Parents of children diagnosed with cancer are at high risk for distress and can have difficulties in problem-solving. Interventions have been implemented to increase parents’ problem-solving skills and decrease emotional turmoil. However, we don’t know to what extent problem-solving skills may contribute to emotional distress. We aimed to (1) assess the contribution of problem-solving skills and perceived competence to emotional distress, and (2) explore the differences between mothers and fathers in this contribution.
Ninety-nine parents (56 mothers and 43 fathers) of childhood cancer patients filled-out questionnaires on problem-solving skills (SPSI-R), perceived competence to face cancer (PCS adapted), mood disturbance (POMS-SF) and perceived stress (PSS), one year after the end of treatments. Multiple regression analysis was used to estimate the unique contribution of problem-solving skills and perceived competence to emotional distress. Models were secondarily compared in mothers and fathers separately.
Mothers had significantly higher levels of perceived stress compared to fathers. No significant differences were observed on others measures. Low problem-solving skills and perceived competence to face cancer were significantly associated with higher levels of mood disturbance and perceived stress in both mothers and fathers. These variables contributed significantly and respectively to 26% and 45% variation in mood disturbance and perceived stress. Sex only contributed to mood disturbance (p<.05).
Parents' distress, particularly perceived stress, probably depends heavily on problem-solving skills and perceived competence. These results support the need to enhance problem-solving skills in parents of children treated for cancer and improve sense of control to further optimize emotional adjustment.
For around 30 years, BC Cancer has offered a support group for kids aged 5-12 with a family member living with cancer. The group includes art therapy, counseling for parents, and an educational lesson on cancer and treatments for children.
Resources for children older than 12 have also been developed, but prior to this group no supports were available for families with children younger than five--besides a parents guide for communicating about cancer.
The idea for this group was proposed by three young parents who attending a Young Adults Group at BC Cancer.
The pilot Parent – Tot Group ran in April 2019. It included a time of free play, a circle time including songs and a story, and an art activity for children to participate in with parental support. Coffee and healthy snacks were also offered.
The environment was informal and parents weren’t required to share anything about their cancer.
All five of the families who attended the pilot expressed the desire to attend again and have it become available for more young families. Two more group sessions are planned. Feedback from each group will be compiled and the structure will be formalized for the group beginning in the Fall of 2019.
A thorough review of the research and current services available to young families has yet to be done, but it seems like there is a demand for services for this population. Given the success of the pilot group, we expect this to become an ongoing group.
Children living with parental cancer are vulnerable to distress and developmental disruption. However, much of the research regarding intervention efficacy focuses on parents’ perspectives. This review aims to identify current interventions available to support patients’ children and summarise how effective these are based on children’s reports.
Between 25 May 2015 and 6 August 2018, a broad search strategy was used to identify relevant references. Seven databases were searched, and grey literature was also vetted. This review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane guidelines. A quality rating tool developed by Keim-Malpass and colleagues was used to appraise studies.
Eight studies evaluating six interventions were retained. Research designs and interventions were heterogenous, and study quality was low. A limited number of significant results were reported by studies. These evidenced improvement for symptoms of Post Traumatic Stress Disorder, emotional regulation, and depression. However, overall current interventions are not yet effective at supporting patients' children.
While findings are encouraging, current interventions are not yet effective at adequately supporting patients’ children and there is a need for more tailored and targeted intervention. A theoretical model conceptualising the impact of parental cancer may assist this.
Findings will assist future intervention research by promoting standardised levels of care among cancer patients’ children, that is empirically supported, effective, and meets principles of non-maleficence.
Purpose: With the aging of the population, more and more older cancer patients will be taken care of at home by spousal caregivers. It is accepted that in general spousal caregivers are supporting the patients often at the expense of their own physical and emotional health. Nevertheless, little is known about the quality of life specifically among spousal caregivers of older cancer patients. The aim of the current study is to explore the variables related to emotional toll of spousal caregivers for cancer patients aged 65 – 85 year
This study surveyed 242 spousal caregivers of patients ≥65 years old , diagnosed with cancer, treated with curative or palliative intent, and within 6 months of treatment at enrollment. Measures included: Depression measure (Geriatric Depression Scale); Distress (Distress Thermometer) and; Social support (The Cancer Perceived Agents of Social Support). Logistic regression analyses were used in order to identify predictor of clinical depression and distress.
Among the caregivers the frequency of clinical depression and distress was 16.5% and 28% respectively. Higher levels of spousal support (support from the patients) and of friends were associated with lower levels of depression and distress. Interestingly, increasing patient age was also associated with reduced levels of caregiver depression.
Clinicians can utilize the fact that caregiver’s perceived spousal support may have a positive effect on caregivers' levels of depression. Older patients may be encouraged to support their own caregivers. thus, empowering both older patients and their spousal caregivers to confront the challenges of cancer treatment into advanced age.
Pancreatic cancer (PC) is a stressful condition for patients and their partners as the patients have a dismal prognosis. The primary aim of the study was to investigate the risk of depression, anxiety and insomnia in partners of PC patients.
We used nationwide registries in a retrospective cohort study to examine the partners’ use of psychotropic medication as a symptom proxy for depression, anxiety and insomnia. We followed 5,840 partners from 2000-2016 and compared them to an age-matched control cohort of 59,763 partners without a cancer diagnosis. The cumulated probability of psychotropic medication during the first two years of follow-up was estimated. Cox proportional hazard models were used to estimate hazard ratios (HRs) of the first prescription of psychotropic medication. We adjusted for socioeconomic positions.
We found an increased cumulated probability risk of first-time medication against depression, anxiety and insomnia during two years in PC partners compared to controls. Use of antidepressants were increased up to 5 years after diagnosis (HR 1.24, 95% CI 1.05-1.46). The use of anxiolytics (HR 1.57, 95% CI 1.27;1.95) and hypnotics (HR 1.95, 95% CI 1.64; 2.32) was increased up to 2 years after diagnosis.
To our knowledge this is the first study to demonstrate the substantial psychological burden as a partner to a PC patient. Interventions to reduce psychological symptoms in partners warrant attention in clinical practice and future research.
The typically late stage diagnosis and frequent recurrences of ovarian cancer (OC) present unique challenges for patients’ caregivers. Evidence suggests that the relationship these caregivers have with the patients’ healthcare providers (HCP) can influence symptoms of depression and anxiety (DA). As attachment insecurity is known to predict DA in the general population, we are investigating the role of attachment to understand the connection between the HCP relationship and DA. We hypothesize that the connection between attachment and DA will be mediated by the HCP relationship.
We designed a cross-sectional, correlational questionnaire study. To achieve adequate power, we proposed a target sample of 118 participants (n=29 recruited by March 2019). We recruited partner-caregivers through Ovarian Cancer Canada, various Canadian cancer support centres, and in gynecology-oncology clinics in Kingston and Toronto. Our questionnaires measured: sociodemographic and OC patient medical information; OC patient quality of life; attachment security; perceived attention from HCP; and symptoms of DA. Hypotheses will be tested using linear regression analyses and Bootstrapping.
This presentation will provide preliminary results including descriptive statistics, correlations between attachment and DA, and results testing our mediation model. We will discuss some of the methodological challenges that arose.
This study will highlight how the HCP can influence the partner’s DA and further the discussion of how caregivers should be integrated into cancer treatment centres. It will provide a potential area of focus when working clinically with these partners who may have difficulty managing DA-related symptoms throughout the patient’s cancer trajectory.
Identifying factors associated with interpersonal coping following friends’ cancer disclosure in the general population.
A cross-sectional internet survey was conducted among the Japanese general population without a history of cancer. A total of 1,076 adults completed 1) the Cancer Attribution Scale, 2) the Cancer Stereotype Scale 3) the Emotional Reaction Scale, 4) the Interpersonal Coping Scale, 5) the Cancer Knowledge Scale, 6) the Illness Perception Questionnaire Causes, 7) the Kessler Psychological Distress Scale, 8) the Minnesota Multiphasic Personality Inventory L-scale, and 8) demographic characteristics. Data from 925 participants were eligible for statistical analysis.
Participants’ average age was 47.2 (±11.3), 65% were male, and 57% had known people (friends, families, or colleagues) with cancer. Hierarchical multiple regression revealed that being male (β = −0.106, 95% CI −5.081–−1.783), perceiving cancer as caused by patients’ psychological factors (β = −0.138, 95% CI 0.363–0.900), psychological distress (β = 0.103, 95% CI 0.170–0.495), attributing responsibility and controllability of cancer to patients (β = 0.291, 95% CI 0.604–0.908), and negative emotional reactions toward friends with cancer (β = 0.307, 95% CI 0.653–0.955) were associated with reduced empathic coping. Interactions between attributions and negative emotional reactions were observed (β = 0.105, 95% CI 0.021–0.060).
Attribution and negative emotional reactions were associated with less empathic coping. Psychoeducational programs should reduce stigma by emphasizing causes of cancer (rather than personal responsibility and controllability of cancer) and managing negative emotional reactions following friends’ cancer disclosure.