Objective
The purpose of this study was to test the efficacy of a cancer parenting program for child-rearing mothers with breast cancer, the Enhancing Connections Program. Primary goals were to decrease maternal depressed mood and anxiety, improve parenting quality, parenting skills and confidence, and enhance the child’s behavioral-emotional adjustment to maternal breast cancer.
Method
A total of 176 mothers diagnosed within 6 months with Stage 0–III breast cancer and their 8–12 year old child were recruited from medical providers in 6 states: Washington, California, Pennsylvania, Minnesota, Arizona and Indiana. After consenting and obtaining baseline measures, study participants were randomized into experimental or control groups. Experimental mothers received five, 1-hour educational counseling sessions at 2- week intervals; controls received a booklet and phone call on communicating and supporting their child about the mother’s cancer. Outcomes were assessed at 2 and 12 months.
Results
Compared to controls, at 2 months experimental mothers significantly improved on depressed mood and parenting skills; experimental children improved on behavioral-emotional adjustment: total behavior problems, externalizing problems, and anxiety/depressed mood significantly declined. At 1 year, experimental children remained significantly less depressed than controls on both mother- and child-reported measures. The intervention failed to significantly affect parenting self-efficacy or maternal anxiety.
Conclusions
The Enhancing Connections Program benefitted mothers and children in specific areas and warrants refinement and further testing.
The purpose of this concept analysis of good death was to examine the attributes of a good death and explore the changes of the concept over time and its impact on terminally ill patients. The method used for this analysis was the Rodgers' evolutionary method. A literature search was completed using Medline Ovid and Journal Storage (JSTOR).The findings describe the evolution of the good death concept over time from the prehistoric era followed by premodern, modern, and postmodern times. In addition, information is presented about surrogate terms, attributes, antecedents, and consequences associated with good death followed by analysis and discussion of the findings. General attributes of a good death include pain and symptom management, awareness of death, patient's dignity, family presence, family support, and communication among patient, family, and health care providers.
Targeted assessment of caregivers' needs is important in the three dimensions of the study domains. Clinicians who work with caregivers of patients with cancer should offer direct support because caregivers cope with the care of their loved one and struggle with their own distress and with maintaining normal family life. Findings suggest the importance of offering psychosocial support to caregivers and providing guidance to caregivers for support of their children and families.
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