Lessons learned in the implementation of an innovative consultation and liaison service for children of cancer patients in various hospital settings

Romer, Georg; Saha, Rina; Haagen, Miriam; Pott, Martina; Baldus, Christiane; Bergelt, Corinna

doi:10.1002/pon.1105

Cited by 44 publications

(36 citation statements)

References 34 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%

“…They told their parents and clinicians that they were satisfied with their direct engagement, without parents present, with the specialists because in this way they felt they were an important part of the family system and they understood that in their families no lies were being told about the illness and so they could trust their parents. Some studies underline that communication and expressiveness in families can be identified as a key issue in children's positive coping with parental illness [10,13]. Our findings in fact underlined the absence of psychological problems in children after the intervention.…”

Section: Discussionsupporting

confidence: 55%

“…Some studies focused on the efficacy of an open communication with children about their parent's illness to reduce distress [3,10]. But, on the other hand, actually several studies showed that parents often may be reluctant to talk openly with children about cancer because they are afraid of frightening them and so they think that if they don't tell them anything about the illness they will protect their children.…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…Nicholls et al (17) identifies that the most unmet needs for these children are during the initial diagnostic stage and is complemented by another study (33) that shows parental stressors, and thereby stressors on these children, also decrease with time, suggesting that an early approach would be more beneficial. However, Romer et al implemented an early curriculumbased intervention and concluded that these parents and their children are overwhelmed early and need time to adjust, cope, and establish a relationship with the medical staff for the intervention to be effective, suggesting a 3 month later approach as more beneficial (34).…”

Section: Resultsmentioning

confidence: 99%

Impact of Parental Cancer on Children

2017

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Abstract. Background It is estimated that 10.4% of newly diagnosed cancer patients are between the ages of 18-55, with 22.4% of all cancer cases occurring in individuals aged 21-55 (1). This range represents common childbearing and child-rearing ages which suggest a significant portion of these patients may have minor children. In fact, in 2010 it was estimated that 2.85 million children under the age of 18 lived with a parent who was diagnosed with cancer in the US (2). Over the last 30 years, overall cancer survival rates have increased with the 5-year survival rate rising 20% across all races (3). The increasing survival rates suggest a concomitant increase in prevalence of cancer survivors with minor children.A cancer diagnosis can affect the whole family, not just the afflicted parent (4, 5). Multiple studies demonstrate that children in particular have a higher risk of emotional and behavioral problems (6, 7). The disruption of schedules and daily routine, shifting of household roles, financial stress, and the physical and emotional availability of either parent all contribute to these emotional and behavioral problems (7-9). These problems, if overlooked or untreated, can persist into adulthood (10). Daily RoutineA daily routine is an important part of life for preschoolers, grade-schoolers, and adolescents for both structural stability and social behavior guidance (7, 11). A parental cancer diagnosis can disrupt the daily routine or schedule due to frequent clinic visits, unexpected hospital admission, and the home turning into a place of care (9, 12, 13). The disruptions also promote problems sleeping in preschoolers and increased post-traumatic stress symptoms as well as internalizing and externalizing behaviors in adolescents (6,7,14). Adolescents also report the impact that physical unavailability has on their emotional well being including the ill parent no longer driving them to school, to extracurricular activities, or even packing lunches (12, 15). Role ChangesIt has long been known that parental roles change as one parent becomes a caregiver and the ill parent becomes less available physically and emotionally, having fewer opportunities to interact while placing increased demands on their children (12). However, children of patients with cancer frequently change roles within their family as well, absorbing more responsibility while one parent cares for the ill parent (4, 16). The literature shows that both children and adolescents have increased personal responsibilities, resulting in a decrease in social activity and subsequent loss of childhood at a time when peer groups are essential for social development (4,10,14,17). Adolescent truancy rates increase and overall attendance decreases as they need to care for their younger siblings or pick-up extra work shifts to help combat the financial burden cancer puts on a household (11, 13). 4025

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“…Thus, despite the finding that existing guidelines for psychosocial cancer care include the families and children of cancer patients, 9 the integration of family-centered support into oncology care is not systematic. 29 In addition, patients might prefer brief child-focused and familyfocused interventions within the context of routine care. The step of seeking specific family-centered service exclusively might be too far.…”

Section: Discussionmentioning

confidence: 99%

Use and need for psychosocial support in cancer patients

Ernst

Beierlein

Romer

et al. 2013

Cancer

Self Cite

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BACKGROUND: Cancer patients and their minor children have been shown to experience psychological distress. The objectives of the current study were to 1) describe the need for and use of psychosocial support and 2) determine predictors of family-centered support use in patients with minor children. METHODS: A population-based sample of 1809 patients was recruited via 2 cancer registries. The eligibility criteria were age 25 years to 55 years, an initial diagnosis received no longer than 6 years before this survey, and having at least 1 minor child. Medical characteristics and self-report measures were used. RESULTS: Overall, approximately 38% cases were identified as being borderline or probable anxiety cases and 16% were identified as being borderline or probable depression cases. Since diagnosis, 44% of the patients had used psychosocial support and 9% had received family-focused and child-focused support. These patients perceived a lower quality of life and poorer family functioning. Approximately 73% of patients with children wanted information concerning or psychosocial services to support their children or parenting. Use of family-centered support was not found to be predicted by disease-related factors (eg, cancer staging) but rather by subjective needs (eg, mental health and having a distressed child in the family). CONCLUSIONS: The results of the current study emphasize the importance of child and parenting concerns in psychosocial care in oncology. Screenings for children and appropriate training programs for health care may increase awareness of this issue. Cancer 2013;119:2333-41.

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Lessons learned in the implementation of an innovative consultation and liaison service for children of cancer patients in various hospital settings

Cited by 44 publications

References 34 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

Impact of Parental Cancer on Children

Use and need for psychosocial support in cancer patients

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