD (Mc Master Family Assessment Device). Se elaboró un cuestionario específico para evaluar los recursos de los pacientes, donde cada ítem era valorado con una escala de 0 a 10 (siendo 0 nada en absoluto y 10, la máxima puntuación posible). También se utilizó una escala numérica de valoración del malestar emocional, en forma de un solo ítem (0-10). El conjunto de pruebas se aplicó a 60 pacientes de edades comprendidas entre los 34 y los 60 años todos ellos padres afectados de cáncer con hijos menores a su cargo. Resultados: Los recursos que parecen poseer en mayor medida los padres evaluados son los recursos relacionados con la gestión de la vida doméstica (media = 8,3), seguidos de los que hacen referencia a delegar a terceras personas los cuidados de sus hijos durante momentos difíciles. Al analizar con más profundidad estos dos recursos, detectamos que más del 80% de los padres de la muestra poseen el recurso relacionado con la gestión de la vida doméstica. Por el contrario, el recurso de como informar sobre la situación de enfermedad a los niños, lo tiene poco más de la mitad de los pacientes evaluados (55%). Los datos indican que existe una relación inversa entre la disponibilidad de este recurso y el nivel de malestar emocional, ya que los pacientes que consideran tener recursos para hablar de la enfermedad a sus hijos, presentan un menor malestar emocional. Conclusiones: Los padres recién diagnosticados de cáncer que plantean comunicar la situación de enfermedad a sus hijos menores, poseen más recursos para gestionar la vida doméstica y delegar el cuidado de sus hijos cuando lo precisan a terceras personas, que para informar sobre la enfermedad y sostener emocionalmente a sus hijos. Así mismo, el no disponer de recursos para comunicar el diagnóstico a los hijos se asocia con una mayor presencia de malestar emocional.