Background: In 2018, >75,000 children were newly affected by the diagnosis of advanced cancer in a parent. Unfortunately, few programs exist to help parents and their children manage the impact of advanced disease together as a family. The Enhancing Connections-Palliative Care (EC-PC) parenting program was developed in response to this gap. Objective: (1) Assess the feasibility of the EC-PC parenting program (recruitment, enrollment, and retention);(2) test the short-term impact of the program on changes in parent and child outcomes; and (3) explore the relationship between parents' physical and psychological symptoms with program outcomes. Design: Quasi-experimental two-group design employing both within-and between-subjects analyses to examine change over time and change relative to historical controls. Parents participated in five telephonedelivered and fully manualized behavioral intervention sessions at two-week intervals, delivered by trained nurses. Behavioral assessments were obtained at baseline and at three months on parents' depressed mood, anxiety, parenting skills, parenting self-efficacy, and symptom distress as well as children's behavioralemotional adjustment (internalizing, externalizing, and anxiety/depression). Subjects: Parents diagnosed with advanced or metastatic cancer and receiving noncurative treatment were eligible for the trial provided they had one or more children aged 5-17 living at home, were able to read, write, and speak English, and were not enrolled in a hospice program. Results: Of those enrolled, 62% completed all intervention sessions and post-intervention assessments. Withingroup analyses showed significant improvements in parents' self-efficacy in helping their children manage pressures from the parent's cancer; parents' skills to elicit children's cancer-related concerns; and parents' skills to help their children cope with the cancer. Between-group analyses revealed comparable improvements with historical controls on parents' anxiety, depressed mood, self-efficacy, parenting skills, and children's behavioral-emotional adjustment. Conclusion:The EC-PC parenting program shows promise in significantly improving parents' skills and confidence in supporting their child about the cancer. Further testing of the program is warranted.

Background: Maternal breast cancer has a significant impact on the well being of school-aged children but we know very little about the concerns these children attribute to their mother's illness. Objective:To describe child-reported illness-related concerns experienced in the initial 6 months of their mother's diagnosis and to identify any differences by age and gender of the child.Methods: Data were obtained from 140 school-aged children (7-12 years) within 6 months of their mother diagnosis with Stage 0-III breast cancer. Children's written responses to an openended question were analyzed, "Think about a situation that has bothered you during the last month that had to do with your mom's breast cancer." Inductive content analysis was used to analyze the data using methods adapted from grounded theory. Trustworthiness of results was protected by coding to consensus, formal peer debriefing, and maintaining an audit trail.Results: Losing Her, the core construct, was identified and organized the children's concerns in 4 domains: (1) her being away from me; (2) worrying about her; (3) seeing my mother be different; and (4) changing how things work. Conclusion:All children reported illness-related concerns about which they were bothered. Even seemingly short-term treatment-related absences from the child were interpreted as difficult.Implication for Practice: Findings from the current study add to nurses' awareness and knowledge about the concerns of school-aged children during their mother's initial treatment for breast cancer. Nurses are in a key position to provide services directly to the child or through the mother. BACKGROUNDBreast cancer is the leading type of cancer among women in the United States in terms of both new cancer cases and deaths. 1 In 2018, an estimated 330,100 women will be diagnosed with invasive or in situ breast cancer and 22 percent of them will be mothers of minor

Background: Cat Intensive care unit (ICU) delirium is a significant complication that increases the mortality, morbidity, and length of stay for critically ill patient. Objective: The aim of this study was to assess the critical care nurse’s knowledge of ICU delirium and the effectiveness of an educational program about the recognition and assessment of ICU delirium on critical care nurse’s knowledge. Methods: A quasi-experimental single group pre-test-post-test design was conducted using delirium knowledge assessment questionnaires. Results: The median post test score of overall nurses’ knowledge was 76.2 (range 19.1-95.2) compared to the median pre-test score of 38.1 (range 14.3 – 61.9) indicating a significant change in nurses’ knowledge after conducting the educational program (p<0.001). Conclusion: Critical care nurses’ knowledge of ICU delirium was low before the intervention and increased significantly after delivering an educational program..

The telephone is an effective and indeed preferred channel for delivering services to child-rearing parents impacted by cancer.

The purpose of this study is to examine the feasibility and short-term impact of a fully manualized, telephone-delivered intervention for spouse caregivers, Taking Care of Her (TCH). A total of 12 study participants from the Pacific NW were enrolled whose wife was diagnosed with Stage III ovarian cancer within 8 months. Feasibility was confirmed by rates of recruitment and retention; the quality of delivery of the intervention by telephone; and through data obtained on program acceptability during follow up exit interviews. Outcomes from the within-group analysis revealed improvements on standardized measures of spouses' and patients' depressed mood and anxiety; marital communication about the cancer; caregivers' skills and confidence to manage the emotional toll of the illness on themselves and wives; and wives' positive appraisal of spousal support. Study results suggest that the TCH Program has the potential to positively affect both spouse caregiver and patients' adjustment to recently diagnosed advanced ovarian cancer. Telephone delivery holds promise for sustainability. A future clinical trial with a larger study sample is warranted.