Adolescent's stress responses and psychological functioning when a parent has early breast cancer

Edwards, Lesley; Watson, Maggie; James‐Roberts, Ian St; Ashley, S.; Tilney, C.; Brougham, Billie-Jaye; Osborn, Tessa; Baldus, Christiane; Romer, Georg

doi:10.1002/pon.1323

Cited by 79 publications

(154 citation statements)

References 35 publications

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“…This intervention confirms the previous studies about the importance of an open communication to support children to face with cancer's diagnosis [5,10,[14][15][16]. The project highlights the advantages of direct engagement of children in the communication of the parent's illness to improve the relationships within the family.…”

Section: Discussionsupporting

confidence: 74%

How to Explain the Parent's Cancer to their Children: A Specific Intervention to Enhance Communication Inside the Family

Gallina¹,

Mazza²

2016

Clinics Mother Child Health

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Objective: This article describes a multidisciplinary intervention dedicated to patients with cancer and with underage children. It is well known that children of severely ill parents can develop emotional and behavioral problems. Different studies underline the efficacy of an open communication with children about the parent's illness to reduce distress but also the difficulties of parents to explain it to their children. The intervention, realized at San Gerardo Hospital, aims to inform or improve the children's knowledge of their parent's cancer, and to open communication about cancer inside the family.Methods: This intervention is characterized by the integration of a psychologist and a pediatric hematooncologist and by the direct involvement of children. After the fact-finding parents sessions, the pediatric hematooncologist and the psychologist meet children in specific settings, without parents present, to describe, with the support of images and metaphors, the parent's cancer and to understand children's needs or fears. In particular the pediatric hemato-oncologyst uses the flowered garden metaphor to explain to children the parent's illness and the treatments. Then the clinicians share the content of the previous sessions with parents. Counseling sessions to parents are also organized to increase the parental competence and the sharing of cancer-related concerns in the family. In addition, a specific questionnaire has been realized to evaluate children's psychological conditions after the intervention, family atmosphere and parents' satisfaction.Results: 36 families and 53 children have participated in the project up to now. The results of the questionnaires have underlined the absence of psychopathological symptoms in children, the presence of more collaboration in the families and more possibilities in the family to have an open communication about the cancer. In addition, most of the parents reported a considerable satisfaction with the intervention. Conclusion:Support for open communication in the family about cancer should be acknowledged as an important aspect of oncology care to reduce family stress.

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Section: Discussionsupporting

confidence: 74%

How to Explain the Parent's Cancer to their Children: A Specific Intervention to Enhance Communication Inside the Family

Gallina¹,

Mazza²

2016

Clinics Mother Child Health

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“…Maternal breast cancer-specific distress was measured using 8 items of the Revised Impact of Event Scale, to parallel the Child Impact of Events Scale (Cronbach's α = 0.88). [47][48][49][50][51][52][53] …”

Section: Methodsmentioning

confidence: 99%

“…[47][48][49][50] Both have been used to evaluate intrusion and avoidance, as indices of cancerspecific "distress." [51][52][53] Daughter performance of health and risk behaviors were assessed with items from the Youth Risk Behavior Survey, 53 which has been used to track health and risk behaviors of >10 000 youths. 54,55 Daughter perception of breast cancer risk was assessed with a single item adapted from a longitudinal study of families at hereditary risk for breast cancer.…”

Section: Methodsmentioning

confidence: 99%

Psychosocial Adjustment in School-age Girls With a Family History of Breast Cancer

2015

PEDIATRICS

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OBJECTIVE-Understanding how young girls respond to growing up with breast cancer family histories is critical given expansion of genetic testing and breast cancer messaging. We examined the impact of breast cancer family history on psychosocial adjustment and health behaviors among >800 girls in the multicenter LEGACY Girls Study.METHODS-Girls aged 6 to 13 years with a family history of breast cancer or familial BRCA1/2 mutation (BCFH+), peers without a family history (BCFH−), and their biological mothers completed assessments of psychosocial adjustment (maternal report for 6-to 13-year-olds, selfreport for 10-to 13-year-olds), breast cancer-specific distress, perceived risk of breast cancer, and health behaviors (10-to 13-year-olds).RESULTS-BCFH+ girls had better general psychosocial adjustment than BCFH− peers by maternal report. Psychosocial adjustment and health behaviors did not differ significantly by selfreport among 10-to 13-year-old girls. BCFH+ girls reported higher breast cancer-specific distress (P = .001) and were more likely to report themselves at increased breast cancer risk than BCFH− peers (38.4% vs 13.7%, P < .001), although many girls were unsure of their risk. In multivariable analyses, higher daughter anxiety was associated with higher maternal anxiety and poorer family communication. Higher daughter breast cancer-specific distress was associated with higher maternal breast cancer-specific distress.CONCLUSIONS-Although growing up in a family at risk for breast cancer does not negatively affect general psychosocial adjustment among preadolescent girls, those from breast cancer risk families experience greater breast cancer-specific distress. Interventions to address daughter and mother breast cancer concerns and responses to genetic or familial risk might improve psychosocial outcomes of teen daughters.Although studies have reported psychosocial adjustment in children of parents with cancer, few studies have evaluated outcomes in youth from families at familial or genetic risk for breast cancer. Understanding the impact of growing up in a family at risk for breast cancer is The LEGACY Girls Study is the first to focus on preadolescent girls growing up in families with breast cancer risk, including girls whose mothers have not had breast cancer. 39 This study addresses limitations of previous studies by being theoretically informed and including sociodemographically diverse girls, an unrelated comparison group, and both parent and child report. We applied a novel conceptual model 40 grounded in the Self-Regulation Theory of Health Behavior 41 and developmental theory. 34,37 Our model posits that response to a health threat, including psychosocial adjustment and the performance of health and risk behaviors, is a product of one's perceptions of the threat. [40][41][42] This model is ideal for the study of youths' maturation because it emphasizes "commonsense" representations, encompasses sociocultural factors, and is iterative and dynamic, providing a unique opportunity to examine chang...

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“…Cognitive development and psychosocial difficulties (Osborn, 2007;Visser et al, 2007;Edwards et al, 2008) were not analysed as the focus was for content evidencing children's conceptualisation of cancer irrespective of any specific age. Moreover, an age specific analysis of the type of children's responses may be inconclusive from only 22 children because children participants had different carer roles, interests and skill sets.…”

Section: Methodsmentioning

confidence: 99%

“…Even though Malaysia recorded lower number of children, the ratio was higher at 2.5 children per household (Banci Penduduk dan Perumahan Malaysia, Jabatan Perangkaan, 2013). Visser et al (2004), Visser et al (2007), Osborne (2007) and Edwards et al (2008) reported that parental cancer had a range of consequences from the aspect of children's functioning and psychosocial difficulties. Anxiety, fear and uncertainty were common emotional distresses (Kornreich et al, 2008;Fourie, 2008;Buchwald, 2007;Watson, 2006).…”

mentioning

confidence: 99%

“She looked like an Alien”

Saat¹,

Hepworth

Jackson

2018

AJIM

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Purpose The purpose of this paper is to explore the Malay children’s information needs from their experience with parental cancer using information behaviour techniques to elicit sensitive information that provided an indication of what children were thinking. Design/methodology/approach Data collection adapted the participatory action research method and used participatory-based techniques that included drawings, essays and interviews. Data explication used an interpretative phenomenological analysis approach. Social constructionism, learning theory and cognitive theory were used to analyse the data. In total, 32 participants took part, ten mothers with breast cancer at different stages of their cancer journey, and 32 children between 6 and 18 years old. Findings There are shortcomings in the provision of cancer information for Malay children. Unlike verbose and difficult to digest medical definitions and descriptions about cancer and its treatment, the Malay children defined cancer as having components made from their experiences and observations about how cancer affected their parent. The findings explain the relationship between children participants’ reaction to a health situation and the subsequent processes they undergo to resolve their state of information need. Originality/value It highlights the importance of determining information needs and the combined methods used to gain and interpret the experience children face with a parental cancer diagnosis. The findings about ethnic-based information problems, needs and provision for dependent children of cancer patients are one of the original contributions of this research. To the best of the authors’ knowledge, this research is believed to be the first in-depth qualitative and highly participative study of the implications of cancer for dependent children of Malay cancer patients.

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Adolescent's stress responses and psychological functioning when a parent has early breast cancer

Abstract: When mothers have breast cancer, a substantial minority of their adolescent children have psychological and stress response-related problems linked with poor family functioning. These results argue in favour of a family-oriented approach to psychological support of breast cancer patients.

Cited by 79 publications

References 35 publications

How to Explain the Parent's Cancer to their Children: A Specific Intervention to Enhance Communication Inside the Family

How to Explain the Parent's Cancer to their Children: A Specific Intervention to Enhance Communication Inside the Family

Psychosocial Adjustment in School-age Girls With a Family History of Breast Cancer

“She looked like an Alien”

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