I’m Still Mom: Young Mothers Living With Advanced Breast Cancer (original) (raw)

When a parent has cancer: challenges to patients, their families and health providers

Expert Review of Pharmacoeconomics & Outcomes Research, 2012

At least 14% of cancer patients live with minor children. Being a parent with cancer has far-reaching consequences for individual treatment decision-making and quality of life in patients and their families. Even though the majority of children and adolescents do not show clinically relevant symptoms of psychopathology, worries about the survival of the parent and the future development of the family are present, and experienced as distressing, in most children. Open communication by parents and clinicians has been found to be of major importance for children and adolescents in adjusting to parental cancer. Support for parents with cancer on relevant parenting issues, starting in the diagnostic phase, should be acknowledged as an important facet of cancer care to reduce the psychosocial burden for cancer patients and their families.

Parenting changes in adults with cancer

Cancer, 2015

Children whose parents have cancer are at risk for psychosocial difficulties; however, the mechanisms are not well understood. This cross-sectional study sought support for a model connecting parental cancer to child distress through its impact on parenting self-efficacy beliefs and parenting behaviors by examining relations among parental illness, quality of life/parent functioning, parenting efficacy beliefs, and concerns about children's emotional distress. One hundred ninety-four adult oncology outpatients with children who were 18 years old or younger completed questionnaires assessing their health-related quality of life (Functional Assessment of Cancer Therapy-General), depression and anxiety symptoms (Hospital Anxiety and Depression Scale), overall distress (Distress Thermometer), and parenting efficacy beliefs and parenting concerns (Parenting Concerns Questionnaire). Parenting efficacy scores for parents and coparents declined significantly after diagnosis. This declin...

Psychosocial Interventions for Parents with Incurable End‐Stage Cancer: A Rapid Evidence Assessment

Australian Psychologist, 2017

Parenting is a primary concern for patients with minor children facing palliative-stage cancer, yet psychosocial support addressing parenting concerns during end-stage cancer is not routinely provided in the healthcare setting. The purpose of this review is to: (a) identify evaluation studies describing psychosocial interventions for parents with incurable end-stage cancer; and (b) review the effectiveness evidence. Method: This review was based on a rapid evidence assessment using transparent and comprehensive search terms and narrative synthesis. Inclusion criteria were broad and consisted of qualitative, quantitative, and mixed method studies that focused on psychosocial interventions for parents with advanced cancer. Results: Four studies were identified, but only one of these reported results specific to parents with end-stage cancer. A child-centred and family-focused approach was central to all program interventions. All programs encompassed a structured format with the majority being dedicated to providing both individual and family sessions. The studies varied in methodological quality and all used small, nonrepresentative samples limiting the generalisability of the findings. There were no high quality quantitative studies that specifically address outcomes for this parent group and few qualitative studies that detail parents' intervention experience. Conclusions: The findings suggest that targeted, child-centred, family-focused psychosocial interventions are sometimes used to support adult patients with parenting during end-stage cancer. These purport to promote child-parent communication and to contribute to parent psychosocial wellbeing. Further research using larger parent populations from diverse sociodemographic backgrounds is required. More importantly, comparative effectiveness studies are needed that test the timing, delivery, and content of these interventions.

Changes in Parents After the Death of a Child From Cancer

Journal of Pain and Symptom Management, 2012

Context. Few studies have compared multiple perspectives of changes experienced by parents after a child's death. Objectives. This study used interviews with bereaved parents and siblings to examine changes in parents during the first year after the death of a child from cancer. Methods. Mothers (n ¼ 36), fathers (n ¼ 24), and siblings (n ¼ 39) from 40 families were recruited from three hospitals in the U.S. and Canada three to 12 months after the death (M ¼ 10.7, SD ¼ 3.5). Semistructured interviews with open-ended questions were conducted in the home with each participating parent and sibling separately. Content analysis identified emerging themes, and frequencies were compared between each paired set of reports (mother vs. sibling, father vs. sibling, and mother vs. father). Results. Parents and siblings identified two major categories of change experienced by bereaved parents. These changes occurred in their personal lives (e.g., emotions, perspectives and priorities, physical state, work habits, coping/ behaviors, spiritual beliefs, and feeling something is missing) and relationships (e.g., family, others). Ninety-four percent of the mothers, 87% of the fathers, and 69% of the siblings reported parental changes in at least one of these categories. Parents were more likely to report changes in priorities, whereas siblings reported more sadness in parents after the death. Conclusion. Positive and negative changes in parents after the death of a child from cancer occur in both personal and relational domains. Additional research is needed to determine the impact of a child's death on bereaved parents over time and to develop strategies to promote healthy adjustment. J Pain Symptom Manage 2012;44:572e582.

Families in the Shadow of Cancer

2008

The aims of this study were 1) to clarify the factors associated with family functioning in cancer patient's families with dependant children, 2) to examine children' mental health when they are exposed to parental cancer, 3) to explore the subjective experience of having cancer during pregnancy, and finally, 4) to describe the implementation of a childcentred family intervention for cancer patients' families with dependant children in an adult oncology setting. The study groups were collected between May 1 st 2002 and April 30 th 2004. They consisted of one European group collected from six different countries (N = 381) and two Finnish clinical groups (N = 85 and N = 2). The first Finnish clinical group of 85 cancer patient families with dependant children included a sub-sample of 54 families with children aged 11-17 years. The second Finnish clinical group consisted of two pregnant cancer patients. Additionally, a control group (N = 59) consisting of a sub-sample of 49 families with children aged 11-17 years was used. Quantitative methods (FAD, BDI, YSR, SOC, SF-8) and qualitative methods (observation, interviews, diaries, videotapes) were used exclusively and/or in combination. The results can be summarised as follows: 1) cancer "per se " did not impair family functioning, children's mental health, early interaction between ill mothers and their infant, 2) maternal depression or the ill parent's depression were significantly associated with impairment in family functioning, 3) the individual's good sense of coherence was associated with improvement in family functioning, and 4) a child-centred family intervention, which aims to give space for elaborating on cancer in the family, validates the sense of coherence and children's feelings, and promotes open communication was welcomed. It is important to note that in the European study group, the prevalence of depression was 35 % (BDI > 16) among ill mothers, and 28% among healthy mothers, 28% among ill fathers, and 13% among healthy fathers. Early screening and effective treatment of depression in cancer patients and their partners is of paramount importance for the mental health of children and the well-being of the family. Pregnant cancer patients are in need of psychosocial support.

Development of a resource for parents with advanced cancer: what do parents want?

ABSTRACT Objective: Parents coping with a diagnosis of advanced cancer experience distress and guilt about the impact of the disease on their children but report that there are few resources specific to advanced disease to guide and support them in discussions with their children. Although some resources have been developed to assist parents with advanced cancer, it appears that these are not widely disseminated. Methods: To determine the need for a brief resource that could be given to parents at the point of diagnosis of advanced cancer, including its content, in-depth interviews were conducted with eight women with advanced breast cancer. Results: Women confirmed that they had received minimal assistance from health professionals in discussing the diagnosis with their children, and even when professional counselors were accessed they were not always attuned to the specific needs of parents with advanced cancer. Women felt frustrated that information they did access focused on early disease and lacked the details women felt they needed in coping with advanced cancer. Women felt that there was a need for a brief resource that reassured parents about the impact of the cancer on their children, including practical strategies to help them cope and examples of the ways other parents had responded to difficult questions such as about parental death. A draft resource was developed, critically reviewed by the participants, and their comments incorporated into a final version. Significance of results: This article expands on the themes highlighted by women as important to assist parents with advanced cancer, including the final resource that was developed. KEYWORDS: Advanced cancer, Parents, Children, Information