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Heuser C, Schneider JN, Heier L, Ernstmann N, Nakata H, Petermann-Meyer A, Bremen R, Karger A, Icks A, Brümmendorf TH, Geiser F. Family resilience of families with parental cancer and minor children: a qualitative analysis. Front Psychol 2024; 14:1251049. [PMID: 38314254 PMCID: PMC10836593 DOI: 10.3389/fpsyg.2023.1251049] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/26/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Estimated 50,000 minor children in Germany experience a newly diagnosed cancer in one of their parents every year. Family resilience has proven to be an important concept against life crises. However, little research exists regarding family resilience in the context of parental cancer with minor children. Based on the "Family Resilience Framework," the aim of the study is to investigate the processes of family resilience of affected families. In addition, we explore which combinations of promoting family resilience processes can be characterized. Methods As part of the mixed-method quasi-experimental interventional study "F-SCOUT," a qualitative content analysis was used to analyze the documentation of the "Family-Scouts" (a fixed contact person who advises, accompanies, and supports the families). Documentation was performed by families' study inclusion (T0), after 3 months (T1) and 9 months (T2) concerning current family situation, organization of everyday life, emotional coping, open communication within the family, and planned tasks. Results The N = 73 families had between one and six children. In 58 (79%) families, the mother had cancer. In the course of the analysis, a category system with 10 main categories and 36 subcategories emerged. Family resilience processes were described to different extents. Combinations of categories promoting family resilience were characterized by the use of social resources, flexibility, economic resources, and open communication. Discussion The findings are consistent with existing assumptions about family resilience in terms of the importance of social resources, family cohesion, mutual support, flexibility, open communication, and psychological well-being. In contrast to the findings of previous research, spirituality, and collaborative problem-solving indicate less centrality here. In turn, the findings on economic resources and information-seeking provide a valuable addition to the family resilience literature in the context of parental cancer with minor children. Clinical trial registration ClinicalTrials.gov, identifier NCT04186923.
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Affiliation(s)
- Christian Heuser
- Chair of Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | - Juliane Nora Schneider
- Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Lina Heier
- Chair of Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, Netherlands
- CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, Netherlands
| | - Nicole Ernstmann
- Chair of Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | - Hannah Nakata
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | - Andrea Petermann-Meyer
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Rebecca Bremen
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - André Karger
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Clinical Institute for Psychosomatic Medicine and Psychotherapy, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Düsseldorf, Germany
| | - Tim H. Brümmendorf
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Franziska Geiser
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University of Bonn, Bonn, Germany
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Alexander ES, Halkett GKB, Lawrence BJ, O’Connor M. A Conceptual Model Depicting How Children Are Affected by Parental Cancer: A Constructivist Grounded Theory Approach. Children (Basel) 2023; 10:1507. [PMID: 37761468 PMCID: PMC10530185 DOI: 10.3390/children10091507] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 09/29/2023]
Abstract
Cancer patients' children are vulnerable to psychosocial and behavioural issues. The mechanisms underlying how children are affected by their parent's diagnosis are unknown, warranting further research. This study investigated how children are affected by their parent's cancer diagnosis and provides a theoretical model conceptualising this experience. Informed by methods of grounded theory, embedded within a social constructivist framework, 38 informants (15 health professionals (HPs); 11 parents; 12 children (5 to 17 years)) were interviewed using a semi-structured format. Three themes were identified: (i) children were worried and distressed because they felt alone, (ii) parents were unable to tend to children's needs because they were overwhelmed by practical factors, and (iii) HPs were not detecting children due to barriers that affected their visibility in clinical settings. The proposed Alexander's Children's Cancer Communication (ACCC) Model and clinical recommendations made can be used to guide the clinical practice and development of future intervention research.
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Affiliation(s)
- Elise S. Alexander
- Discipline of Psychology, School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia; (E.S.A.); (B.J.L.)
| | - Georgia K. B. Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
| | - Blake J. Lawrence
- Discipline of Psychology, School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia; (E.S.A.); (B.J.L.)
| | - Moira O’Connor
- Discipline of Psychology, School of Population Health/Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia;
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Alexander ES, O’Connor M, Halkett GKB. The Psychosocial Effect of Parental Cancer: Qualitative Interviews with Patients' Dependent Children. Children (Basel) 2023; 10:children10010171. [PMID: 36670721 PMCID: PMC9857104 DOI: 10.3390/children10010171] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/05/2022] [Accepted: 12/16/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Children living with parental cancer are at an increased risk for various psychosocial, emotional, and behavioural problems. However, research regarding how children are affected by their parent's diagnosis is still developing and patients' children are typically invisible in clinical practice. This study aimed to investigate how children are affected by their parent's cancer diagnosis, from children's perspectives. METHODS Informed by methods of grounded theory and embedded within a social constructivist framework, twelve children (ranging from 5 to 17 years) living with a parent with cancer were interviewed using a semi-structured format assisted by a novel approach derived from play- and art-based developmental literature. RESULTS Findings indicate that patients' children are constantly worried and distressed, and there are barriers that can be overcome to mitigate this. Four overarching themes were identified: (I) Feeling worried and distressed; (II) Comprehending their parent's cancer diagnosis; (III) Being disconnected from their supports; and (IV) Needing someone to talk to. CONCLUSIONS Children experience considerable levels of ongoing worry and distress when a parent is diagnosed with cancer and have difficulties comprehending and articulating this. They also feel a level of disconnection from their usual support systems (e.g., parents) and are limited regarding who they can seek out and talk to. Mitigating children's ongoing worries and distress by promoting the availability and accessibility of parents and other supports to children, and reducing communication barriers between children and adults, should be a primary focus of psycho-oncology research and practice.
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Affiliation(s)
- Elise S. Alexander
- Discipline of Psychology, School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
| | - Moira O’Connor
- Discipline of Psychology, School of Population Health/Curtin Health Innovation Research Institute (CHIRI), enABLE Institute, Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
| | - Georgia K. B. Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
- Correspondence: ; Tel.: +61-8-9266-1762
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Hanna JR, Semple CJ. 'I didn't know what was in front of me'-Bereaved parents' experience of adapting to life when a co-parent of dependent children has died with cancer. Psychooncology 2022; 31:1651-1659. [PMID: 35949162 PMCID: PMC9825999 DOI: 10.1002/pon.6010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE It is not clear how the bereaved parent navigates life with the children after a co-parent has died. The objective of this study is to explore bereaved parents' experience of managing life when a co-parent of dependent children has died with cancer. METHODS Twenty-one in-depth interviews were conducted with bereaved parents when a co-parent died with cancer. Data were analysed thematically. RESULTS Bereaved parents highlighted how their children was their key focus after the death of a co-parent with cancer, as they effortfully strived to be a 'perfect parent'. While some bereaved parents struggled to adapt to the role as a sole parent, others described the importance of maximising social networks to help with the practical aspects of parenting. However, most bereaved parents described intense feelings of loneliness as they navigated parenting alone. To help navigate this post-bereavement period, parents considered it important for their children to openly talk about the deceased parent. Also, meeting others who have experienced similar situations was helpful for the bereaved parent and children, providing hope for the future. Results are discussed under two themes: (1) adapting to life without the parent, and (2) a desire to keep the memory alive of the parent that died with cancer. CONCLUSIONS Bereaved parents should be encouraged to practice self-care when a co-parent has died from cancer so they can appropriately meet the needs of their children. Bereaved parents should be reassured that showing emotion in front of the children is helpful and could facilitate better grief experiences for the whole family.
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Affiliation(s)
| | - Cherith J. Semple
- School of NursingUlster UniversityNewtownabbeyUK,South Eastern Health and Social Care TrustCancer Services Ulster HospitalBelfastUK
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Phillips F, Prezio EA, Currin-McCulloch J, Jones BL. Wonders & Worries: A randomized clinical trial of a psychosocial intervention for children who have a parent with cancer. Psychooncology 2022; 31:1399-1411. [PMID: 35470518 DOI: 10.1002/pon.5943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/14/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to test the effectiveness of Wonders & Worries, a psychosocial intervention for children who have a parent with cancer. Primary goals were to improve family quality of life, functioning and communication skills as reported by parent and child, enhance children's emotional/behavioral adjustment and parenting efficacy, while decreasing parenting concerns and ill parents' depression and anxiety. METHODS Sixty families were recruited from a community based non-profit agency. Parents diagnosed with Stage I-III cancer and their children ages 5-14 years were enrolled and randomized into intervention (n = 32) or wait-list control groups (n = 28). Families received 2 parent consults, six weekly 1-h individual child sessions, and 1 treatment center tour. The intervention was comprised of an age-appropriate understanding of cancer and expression of feelings, coping skills to ease feelings related to parent's cancer and enhanced ability to communicate about the disease. Controls received parent consult and access to W & W resources. Data were obtained from standardized measures at baseline; 6 and 10 weeks follow up. RESULTS Intervention group significantly improved on parenting concerns, parenting self-efficacy, and family quality of life. Children in the intervention group had significantly lower emotional and behavioral problems and worries related to cancer compared to controls. The intervention failed to significantly affect ill parent's anxiety, depressed mood, family functioning and child's anxiety. CONCLUSIONS The Wonders & Worries intervention promoted positive adaptation for ill parents and their children. This intervention is promising enough to warrant further refinement and testing with larger, more diverse samples.
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Melchiors L, Geertz W, Inhestern L. Parental Cancer: Acceptance and Usability of an Information Booklet for Affected Parents. Front Psychol 2022; 13:769298. [PMID: 35282192 PMCID: PMC8907886 DOI: 10.3389/fpsyg.2022.769298] [Citation(s) in RCA: 2] [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: 09/01/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background Parents affected by cancer are confronted with challenges such as communicating with their children about the disease and dealing with changes in their parental role. Providing appropriate information could support affected parents and their children. Still, high-quality and information booklets are rare. Therefore, we developed an information booklet for affected families. The study aims are: (1) investigating the acceptability and usability of the information booklet, (2) determining parental information needs, and (3) collating suggestions for implementation. Finally, we adapted the booklet according to the findings. Methods We interviewed five experts in psychosocial care of parental cancer and nine affected parents using a semi-structured interview guideline. Participants received the developed booklet after giving the consent to participate. Interviews on acceptability and usability of the booklet and information needs were conducted about 1 week after receiving the booklet. The interviews were analyzed using structuring content analysis. Results (1) Experts and parents reported that the information booklet addresses the experiences of affected families and that the content combination makes it useful in an unprecedented way indicating both acceptance and usability. (2) Following dimensions were identified as information needs: (a) communication, (b) support offers, (c) children's disease understanding and needs, (d) organization of family life, (e) competence in parenting, and (f) sources of additional information material. (3) The booklet should be handed out personally by, e.g., healthcare professionals and might be accompanied by a personal counseling. Minor adaptations on language and content were conducted based on the findings. Conclusion Indicated acceptance and usability of the developed information booklet for parents with cancer suggest a low-threshold, basic support for affected families and health professionals. The diverse parental information needs are covered. The long-term effects of the booklet, e.g., on the use of psychosocial support offers, parental self-efficacy and psychological distress will be quantitatively investigated.
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Affiliation(s)
- Leslie Melchiors
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, Hamburg, Germany
| | - Wiebke Geertz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Steiner V, Joubert L, Shlonsky A, Morris A. Hospital Parenting Support for Adults with Incurable End-Stage Cancer: Multidisciplinary Health Professional Perspectives. Health Soc Work 2021; 46:289-298. [PMID: 34648638 DOI: 10.1093/hsw/hlab024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/18/2020] [Accepted: 07/30/2020] [Indexed: 06/13/2023]
Abstract
Patients with incurable end-stage cancer (IESC) who are parenting minor-age children often experience parenting-related distress. Parenting concerns are not always addressed as part of routine hospital-based psychosocial care. Currently, there is a lack multidisciplinary health professional (HP) perspectives in this area. An exploratory study of hospital-based HP perspectives of adult patients' and coparents' parenting experiences, support needs, and parenting supportive care practice was conducted. Twelve multidisciplinary HPs from one Australian tertiary hospital participated in a semistructured focus group and interviews. Data were audio recorded, transcribed, and analyzed using thematic analysis. Results showed HPs were cognizant of patients' and coparents' diverse parenting support needs and experiences and other aspects that comprise best practice. However, multilevel organization, HP, and patient/coparent barriers impeded optimal practice. Barriers included a nonsystemized approach to screening patients' parenting status and parenting support needs, inadequate resources, limited professional support, hospital environment, and parent psychosocial factors. This article provides feasible options for addressing practice barriers. Reviewing what factors influence optimal parenting focus from interdisciplinary HP perspectives helped identify potential strategies that could influence a shift from medical-focused care to more holistic family-focused patient care.
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Patterson P, McDonald FEJ, Kelly-Dalgety E, Lavorgna B, Jones BL, Sidis AE, Powell T. Development and evaluation of the Good Grief program for young people bereaved by familial cancer. BMC Palliat Care 2021; 20:64. [PMID: 33926449 PMCID: PMC8083089 DOI: 10.1186/s12904-021-00752-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) bereaved by the death of a parent or sibling from cancer report unique psychosocial needs and can have difficulty adjusting to their loss. Unaddressed, this can result in poor long-term bereavement outcomes. This paper describes the development and evaluation of Good Grief - a 3-day camp-based program focused on meeting coping, social support, and respite needs of AYAs bereaved by familial cancer. METHODS One hundred and nine Australian AYAs (68% female; age: 12-25 years, M = 16.63) participated in the evaluation. Grief intensity (Texas Revised Inventory of Grief), meaning-making (Grief and Meaning Reconstruction Inventory), trauma coping (Perceived Ability to Cope with Trauma Scale) and unmet needs (Bereaved Cancer Needs Instrument) measures were administered pre-program and 3-months post-program. Acceptability was measured after each session and at the program's conclusion. Appropriateness was measured at 3-month follow-up. Thirteen participants were interviewed three months post-program on their perceptions of the program. RESULTS Participants reported high program satisfaction, engagement with psychosocial sessions, and enjoyment of recreational activities. Significant improvements were observed in trauma coping abilities and reductions in unmet needs for managing emotions, social support, respite, future planning, and accessing information and support domains. No change was evident in grief intensity or meaning-making as measured quantitatively. Interviews supported these quantitative findings but also identified evidence of personal growth, a component of meaning-making. CONCLUSIONS Good Grief is a highly acceptable and beneficial intervention that addresses the unique needs of AYAs bereaved by familial cancer.
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Affiliation(s)
- Pandora Patterson
- Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia.
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Fiona E J McDonald
- Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Bianca Lavorgna
- Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia
- Present address: Support After Suicide, Jesuit Social Services, Australia and the Faculty of Education, Monash University, Melbourne, Australia
| | - Barbara L Jones
- Steve Hicks School of Social Work and Dell Medical School, The University of Texas at Austin, Austin, USA
| | - Anna E Sidis
- Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia
- Present address: School of Psychology, University of Wollongong, Wollongong, Australia
| | - Thomasin Powell
- Canteen Australia, GPO Box 3821, Sydney, NSW, 2001, Australia
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Chin JC, Lin MH. Children's experiences of living with maternal breast cancer: A qualitative study. J Adv Nurs 2021; 77:3446-3457. [PMID: 33905553 DOI: 10.1111/jan.14866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/28/2020] [Revised: 03/12/2021] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Abstract
AIMS To investigate the experiences of Taiwanese school-aged children coping with maternal breast cancer. DESIGN A qualitative interview study. METHODS A cohort of 10 boys and 12 girls aged 6 to 13 years (mean age, 9.86 years) whose mothers were diagnosed with breast cancer in the last 2 years were recruited from patient networks in Taiwan. Data were collected from February to June 2019 via semi-structured individual interviews. Their responses were subjected to content analysis. RESULTS Content analysis yielded six themes: (1) reluctance to share feelings with others; (2) recognizing changes in the tone of family life; (3) casting the cause of breast cancer onto oneself; (4) engaging in active coping; (5) maturing and gaining life lessons; and (6) family communication matters. CONCLUSION The findings shed light on how family processes and cultural beliefs shape children's experiences. School-aged children came to terms with the significance of maternal breast cancer from a broad context of family experiences over time, and thus gained insights into their self-expectations and future aspirations. IMPACT Healthcare professionals can help school-aged children develop a rational view of breast cancer pathogenesis. In addition, we suggest nursing interventions to support a family-oriented approach to coping. Such interventions should address changes in family processes to improve coping abilities of children and the entire family.
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Affiliation(s)
- Jui-Chih Chin
- Department of Early Childhood Education, University of Taipei, Taipei City, Taiwan
| | - Miao-Hui Lin
- Department of Early Childhood Education, National University of Tainan, Tainan, Taiwan
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Tafjord T. Managing Strong Emotions: Nurses' Recognition and Responses to Personal Emotions When Approaching Parents With Cancer and Their Dependent Children. Qual Health Res 2021; 31:926-941. [PMID: 33554765 DOI: 10.1177/1049732320983788] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Care for sick parents and their dependent children (<18 years) has become a pertinent issue in health care. Nurses play an important role in caring for parents with cancer as well as their children. By utilizing a constructivist grounded theory approach, the aim of this study was to expand the research-based knowledge of nurses' experiences of personal emotions in this research field and to develop a subsequent explanatory theory extending the existing concept of emotional labor. Interviews with 12 nurses were conducted and analyzed. The nurses experienced this area of work as particularly emotionally challenging and attempted to manage personal emotions through regulating and processing strategies. Through this process, they sought for emotional strength by balancing their private lives and work lives to manage work-related emotions. An increased awareness of emotional labor may strengthen nurses' emotional competence in nursing.
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Affiliation(s)
- Trine Tafjord
- Molde University College-Specialized University in Logistics, Molde, Norway
- Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Marín-Chollom AM, Revenson TA. Cultural values as a resilience resource for Latino/a adolescents and young adults coping with parental cancer. J Psychosoc Oncol 2021; 40:26-44. [PMID: 33576717 DOI: 10.1080/07347332.2021.1881197] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: Although research on how adolescents and young adults (AYAs) cope with their own cancer is expanding, there is little knowledge on how AYAs cope with a parent's cancer. And, thus, little evidence-based knowledge for how to deliver services. Moreover, most research has been with majority White populations. To fill this gap, we examined whether the cultural values of familismo (familism) and espíritu (spirit) moderate the association between stress appraisals and coping with psychological distress among Latino/AYAs facing a parent's cancer.Design: Cross-sectional, observational.Sample: Thirty eight adolescents and young adults between the ages of 12 and 25 whose mother had breast cancer.Methods: Participants completed standardized measures. Generalized estimating equation analysis was used to analyze the nested data.Results: There was a protective pattern of familismo and espíritu against symptoms of depression. AYAs experienced psychological distress, but those with higher levels of familismo and espíritu fared better than those with lower levels, regardless of the coping strategies they used.Implications: Psychosocial interventions for Latino/a AYAs coping with parental cancer should incorporate or strengthen these values.
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Affiliation(s)
- Amanda M Marín-Chollom
- Department of Psychological Science, Central Connecticut State University, New Britain, Connecticut, USA
| | - Tracey A Revenson
- Department of Psychology, Hunter College, New York, New York, USA.,Psychology, The Graduate Center, City University of New York, New York, New York, USA
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Hayes B, Brent J, Zhong Y, Bazmi S, Porta G, Bovbjerg DH, Tarhini A, Kirkwood JM, Brent DA, Marsland A, Melhem NM. Early Cortisol and Inflammatory Responses to Parental Cancer and Their Impact on Functional Impairment in Youth. J Clin Med 2021; 10:576. [PMID: 33557083 PMCID: PMC7913784 DOI: 10.3390/jcm10040576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/28/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Chronic stress is associated with increased risk for maladaptive psychological responses during childhood, adolescence, and young adulthood. Adults exposed to chronic stress during childhood exhibit dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity and inflammation. There are no studies examining the impact of stress on biological stress responses and functional impairment in adolescents and young adults early after the onset of a stressor. METHODS The sample consisted of 59 offspring, aged 11-25 years, 33 of parents diagnosed with cancer and 26 controls from families with no cancer or severe chronic illness in parents or siblings. Cancer patients and their families were recruited within an average of 62 days (SD = 35.9) and followed at 6 and 9 months later. Functional impairment was assessed and hair cortisol concentrations (HCC), salivary cortisol, and inflammatory markers were measured. Mixed regression analyses were conducted. RESULTS The stress group showed higher functional impairment (β = -5.5, 95% CI (-10.4, -0.06), p = 0.03, d= -0.40) and HCC (β = 10.5, 95% CI (-5.5, -0.50), p < 0.001, d = 1.43). However, HCC were reduced over time in the stress group (β= -0.3, 95% CI (-0.04, -0.01), p < 0.001, d = -1.08). Higher total cortisol output was associated with increased functional impairment over time (β = -3.0, 95% CI (-5.5, -0.5), p = 0.02, d = -0.60). CONCLUSIONS Parental cancer is associated with early increase in cortisol, which was associated with increased functional impairment in offspring. Clinicians need to assess and monitor psychiatric symptoms and functioning in these offspring early on following parental cancer diagnosis.
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Affiliation(s)
- Benjamin Hayes
- University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA 15213, USA;
| | - Jacob Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA 15213, USA; (J.B.); (D.A.B.)
| | - Yongqi Zhong
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 130 De Soto St, Pittsburgh, PA 15261, USA;
| | - Shervin Bazmi
- Department of Psychology, University of Pittsburgh, 210 South Bouquet Street, Pittsburgh, PA 15260, USA; (S.B.); (A.M.)
| | - Giovanna Porta
- University of Pittsburgh Medical Center (UPMC), 100 N Bellefield Ave, Pittsburgh, PA 15213, USA;
| | - Dana H. Bovbjerg
- UPMC Hillman Cancer Center, 5150 Centre Ave. Pittsburgh, PA 15232, USA; (D.H.B.); (A.T.); (J.M.K.)
| | - Ahmad Tarhini
- UPMC Hillman Cancer Center, 5150 Centre Ave. Pittsburgh, PA 15232, USA; (D.H.B.); (A.T.); (J.M.K.)
| | - John M. Kirkwood
- UPMC Hillman Cancer Center, 5150 Centre Ave. Pittsburgh, PA 15232, USA; (D.H.B.); (A.T.); (J.M.K.)
| | - David A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA 15213, USA; (J.B.); (D.A.B.)
| | - Anna Marsland
- Department of Psychology, University of Pittsburgh, 210 South Bouquet Street, Pittsburgh, PA 15260, USA; (S.B.); (A.M.)
| | - Nadine M. Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA 15213, USA; (J.B.); (D.A.B.)
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Inhestern L, Bultmann JC, Johannsen LM, Beierlein V, Möller B, Romer G, Koch U, Bergelt C. Estimates of Prevalence Rates of Cancer Patients With Children and Well-Being in Affected Children: A Systematic Review on Population-Based Findings. Front Psychiatry 2021; 12:765314. [PMID: 34899425 PMCID: PMC8656299 DOI: 10.3389/fpsyt.2021.765314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
This review assessed population-based estimate rates of cancer patients with minor and young adult children (≤ 25 years), children and young adults having a parent with cancer as well as the psychosocial situation and well-being of children and young adults affected by parental cancer. Eighteen publications on population-based studies were included. Studies varied in the age ranges of both cancer patients and children. The prevalence rates of cancer patients having children ranged from 14 to 24.7% depending on the sample structure (e.g., age, gender). Studies reported that between 1.6 and 8.4% of children resp. young adult children have a parent with a history of cancer. Seven publications reported on the psychosocial situation or well-being in children and young adults affected by parental cancer. Estimate rates of psychosocial problems, psychiatric diagnoses or distress ranged between 2.5 and 34% of children depending on the method of measurement and outcome. The differences in the sample structure between the studies impeded the comparison of prevalence rates. However, the findings help to determine the need for specific support services and health care planning. The results emphazise the importance to routinely include issues on the parental role of patients and questions on the well-being and coping of children into psychooncological care. If necessary, support should be provided to families living with a cancer diagnosis.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Lene Marie Johannsen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Volker Beierlein
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Möller
- Department of Social Work, Münster University of Applied Sciences, Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Münster, Münster, Germany
| | - Uwe Koch
- 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, Greifswald, Germany
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14
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Hammersen F, Pursche T, Fischer D, Katalinic A, Waldmann A. Psychosocial and family-centered support among breast cancer patients with dependent children. Psychooncology 2020; 30:361-368. [PMID: 33137218 DOI: 10.1002/pon.5585] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 03/27/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To evaluate the psychosocial situation of breast cancer (BC) patients with dependent children, with regard to who used family-centered psychosocial support (PS) services, reasons against using it, as well as existing, unmet needs, and current PS need. METHODS Data were collected via survey and patient files during an inpatient rehabilitation program for mothers with BC, who were accompanied by a child <12 years. Descriptive statistics and tests for statistical significance were used. RESULTS Out of the total of 561 patients, 23.0% had used family-centered PS services before. Common reasons against it were enough support, no anticipated need and organizational issues. Patients stated a high number of unmet needs. The most urgent ones related to their children. About 59.3% of mothers stated a current PS need (PSN) and 33.3% a need for their children. Little social support and a worse maternal HRQOL, but not time since diagnosis, were related to a higher PSN in mothers and children (bivariate association). CONCLUSION Among BC patients with dependent children, clinicians need to take the whole family and their support needs into account. They should know about the existing organizational barriers, which need to be overcome with the help of tailored offers. Patients with low HRQOL, little social support and single-mothers (with regard to children's PSN) need special attention as these can be indicators of high PSN.
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Affiliation(s)
- Friederike Hammersen
- Institute for Social Medicine and Epidemiology, University of Luebeck, Lübeck, Germany
| | - Telja Pursche
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Luebeck, Lübeck, Germany.,Department of Gynaecology and Obstetrics, Hospital Dueren gem. GmbH, Düren, Germany
| | - Dorothea Fischer
- Department of Obstetrics and Gynecology, Ernst von Bergmann Clinic, Potsdam, Germany
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Luebeck, Lübeck, Germany.,Institute for Cancer Epidemiology e.V, University of Luebeck, Lübeck, Germany
| | - Annika Waldmann
- Institute for Social Medicine and Epidemiology, University of Luebeck, Lübeck, Germany
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15
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Alexander E, O'Connor M, Halkett GKB. The perceived effect of parental cancer on children still living at home: According to oncology health professionals. Eur J Cancer Care (Engl) 2020; 29:e13321. [PMID: 32902057 DOI: 10.1111/ecc.13321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/28/2020] [Revised: 05/26/2020] [Accepted: 08/07/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE How children are affected by their parent's diagnosis is limited in the literature, and children are typically not considered in current clinical practice. Despite suggestion that the patient's oncology team are well placed to support their children, this is yet to be sufficiently explored. This study aimed to explore how oncology healthcare professionals (HPs) perceive children are affected by a parent's diagnosis of cancer. METHODS This qualitative study was informed by principles of grounded theory and embedded within a social constructivist framework. 15 health professionals working in oncology were interviewed using a semi-structured format. Data were analysed using methods of constant comparison. RESULTS From the perspective of HPs, when a parent is diagnosed with cancer, their dependent children are rendered invisible. Factors within the (a) clinical healthcare system and (b) the families' psychosocial context were identified, which contribute to the invisibility of children. CONCLUSION HPs are well-placed to facilitate an entry point into the healthcare system for patients' children; however, this is not occurring due to children's lack of visibility. Clinical and psychosocial barriers need to be addressed to ensure HPs are visibly aware of all children and thus able to appropriately support, intervene or refer on.
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Affiliation(s)
- Elise Alexander
- Western Australian Cancer Prevention Research Unit (WACPRU), School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Moira O'Connor
- Western Australian Cancer Prevention Research Unit (WACPRU), School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Georgia K B Halkett
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Australia
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16
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Steiner V, Joubert L, Shlonsky A, Hocking A. Australian Hospital-Based Parenting Support for Adults with Incurable End-Stage Cancer: Parent Perspectives. J Evid Based Soc Work (2019) 2020; 17:172-190. [PMID: 33300474 DOI: 10.1080/26408066.2019.1705957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Parenting support needs of patients diagnosed with incurable end-stage cancer (IESC) with young families are not addressed as part of routine hospital health care. Their support needs and experiences of hospital-based parenting support are largely unknown. The study aims to explore hospital-based parenting support delivery from patient and co-parent perspectives in context to their parenting experience and support needs. Exploratory, prospective, cross-sectional qualitative design. Semi-structured in-depth interviews with eight adult patients with IESC and four co-parents purposively recruited from a tertiary hospital in Melbourne, Australia. Findings were thematically analyzed. Parents desire support with challenging multidimensional parenting issues. Organization, health professionals (HP), and parental-based factors hinder and facilitate optimal service provision. Responsibility rests with HP to initiate parenting support. Interdisciplinary family-focused support offered throughout IESC health-care journey is key. Patient-centered family-focused support is warranted. Surmountable challenges lie with management and HPs to address barriers affecting optimal service delivery.
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Affiliation(s)
- Vera Steiner
- Department of Social Work, University of Melbourne, Parkville, VIC, Australia
| | - Lynette Joubert
- Department of Social Work, University of Melbourne, Parkville, VIC, Australia
| | - Aron Shlonsky
- Department of Social Work, Monash University, Caulfield East, VIC, Australia
| | - Alison Hocking
- Department of Social Work, University of Melbourne, Parkville, VIC, Australia
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17
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Marcussen J, Hounsgaard L, Bruun P, Laursen MG, Thuen F, Wilson R. The Divorced Family-Focused Care Model: A Nursing Model to Enhance Child and Family Mental Health and Well-Being of Doubly Bereaved Children Following Parental Divorce and Subsequent Parental Cancer and Death. J Fam Nurs 2019; 25:419-446. [PMID: 31387426 DOI: 10.1177/1074840719863918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The experience of parental death concomitant with parental divorce occurs for 46% of Danish children and 50% of American children who lose a parent to death. This experience of loss and double bereavement compounds increased risk of mental health problems. The aim of this study was to explore nursing interventions for double bereaved children that promoted their well-being. A phenomenological-hermeneutic approach was used to conduct 20 interviews with nurses in family cancer care. Ricoeur's theoretical framework was followed with naïve reading, structural analysis, and critical interpretation, resulting in the formulation of a new model of nursing care for these children: the Divorced Family-Focused Care Model. Four themes were apparent: (a) collection of information about family structure, (b) assessment of support needs, (c) initiation of well-being support, and (d) coordination and follow-up focused on the child's well-being. The new intervention model has implications for health care education and implementation of health care policies.
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Affiliation(s)
- Jette Marcussen
- 1 University of Southern Denmark, Odense, Denmark
- 2 University College Lillebaelt, Odense, Denmark
| | - Lise Hounsgaard
- 1 University of Southern Denmark, Odense, Denmark
- 2 University College Lillebaelt, Odense, Denmark
- 3 University of Greenland, Nuuk, Greenland
| | - Poul Bruun
- 2 University College Lillebaelt, Odense, Denmark
| | | | | | - Rhonda Wilson
- 1 University of Southern Denmark, Odense, Denmark
- 5 University of Canberra, Australia
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18
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Denzinger A, Bingisser MB, Ehrbar V, Huggenberger HJ, Urech C, Woessmer B, Gaab J, Roth B, Rochlitz C, Alder J. Web-based counseling for families with parental cancer: Baseline findings and lessons learned. J Psychosoc Oncol 2019; 37:599-615. [PMID: 31010412 DOI: 10.1080/07347332.2019.1602576] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: This is the first study in Switzerland to report on psychological adjustment in children of a parent with cancer using a web-based intervention during cancer therapy. Design/Sample: Twenty-two families participated in this randomized controlled web-based intervention program. Methods: Quality of life and emotional-behavioral well-being of children were examined using child self-reports, and parent proxy-reports. Furthermore, family communication and satisfaction and feedback on the web-based program were assessed. Findings: Children's first stage adjustment to parental cancer did not show detrimental patterns. The "lesson learned" in this setting emphasizes the challenge to reach families in need. The web-based program was appreciated as an additional source of information and support in this mostly highly functioning population. Conclusion: While feasibility was shown, it remains unclear how to contact families with lower psychosocial functioning.
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Affiliation(s)
- Anna Denzinger
- Department of Obstetrics and Gynaecology, University Hospital Basel , Basel , Switzerland
| | | | - Verena Ehrbar
- Department of Obstetrics and Gynaecology, University Hospital Basel , Basel , Switzerland
| | - Harriet J Huggenberger
- Department of Obstetrics and Gynaecology, University Hospital Basel , Basel , Switzerland
| | - Corinne Urech
- Department of Obstetrics and Gynaecology, University Hospital Basel , Basel , Switzerland
| | - Brigitta Woessmer
- Division of Psychosomatic, Department of Internal Medicine, University Hospital Basel , Basel , Switzerland
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel , Basel , Switzerland
| | - Binia Roth
- Child and Adolescent Psychiatry of Baselland , Bruderholz , Switzerland
| | | | - Judith Alder
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel , Basel , Switzerland
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19
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Hauken MA, Dyregrov K, Senneseth M. Characteristics of the social networks of families living with parental cancer and support provided. J Clin Nurs 2019; 28:3021-3032. [PMID: 30941831 DOI: 10.1111/jocn.14859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/15/2018] [Revised: 02/04/2019] [Accepted: 03/23/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To examine the characteristics of the social networks of families living with parental cancer and the kind of social support they provide compared with what the families report having received. BACKGROUND Parental cancers are highly distressing for both parents and children. Among other concerns, families report a severe lack of social support. However, we know little about these families' private social networks, nor support provided and received as reported by network members and the family. METHODS Using a descriptive cross-sectional design, 16 families living with parental cancer and 130 of their network members participated. Healthy parents and network members filled out The Assistance Questionnaire-Receivers of support (AQR)/The Assistance Questionnaire-Providers of Support (AQP). RESULTS Network members were mainly resourceful friends (44%) and family members (42%). Only 1/3 became supporters at diagnosis, and nearly 50% had to be asked. Supporters provided a variety of types of help, especially emotional support. A match between the perception of the healthy parent and that of the network members was found for provided (p = 0.211) and received (p = 0.741) support. Supporters were satisfied with their provided support, experiencing it as rewarding and associated with few negative aspects. The STROBE checklist for observational studies was followed in reporting the results. CONCLUSIONS The social networks, being mainly family and friends, were able to provide different types of help, especially emotional support. A useful suggestion may be to involve supporters at an earlier stage, providing more practical support. RELEVANCE FOR CLINICAL PRACTICE Nurses are in a unique position to promote social support for families living with parental cancer by embracing a network focus, by emphasising the importance and potential of social support, by helping families to map their network and by teaching them how to be explicit in their requests for support.
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Affiliation(s)
- May Aasebø Hauken
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Kari Dyregrov
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Mette Senneseth
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.,Centre for Research and Education in Forensic Psychiatry, Haukeland University, Bergen, Norway
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20
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McPhail C, Dwyer JJM, Hanemaayer R, Preyde M. The experience of parental cancer among emerging adult university students. J Psychosoc Oncol 2016; 35:202-219. [PMID: 28010678 DOI: 10.1080/07347332.2016.1275918] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cancer is a disease that can have negative as well as some positive outcomes for the survivor, caregiver, and offspring. To date, there has been little research on the experiences of emerging adult offspring. When these offspring are also university students, they can experience unique challenges. In this phenomenological study, we explored the lived experience of parental cancer among emerging adult university students by interviewing 17 university students and using thematic analysis. The overarching themes were perceptions and beliefs about cancer, the outcomes of having a parent with cancer, influence of parental cancer on life as a university student, coping with having a parent with cancer, and attitudes and experiences around health and personal lifestyle. These results will be particularly useful to practitioners who provide services to university students experiencing parental cancer.
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Affiliation(s)
- Christine McPhail
- a Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
| | - John J M Dwyer
- a Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
| | - Rebecca Hanemaayer
- a Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
| | - Michèle Preyde
- a Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
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21
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Hauken MA, Senneseth M, Dyregrov A, Dyregrov K. Optimizing Social Network Support to Families Living With Parental Cancer: Research Protocol for the Cancer-PEPSONE Study. JMIR Res Protoc 2015; 4:e142. [PMID: 26733339 PMCID: PMC4712344 DOI: 10.2196/resprot.5055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/02/2015] [Indexed: 11/13/2022] Open
Abstract
Background Parental cancer can have a significant impact on a family's psychosocial functioning and quality of life, whereby the children’s situation is strongly related to parental coping and capacity. Such parents ask for more help in order to increase their care capacity, while the network is often insecure about how to help and thereby withdraw. They ask for guidance and training to be able to support cancer families. Based on this, the Cancer- Psycho-Educational Program for the SOcial NEtwork (PEPSONE) study was developed. Objective To optimize social network support through a psycho-educational program for families living with parental cancer and their network members in order to increase parental capacity and thereby secure the children’s safety and quality of life. Methods A randomized controlled trial (RCT) in which families (N=60) living with parental cancer will be randomized to either an intervention group or a control group. The intervention will last for 3 hours and includes (1) introduction, (2) psycho-education (living with cancer in the family and the importance of social network support), and (3) discussion (this family’s need for social support). Primary outcomes are social support, mental health, and quality of life, and secondary outcomes are resilience and parental capacity. Data will be collected by a set of questionnaires distributed to healthy parents (N=60) living with a partner with cancer, one child in the family between 8-18 years of age (N=60), and network members (N=210) of the intervention families at inclusion, and after 3 and 6 months. Comparing differences between the intervention group (n=30) and the control group (n=30), the power analysis shows that P<.05 and a statistical power = .80 would detect effect sizes of clinical interest. Results This paper presents the Cancer-PEPSON study’s protocol to provide a broader understanding of the background and content of the program. The study is ongoing until August 2016 and the first results are anticipated to be finished by November 2015. Conclusions To our knowledge, this will be the first RCT study to optimize social network support through a psycho-educational program for families living with parental cancer and their network members, as well as provide an evidence basis for social network support. The results may provide important knowledge that is useful for clinical practice and further research. The trial is reported according to the CONSORT checklist. ClinicalTrial International Standard Randomized Controlled Trial Number (ISRCTN): 15982171; http://www.controlled-trials.com/ISRCTN15982171/15982171 (Archived by WebCite at http://www.webcitation.org/6cg9zunS0)
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22
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Abstract
BACKGROUND Parental cancer is a stressful experience for young people, constituting a potential threat to physical and mental health and normative development. Currently, there is insufficient information describing the sources and nature of this distress during advanced parental cancer, especially concerning families with adolescent children. AIM To address the significant gap in the literature by providing the adolescent's perspective on the impact of their parent's advanced cancer on their lives. DESIGN This qualitative study involved single-occasion, semi-structured elicitation interviews with adolescents whose parents were diagnosed with advanced stage cancer. SETTING/PARTICIPANTS The study sample consisted of seven adolescents from six families, five females and two males ranging in age from 11 to 15 years (mean = 13.6 years, standard deviation = 1.4 years). The ill parents consisted of four females and two males diagnosed with Stage IV cancer. RESULTS The core construct that organized study results was Weaving a Normal Life with Cancer which involved five major domains: feeling the weight of the world on my shoulders; cancer changes everything; confronting or getting away from the cancer; talking about it; and cancer was a positive for me … it taught me. CONCLUSION Study findings shed light on how adolescents self-manage their parent's advanced cancer and work to delimit the illness even as they are aware of its constant presence. Future research and intervention studies are needed to support and add to the adolescents' self-management strategies to weave a normal life for themselves while in the throes of the cancer's uncertainty and challenges with family communication.
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23
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Jeppesen E, Bjelland I, Fosså SD, Loge JH, Sørebø O, Dahl AA. Does a parental history of cancer moderate the associations between impaired health status in parents and psychosocial problems in teenagers: a HUNT study. Cancer Med 2014; 3:919-26. [PMID: 24723456 PMCID: PMC4303159 DOI: 10.1002/cam4.245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/22/2013] [Revised: 02/27/2014] [Accepted: 02/27/2014] [Indexed: 11/15/2022] Open
Abstract
Severe disease in a parent is associated with increased psychosocial problems in their children. However, moderating factors of such associations are less studied. In this cross-sectional population-based controlled study we examined the moderating effects of a history of parental cancer on the association between impaired health status in parents and psychosocial problems among their teenagers. Among families with both parents responding to the adult Health Survey of Nord-Trøndelag County of Norway (the HUNT-2 study) 71 couples were identified with primary invasive cancer in one parent. Their 81 teenage children took part in the Young-HUNT study. These families were compared to 322 cancer-free families with 328 teenagers. Based on self-report data the relations between three variables of parental impaired health and six psychosocial problems in teenagers were analyzed family wise by structural equation modeling. Significant associations between parental and teenagers' variables were observed in eight of 18 models. A history of parental cancer was a significant moderator which decreased four of eight significant associations. Such a history significantly weakened the associations between parental poor self-rated health and teenagers' anxiety/depression and school problems. A similar association of a history of parental cancer was found between psychological distress in parents and teenagers' feelings of loneliness and poor self-rated health. This study confirmed strong associations between impaired parental health and psychosocial problems in their teenagers. A history of parental cancer weakened several of the significant associations between parental impaired health variables and psychosocial problems in their teenagers.
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Affiliation(s)
- Elisabeth Jeppesen
- National Resource Center for Late Effects, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway; University of Oslo, Oslo, Norway
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24
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Teixeira RJ, Pereira MG. Psychological morbidity, burden, and the mediating effect of social support in adult children caregivers of oncological patients undergoing chemotherapy. Psychooncology 2012; 22:1587-93. [PMID: 22972765 DOI: 10.1002/pon.3173] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [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: 04/05/2012] [Revised: 07/16/2012] [Accepted: 08/15/2012] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This study examines the association between psychological morbidity, social support, and demographic and clinical variables in adult children of cancer patients undergoing chemotherapy. Special attention was given to the variable level of parental dependency. The main predictors of caregiving burden were tested, as well as the mediating role of social support in the relationship between psychological morbidity and burden. METHODS A total of 214 adult children caregivers of parents with cancer were recruited in Northern Portugal central hospitals. Caregivers completed Portuguese versions of the Depression Anxiety and Stress Scales, Impact of Event Scale-Revised, Satisfaction with Social Support Scale, and Burden Assessment Scale. RESULTS Significant associations among psychological, demographic, and clinical variables were found. Adult children with a greater perception of parent's dependency showed more distress, higher posttraumatic stress disorder (PTSD) symptoms, greater caregiving burden, and less satisfaction with social support. Hierarchical regression analyses revealed the main predictors of caregiver burden to be as follows: being a woman, caregiving duration, having a dependent parent, more distress and PTSD symptoms, and poorer social support. Social support was found to be a partial mediator in the relationship between psychological morbidity and caregiver burden. CONCLUSIONS Results underscore the importance of perceived parental dependency in offspring's caregivers. Findings support the multidimensional issues associated to burden in this specific population, stressing satisfaction with social support as an important mediator between distress/PTSD and burden. Implications for further research as well as limitations of the present study are discussed. Psychosocial interventions should focus on caregivers' social resources to facilitate psychological well-being.
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25
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Abstract
Background Today many people are choosing to have children later in life. Additionally, the use of sophisticated diagnostic tools and screening modalities has increased over recent years. Because of these factors, cancer is being diagnosed more frequently during the child-rearing years. Sociodemographic and cancer-related information on families and minor (0–18 years) and young adult (YA) (19–25 years) children experiencing parental cancer is scarce, but this information is vital for healthcare initiatives aimed toward those potentially adversely affected. Therefore, the aim of this study was to describe features of families and minor and YA children affected by parental cancer in a nationwide population. Methods Complete Norwegian birth cohort data were obtained from national registries. Descriptive prevalence and incidence statistics were collected for parents and minor and YA children. Logistic regression models were used to assess factors likely to influence parental death. Results Every year around 0.3% of all families with children under the age of 18 years encounter parental cancer, and 3.1% of minors and 8.4% of YAs have a parent who has been diagnosed with cancer. This study found skin, breast, testicular, and colorectal cancers were the most common forms of cancer diagnosed. The sociodemographic features of those affected were fairly similar to those of the general population. One in five children experienced parental death from cancer; parental death was more often paternal than maternal and was most common in parents diagnosed with leukemia or brain, colorectal, and lung tumors. Deaths are uncommon among parents without cancer. Conclusion Adequate assistance for minor and YA children affected by parental cancer requires knowledge of their number and characteristics. Parental cancer is more common than previously suggested: the annual incidence of parental cancer for children under 18 years of age is 0.3%, whereas approximately 4% of children aged 0–25 years have or have had parents diagnosed with cancer, corresponding to a population prevalence of 1.4%. Around 20% of these children experience parental death, and surveys of live respondents should account for this.
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Gazendam-Donofrio SM, Hoekstra HJ, van der Graaf WT, Pras E, Visser A, Huizinga GA, Hoekstra-Weebers JE. Quality of life of parents with children living at home: when one parent has cancer. Support Care Cancer 2008; 16:133-41. [PMID: 17609990 PMCID: PMC2206248 DOI: 10.1007/s00520-007-0299-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Accepted: 06/11/2007] [Indexed: 11/27/2022]
Abstract
GOALS OF WORK This study examined the quality of life (QoL) of cancer patients diagnosed 1-5 years previously and their spouses, with children 4-18 years living at home. Relationships between parents' QoL and the children's functioning were explored. PATIENTS AND METHODS 166 cancer patients and their spouses provided information on their QoL (RAND-36) and on their children's functioning (Child Behavior Checklist). MAIN RESULTS Male and female patients scored similarly to a norm population on five domains. Patients' QoL was clinically relevantly and/or statistically lower on social functioning, role limitations because of physical problems, and vitality than the norm. Male spouses' QoL was comparable to the norm. However, female spouses reported better physical functioning but more social problems. QoL varied according to type of cancer, treatment intensity, and recurrence. Using the QoL composite scores, a significant relationship was found between patients' psychosocial and physical functioning and spouses' psychosocial functioning. Patients' psychosocial functioning correlated moderately strongly to weakly with their reports of their younger children's and adolescents' functioning; physical functioning correlated only weakly with adolescents' functioning. The patients' functioning related weakly to moderately strongly to adolescents' self-reports of functioning. Spouses' psychosocial functioning weakly related to their and adolescents' reports of adolescents' functioning. CONCLUSIONS Cancer patients' QoL 1-5 years after diagnosis was decreased in three of eight domains; their spouses seem to be doing well. Parents' physical and psychosocial functioning related weakly to moderately strongly to their children's functioning, depending on the child's age and information source. The patients' functioning related more strongly to the children's functioning than the spouses' did.
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Affiliation(s)
- Stacey M. Gazendam-Donofrio
- Wenckebach Institute, University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands
| | - Harald J. Hoekstra
- Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Elizabeth Pras
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Annemieke Visser
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gea A. Huizinga
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Josette E.H.M. Hoekstra-Weebers
- Wenckebach Institute, University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Comprehensive Cancer Center North-Netherlands, Groningen, The Netherlands
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