A Balancing Act: Working and Caring for a Child with Cancer

Hjelmstedt, Sofia; Forinder, Ulla; Norberg, Annika M. Lindahl; Hovén, Emma

doi:10.1007/s10826-021-01997-1

Cited by 10 publications

(19 citation statements)

References 44 publications

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“…Consolidating their care and avoiding extra visits for rehabilitation services demonstrates our program's approach to family-centered care; we recognize that parents and families experience a great deal of stress while trying to balance the demands of their child's illness with work and family life. 36,37 Recently, an integration model of PT was proposed in adult oncology as well. 38 The dramatic reduction in time to first rehabilitation outpatient evaluation evidenced in 2005 and 2010 assists in meeting the aims of the prospective surveillance model by identifying and treating impairments early.…”

Section: Discussionmentioning

confidence: 99%

CREATE Childhood Cancer Rehabilitation Program development: Increase access through interprofessional collaboration

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Gossai

et al. 2022

Pediatric Blood & Cancer

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Background Cancer and its treatment can lead to functional limitations affecting ongoing development in children and adolescents. We developed a pediatric cancer rehabilitation program that integrates evidence‐based rehabilitative care into cancer treatment. The program utilizes the CREATE (collaboration, rehabilitation/research, education, assessment, treatment, evaluation) Childhood Cancer Rehabilitation model. We aim to describe the structural and process components of our rehabilitation program and provide an access and utilization analysis. Procedures To evaluate the rehabilitation program, we identified new patients with oncologic diagnoses from 2002 to 2019 using our database. To evaluate rehabilitative care, descriptive data, including the timing and type of rehabilitation services utilized within 5 years of a child's diagnosis, were collected and reviewed. Statistical analysis focused on change over time. Results Among 1974 children assessed, 1580 (80.0%) received care from at least one rehabilitation service. Between 2002 and 2018, the percentage of children receiving rehabilitation services grew significantly throughout all disciplines, except for outpatient speech‐language pathology. Utilization differed by age and diagnosis. Integrating therapists in the clinic improved patient access, reduced the time to access outpatient services, and increased the number of attended visits. Additional factors supporting program growth included: identifying leaders, using a prospective surveillance model, education, and program evaluation. Conclusion A multimodal interprofessional approach, such as the CREATE model, improves access to and the efficiency of evidence‐based rehabilitation services promoting recovery, ongoing development, and quality of life.

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Section: Discussionmentioning

confidence: 99%

CREATE Childhood Cancer Rehabilitation Program development: Increase access through interprofessional collaboration

Tanner

Sencer

Gossai

et al. 2022

Pediatric Blood & Cancer

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“…Parents of children with cancer often follow traditional gender roles, with mothers taking the main responsibility of care not only for the diagnosed child, but also for the healthy siblings. 14,33,49 Difficulties in combining parenting responsibilities and work may also be more pronounced among mothers. 14 In Sweden, while both mothers and fathers take time off from work around the time of their child's diagnosis, fathers return to work earlier while mothers continue to be on leave, 50,51 which is reflected on the lower long-term employment status and income of mothers of children with cancer even in the genderegalitarian Nordic countries.…”

Section: Discussionmentioning

confidence: 99%

“…The increase in medication use was similar regardless of cancer type, child's age at diagnosis, and other family characteristics with potential impact on caregiving strain. This could be expected, as difficulties in combining the care of the child with other responsibilities are likely to emerge only later on 14 …”

Section: Discussionmentioning

confidence: 99%

“…14,30,31 Across Europe, women usually provide more childcare than men, 32 and parents of children with cancer often follow traditional gender roles when dividing parental tasks. 33 Mothers are thus more likely than fathers to experience problems with balancing family and work, 14 and particularly during active treatment mothers of children with cancer have reported higher levels of distress compared to fathers. 2 These problems may be most pronounced among singlemothers, who are on average socioeconomically less advantaged, 34 and also lack support from the other parent.…”

Section: Introductionmentioning

confidence: 99%

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Changes in parents' psychotropic medication use following child's cancer diagnosis: A fixed‐effects register‐study in Finland

et al. 2022

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Background Symptoms of depression and anxiety are elevated among parents of children with cancer. However, knowledge of parents' psychotropic medication use following child's cancer diagnosis is scarce. Methods We use longitudinal Finnish register data on 3266 mothers and 2687 fathers whose child (aged 0–19) was diagnosed with cancer during 2000–2016. We record mothers' and fathers' psychotropic medication use (at least one annual purchase of anxiolytics, hypnotics, sedatives, or antidepressants) 5 years before and after the child's diagnosis and assess within‐individual changes in medication use by time since diagnosis, cancer type, child's age, presence of siblings, and parent's living arrangements and education using linear probability models with the individual fixed‐effects estimator. The fixed‐effects models compare each parent's annual probability of psychotropic medication use after diagnosis to their annual probability of medication use during the 5‐year period before the diagnosis. Results Psychotropic medication use was more common among mothers than fathers already before the child's diagnosis, 11.2% versus 7.3%. Immediately after diagnosis, psychotropic medication use increased by 6.0 (95% CI 4.8–7.2) percentage points among mothers and by 3.2 (CI 2.1–4.2) percentage points among fathers. Among fathers, medication use returned to pre‐diagnosis level by the second year, except among those whose child was diagnosed with acute lymphoblastic leukemia or lymphoblastic lymphoma. Among mothers of children with a central nervous system cancer, medication use remained persistently elevated during the 5‐year follow‐up. For mothers with other under‐aged children or whose diagnosed child was younger than 10 years, the return to pre‐diagnosis level was also slow. Conclusions Having a child with cancer clearly increases parents' psychotropic medication use. The increase is smaller and more short‐lived among fathers, but among mothers its duration depends on both cancer type and family characteristics. Our results suggest that an increased care burden poses particular strain to the long‐term mental well‐being of mothers.

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“…Moreover, many mothers drop out of their jobs once they have children [67], or return to work later than fathers, especially when their child has a severe physical health condition [76] such as a brain tumor. Additionally, mothers are often the primary caregiver, who spends more time with the child [67].…”

Section: Introductionmentioning

confidence: 99%

The Influence of Socioeconomic Status (SES) and Processing Speed on the Psychological Adjustment and Wellbeing of Pediatric Brain Tumor Survivors

Oprandi

Oldrati

Cavatorta

et al. 2022

Cancers

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(1) Background: The relationship between processing speed (PS) and psychological adjustment in the healthy population is well established, as is that between low socio-economic status (SES) and psychological distress. While PS is one of the most impaired functions in pediatric brain tumor survivors (PBTSs), previous research has demonstrated that low SES may be a predictor of increased psychosocial risk in PBTSs. Given the psychological adjustment difficulties observed in PBTS, in the current study we aimed to explore the relationship between SES and psychological functioning, considering the contribution of PS as a mediator. (2) Methods: demographic and clinical data of 80 children (age range: 4–17 y.o.) were retrospectively collected. Psychological measures were the parent-compiled versions of the Child Behavioral Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ). Mediation analysis models were performed on psychological measures with and without the inclusion of covariates. (3) Results: The influence of SES on the CBCL total index was mediated by PS. Furthermore, PS was found to have a mediating effect on the relationship between SES and internalizing problems but not on the relationship between SES and externalizing problems. (4) Conclusions: The results suggest that PS may be a rehabilitation target for the prevention of psychological distress and should be addressed especially for PBTSs who live in a disadvantaged situation.

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A Balancing Act: Working and Caring for a Child with Cancer

Cited by 10 publications

References 44 publications

CREATE Childhood Cancer Rehabilitation Program development: Increase access through interprofessional collaboration

CREATE Childhood Cancer Rehabilitation Program development: Increase access through interprofessional collaboration

Changes in parents' psychotropic medication use following child's cancer diagnosis: A fixed‐effects register‐study in Finland

The Influence of Socioeconomic Status (SES) and Processing Speed on the Psychological Adjustment and Wellbeing of Pediatric Brain Tumor Survivors

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