4.5 Article

Living With an Advanced Cancer While Parenting Minor Children: A Needs Assessment Study

期刊

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
卷 66, 期 2, 页码 160-+

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpainsymman.2023.04.027

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Metastatic cancer; spousal caregivers; co-parents; parenting; mixed-methods; service preferences

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This study aims to identify the parenting-related intervention needs and delivery preferences of advanced cancer patients and their spouses/co-parents. The results showed that family distress and marital distress were common, and patients and spouses had high concerns about parenting. Qualitative interviews revealed needs related to family routines, childcare, transportation, meals, home maintenance, and finances. Most patients and spouses preferred parenting-related education/services, with some preferring self-led readings or counseling sessions.
Background: Evidence-based interventions addressing the needs of couples co-parenting young children while facing an advanced cancer diagnosis are lacking. Thus, this study seeks to identify parenting-related intervention needs and delivery preferences of advanced cancer patients and their spouses/co-parents. Methods: Twenty-one couples completed quantitative measures of cancer-related parenting concerns, relationship and family functioning, and service needs along with individual semi-structured interviews. Results: Patients (mean age=44 years, 48% female, 91% White) and spouses (mean age=45 years, 52% female, 91% White) reported family distress (62% of couples) and marital distress (29% of couples). Parenting concerns were generally high with patients revealing concerns particularly regarding the practical impact of the cancer on the child(ren). Spouses rated concerns about the coparent significantly higher (P<.001) than patients. Parenting concerns were inversely associated with relationship (P<.001 for patients; P=.03 for spouses) and family functioning (P<.001 for patients). Themes identified through qualitative interviews include needs related to maintenance of family routines and traditions, childcare, transportation, meals, home maintenance, and finances. Couples who endorsed marital distress also indicated a need for conflict resolution skills. All patients and 89% of spouses would like to receive parenting-related education/services; up to 50% of couples preferred targeted, self-led readings without therapist support; and up to 50% desired counseling sessions indicating a preference towards dyadic and video conferenced intervention delivery. Conclusions: The delivery of optimal supportive care involves a family-focused perspective such as screening for parenting status and referrals to social work services to address the need of tangible resources and manage parenting-related distress. J Pain Symptom Manage 2023;66:160-167. & COPY; 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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