Minor Children of Palliative Patients: A Systematic Review of Psychosocial Family Interventions

Abstract

Although the whole family is affected by a parent's palliative disease, palliative care research does not yet routinely consider patients' minor children. Children's and adolescents' psychosocial functioning may be impaired during prolonged parental disease with poor prognosis. Therefore, more and more health care providers are establishing clinical initiatives for families of palliative patients with minor children. However, the number of these family interventions, as well as their theoretical and empirical backgrounds and evidence base, has yet to be determined. The purpose of this study was to systematically review structured and published interventions for this target group, as well as empirical studies on these interventions. The evidence base and impact of interventions on families were considered. Literature published between 1980 and present focusing on psychosocial family-, child- or parent-centered interventions during palliative care was retrieved from PsycINFO®, Embase, MEDLINE®, CINAHL®, and PSYNDEX databases. Five interventions met the inclusion criteria. Programs focused on different populations, had diverse empirical and theoretical backgrounds and features, and were evaluated by studies of varying methodological quality. This systematic review illustrates the lack of well designed and elaborated intervention concepts and evaluation studies in this field, highlighting the necessity of conceptual and methodological rigor to inform clinical practice on a sustainable basis in the future.

Psychosocial Interventions for Parents with Incurable End‐Stage Cancer: A Rapid Evidence Assessment

“…Of the four intervention studies included in this review, only one psychosocial intervention program was specifically tailored for parents with incurable metastatic cancer and reported intervention outcomes for parents (Bugge et al, 2009). This finding-along with related intervention reviews (Kühne et al, 2012;Phillips, 2014)strongly indicates that further intervention research is needed. Without high quality research, the delivery of patient-centred evidence-informed psychosocial supportive care is compromised.…”

“…One study (Thastum, Munch‐Hansen, Wiell, & Romer, ) however, included parents with end‐stage cancer but did not report parent outcome findings according to disease stage. More recently, a systematic review examining structured psychosocial interventions for families of palliative patients with minor children (Kühne et al, ) identified one program that reported on intervention outcomes for parents with end‐stage cancer (Bugge, Helseth, & Darbyshire, ); other studies included parents with palliative‐stage cancer but did not report parent outcomes (Kissane & Lichtenthal, ; Schmitt et al, ; Thastum et al, ) or focused on the evaluation of service implementation processes (Romer et al, ). The latest review targeting child‐centred and family‐centred interventions that focused on adolescents living with a parent with advanced cancer (Phillips, ) identified one intervention involving parents with incurable end‐stage cancer (Bugge et al, ), as reported by Kühne et al, ().…”

Oncology Case Report – When Is the Appropriate Time to Integrate Palliative Care?

“…Práce psychologa s pa cientkou a její rodinou mohla být mnohem komplexnější. Sociální pracovnice mohly napomoci v zajištění následné podpory pro ovdovělého manžela a děti [1,2]. Nemocniční kaplan mohl nabídnout spirituální podporu zejména manželovi, který nebyl schopen situaci zvládnout.…”

To disclose or not to disclose? Communication between mothers with cancer and their young children

“…Providing honest information adapted to the child's language may enhance communication, thereby curbing the child's curiosity and concern (3) . Children are unsurprisingly curious and fearful of death when facing a disturbing situation, particularly because they detect certain signs (3,21) . Thus, to decrease the child's anxiety, mothers may take the opportunity to talk to the child about cancer, explaining the treatment and care and listening to the child's concerns about the disease (2) .…”