The diagnosis of cancer in a child is one of the most significant stressors a parent can experience, and research in the area of stress-related effects of illness on parents has emerged in many areas. The majority of studies have focused on the potential or actual negative impact on parents during and after treatment of their child's illness. However, studies that initially set out to explore the difficulties associated with coping with childhood cancer found that parents often reported positive aspects about the experience. There is now increasing interest and support for the study of "positive-health" factors that contribute to protective variables influencing the health and well being of parents, such as benefit finding. The present study aimed to illuminate the process of benefit finding in parents of children with cancer and to develop a theoretical model of this process based on the findings.This grounded theory study resulted in a conceptual model that organized and depicted the constructs and structures related to the process of benefit finding. Through constant comparative analysis, the Basic Psychosocial Problem was identified as being overwhelmed with fear. The parents identified intervening conditions that helped move them from feeling overwhelmed to feeling that they could manage the fear. Many parents identified a specific event, an "epiphenomenon" that created a turning point for them. This event, along with the intervening conditions, moved the parent from being overwhelmed to managing/transforming the fear, which was the Basic Psychosocial Process. The strategies that the parents identified as helping to manage the fear are being in the present, being strong, having faith/maintaining hope, and making meaning out of the event, of which benefit finding was the major component. This entire process occurred within the context of being a parent, as this awareness colored the entire experience. Benefit finding emerged as both a strategy and an outcome within this process and encompassed a growth in character, strengthening of relationships, and a gain in perspective. The theoretical model and substantive theory that emerged during the course of this study provide a way to understand this process in parents of children with cancer.

O câncer infantil é uma doença crônica que demanda um tratamento longo, invasivo e doloroso. Os avanços terapêuticos possibilitam sua realização ao nível ambulatorial, no entanto, este se mostra tão desgastante e cansativo quanto a hospitalização. Com isso, é importante que a criança com câncer tenha um espaço para que possa distrair-se, além de expressar suas angústias e ansiedades com relação a sua nova realidade – o mundo da doença e do tratamento oncológico – enquanto aguarda ser atendida. A brinquedoteca se mostra como o espaço capaz de favorecer o desenvolvimento da criança, além de ajudá-la a compreender o que está acontecendo consigo por meio do brincar. A proposta deste estudo é desvelar o sentido de Ser-criança com câncer em tratamento ambulatorial, utilizando a brinquedoteca como possibilidade de favorecer a expressão, pela criança, de seu mundo cotidiano. Para isso foi implantada uma brinquedoteca em um hospital filantrópico de Ribeirão Preto, S. P. Houve a participação de sete crianças entre 3 e 9 anos com diagnóstico de algum tipo de câncer infantil, no período de agosto/01 a janeiro/02. Durante o retorno médico, a criança era convidada a brincar na brinquedoteca e orientada a permanecer o período que desejasse. Após as “sessões de brinquedo", as fitas foram transcritas e complementadas com as observações anotadas. A fim de desvelar o sentido das vivências das crianças com câncer em tratamento ambulatorial, foi realizada uma análise à luz da fenomenologia existencial de Martin Heidegger. A criança-com-câncer configurou-se como um ir e vir permeado ora pela autenticidade, quando a criança assumia sua doença e seu ser-para-a-morte, ora pela inautenticidade, quando deixava-se levar pelo modo de ser da decadência dos familiares e da equipe de saúde. O brincar pôde favorecer um rico acesso às vivências da criança gravemente doente. / Children’s cancer is a chronic disease that demands a long, invasive and painful treatment. The therapeutic advances enable the ambulatory treatment. However, it is as stressful as the hospitalization. Therefore, it is important for the child to have space to express their anxieties regarding this new reality – the disease’s world and the oncology treatment– when they are waiting to receive their treatment. The playing room is a place that favors the children’s development and help them to understand what is happening with them while they play. The purpose of this study is to learn the meaning of being children with cancer being submitted to ambulatory treatment and using the play room as a possibility to enable their expression about their world. Thus, a play room was built at a philanthropic hospital in the city of Ribeirão Preto, SP, Brazil. Seven children from 3 to 9 years of age with the diagnosis of cancer participated in the study from August, 2001 to January, 2002. During their appointments, the children were invited to play and oriented to stay there as long as they wanted. After the playing sessions, the tapes were transcribed and complemented with observations. Aiming at learning about the meaning of these experiences to children with cancer, author analyzed these data based on the Marting Heidegger’s existential phenomenology. The children-with-cancer showed a movement that was permeated sometimes by the authenticity, when the child assumed the disease and their being-to-death and also by the lack of authenticity, when they were influenced by their family and members of the health team. The situation of playing enabled the access to these children who were severely ill.

The proposed study is a preliminary investigation of a hypothesized relationship between family therapy and levels of child patient and parent anxiety and depression. Currently, medical practice does not include mental health services and familial support to oncology patients in typical treatment protocol. While anxiety and depression appear to be present during all phases of cancer, providing family therapy at the time of diagnosis is warranted as symptom alleviation at this juncture may mitigate these symptoms throughout subsequent phases and potentially decrease somatic difficulties. Research questions will be addressed by analyzing data, including scores on measures of anxiety and depression. Statistical analyses will include two and three-way analyses of variance (ANOVA) and repeated measures multivariate analysis of variance (MANOVA). / text

The specific aims for this study were to: (a) describe positive and negative well-being in parental caregivers of children with cancer, (b) examine if parental caregivers' personal factors (i.e., resilience and/or demographic characteristics) and child-related contextual factors (i.e., ill child's cancer characteristics and/or demographic characteristics) predict parental caregivers' positive and negative well-being, and (c) test if self-transcendence mediates the relationship between resilience and well-being (positive and negative) in parental caregivers of children with cancer. Eighty parental caregivers whose children were diagnosed with any type of childhood cancer since at least two months prior to study start participated and completed a demographic instrument, the General Well-Being Schedule, the Center for Epidemiologic Studies Depression Scale, the State scale of the State-Trait Anxiety Inventory, the Self-Transcendence Scale, and the Brief Resilience Scale. Descriptive statistics were used to describe sample demographics, levels of positive and negative well-being, self-transcendence levels, and resilience levels. Standard multiple regression was used to examine predictors of well-being. Baron and Kenny's three-step mediation analysis was used to test if self-transcendence mediated the relationship between resilience and well-being (positive and negative). Both positive and negative well-being exist in parental caregivers of children with cancer as 47% of parental caregivers were in the `positive well-being' category with total General Well-Being Schedule scores above the positive well-being cutoff of 73, 36.3% were in the `depressed' category with total scores above the depression cutoff of 16 on the Center for Epidemiologic Studies-Depression Scale, and 45% had scores that exceeded the mean anxiety score of 39.64 on the State Scale of the State-Trait Anxiety Instrument. None of the child-related contextual factors were found to predict positive and negative well-being in parental caregivers of children with cancer. Resilience positively predicted general well-being and negatively predicted depression and anxiety in parental caregivers of children with cancer. Satisfaction with current financial status negatively predicted depression. Employment status negatively predicted anxiety such that those who were not employed had significantly lower anxiety than those who were employed part-time and full-time. Self-transcendence mediated the relationship between resilience and positive and negative well-being respectively.

O câncer infantil é uma doença crônica que demanda um tratamento longo, invasivo e doloroso. Os avanços terapêuticos possibilitam sua realização ao nível ambulatorial, no entanto, este se mostra tão desgastante e cansativo quanto a hospitalização. Com isso, é importante que a criança com câncer tenha um espaço para que possa distrair-se, além de expressar suas angústias e ansiedades com relação a sua nova realidade – o mundo da doença e do tratamento oncológico – enquanto aguarda ser atendida. A brinquedoteca se mostra como o espaço capaz de favorecer o desenvolvimento da criança, além de ajudá-la a compreender o que está acontecendo consigo por meio do brincar. A proposta deste estudo é desvelar o sentido de Ser-criança com câncer em tratamento ambulatorial, utilizando a brinquedoteca como possibilidade de favorecer a expressão, pela criança, de seu mundo cotidiano. Para isso foi implantada uma brinquedoteca em um hospital filantrópico de Ribeirão Preto, S. P. Houve a participação de sete crianças entre 3 e 9 anos com diagnóstico de algum tipo de câncer infantil, no período de agosto/01 a janeiro/02. Durante o retorno médico, a criança era convidada a brincar na brinquedoteca e orientada a permanecer o período que desejasse. Após as “sessões de brinquedo”, as fitas foram transcritas e complementadas com as observações anotadas. A fim de desvelar o sentido das vivências das crianças com câncer em tratamento ambulatorial, foi realizada uma análise à luz da fenomenologia existencial de Martin Heidegger. A criança-com-câncer configurou-se como um ir e vir permeado ora pela autenticidade, quando a criança assumia sua doença e seu ser-para-a-morte, ora pela inautenticidade, quando deixava-se levar pelo modo de ser da decadência dos familiares e da equipe de saúde. O brincar pôde favorecer um rico acesso às vivências da criança gravemente doente. / Children’s cancer is a chronic disease that demands a long, invasive and painful treatment. The therapeutic advances enable the ambulatory treatment. However, it is as stressful as the hospitalization. Therefore, it is important for the child to have space to express their anxieties regarding this new reality – the disease’s world and the oncology treatment– when they are waiting to receive their treatment. The playing room is a place that favors the children’s development and help them to understand what is happening with them while they play. The purpose of this study is to learn the meaning of being children with cancer being submitted to ambulatory treatment and using the play room as a possibility to enable their expression about their world. Thus, a play room was built at a philanthropic hospital in the city of Ribeirão Preto, SP, Brazil. Seven children from 3 to 9 years of age with the diagnosis of cancer participated in the study from August, 2001 to January, 2002. During their appointments, the children were invited to play and oriented to stay there as long as they wanted. After the playing sessions, the tapes were transcribed and complemented with observations. Aiming at learning about the meaning of these experiences to children with cancer, author analyzed these data based on the Marting Heidegger’s existential phenomenology. The children-with-cancer showed a movement that was permeated sometimes by the authenticity, when the child assumed the disease and their being-to-death and also by the lack of authenticity, when they were influenced by their family and members of the health team. The situation of playing enabled the access to these children who were severely ill.

Background: There are 2,2 million children living in Sweden and every day about one child is diagnosed with cancer. Nurses have an important role in nursing the sick child and comforting it´s families. Little is known about the nurses´ experiences in working with this severely ill children. Aim: The aim of this study was to highlight nurses´ experiences of caring for children with cancer. Method: A method to contribute to evidence-based nursing with the ground in analysis of qualitative research was conducted. An analysis of fourteen qualitative articles was carried out. The analysis resulted in four main themes and eleven subthemes. Result: Four main themes emerged; The adequate knowledge needed, Difficulties in ethical stance, Caring relationships where the child is in the centre, Emotional contrasts. The results of the study showed that the nurses experienced that they were not fully-trained and that the knowledge was not sufficient when they were new to childhood cancer. The nurses experienced a lot of emotions caring for children with cancer and felt it valuable to use coping to deal with the upcoming emotions and prevent emotional burn-out. Conclusion:More knowledge in childhood cancer is needed for nurses caring for children sick with cancer. It is important for the nurses to see the child's best, but also to work family-centered. The work is emotionally stressful and requires coping strategies to prevent emotional burnout.

Background: Every year 250,000 children worldwide receive the unimaginable diagnosis of cancer. A cancer diagnosis inflicts a major impact on the family situation. They must deal with an entirely, both emotionally and socially new situation they are not prepared for. It is of great importance that the nurse has adequate knowledge to be able to provide the best possible care to the entire family. Aim: The aim of this study was to describe the family members' experiences of losing a child in cancer. Method: A method to contribute to evidence-based nursing with ground in analysis of qualitative research was performed to get a better understanding of families' experiences. An analysis of thirteen qualitative articles was carried out. The analysis resulted in five main themes and sixteen subthemes. Results: The results of the study showed that families losing a child in cancer are having a heart-breaking time. They described combative feelings between hope and despair. The mothers often took care of the sick child at home and the fathers kept their minds busy while working. The families put all their own needs and sorrows aside. The siblings felt lonely since the parents took care of the sick child. After the passing, the family kept a bond to the deceased child through memories and dreams. Conclusion: The families experienced a greater need of support from the nurses and the hospital staff, during the time when the child was sick and after the death.

Bakgrund: Sjuksköterskeyrket är ett stressande yrke och sjuksköterskor som arbetar med cancersjuka barn har identifierats som en grupp som löper större risk för stress, på grund av den exponering av patienternas samt deras anhörigas lidande. Cancer hos barn är ovanligt och att arbeta på en barncanceravdelning kan vara krävande på både professionella och personliga plan. Syfte: Syftet med studien var att beskriva sjuksköterskors upplevelser av stress vid vård av cancersjuka barn.  Metod: En litteraturstudie med åtta kvalitativa artiklar har använts. Databaserna CINAHL och PubMed har använts vid sökprocessen.  Resultat: Analysen resulterade i tre teman med tillhörande subteman. Huvudteman var: "Sjuksköterskans upplevelse av stress", "Sjuksköterskans beskrivning av en stressfylld situation" och "Sjuksköterskans hantering av stress". Konklusion: Sjuksköterskans upplevelse av stress kan yttra sig på olika sätt, en känsla av hjälplöshet och en känsla av ångest. Mötet med föräldrar och hög arbetsbelastning beskrevs som stressfyllda situationer för sjuksköterskan. Med hjälp av distansering, kollegor och reflektion hanterade sjuksköterskan den upplevda stressen. Vidare forskning kring hur sjuksköterseyrket kan underlättas vid svåra situationer bör genomföras samt forskning kring sjuksköterskans upplevelse av stress vid vård av cancersjuka barn. / Background: It is recognized that nursing is a stressful occupation and nurses that work in a pediatric cancer ward have been identified as a group that are at a greater risk of experiencing stress, as a result of the exposure of patients and their relatives suffering and agony. Cancer in children is uncommon and it is recognized that working on a pediatric cancer ward can be demanding on both a professional and a personal level. Aim: The purpose of this study is to describe the experienced stress that nurses have when caring for children with cancer.  Methods: A literature study conducted with eight qualitative articles. The databases CINAHL and PubMed have been utilized in the search process.  Results: The analysis resulted in three themes with connected subthemes. The main themes were “Nurses’ experience of stress”, “Nurses’ description of a stressful situation” and “Nurses’ stress management”. Conclusion: The experienced level of stress with nurses can be observed in many ways, a feeling of helplessness and a feeling of anxiety. The encounter with the parents of the patient and the high level of workload was described as stressful situations for the working nurse. With the aid and usage of personal tools such as distancing, colleagues and reflection, can the working nurse handle the experienced level of stress. Further research in the area can favor how the nursing profession can ease difficult situations, and also how research can be developed in the area of how the experience of stress by nurses that work in a pediatric cancer ward.

No description available.

När ett barn drabbas av cancer blir hela familjen drabbad. Barn som diagnostiserats med cancer har en lång vårdprocess framför sig med behandlingar som kan ge stora biverkningar. Vara förälder till ett barn med cancer, där framtiden är oviss, är psykiskt påfrestande. Syftet var att beskriva hur föräldrar påverkas av att ha ett barn med cancerbehandling. Metod för studien var allmän litteraturstudie där sökningar gjordes i två olika databaser med omvårdnadsfokus. Det resulterade i 9 vetenskapliga resultatartiklar som granskades och sammanställdes till ett resultat. Resultatet beskriver föräldrars upplevelser genom kategorierna: Att familjen och relationer påverkas, resan till och från sjukhus, att vara stark och finna hopp och att ansvara för barnet vid hemkomst. Det framkom att det är viktigt att föräldrarna är delaktiga i sitt barns omvårdnad eftersom det fick dem att känna sig viktiga och att de hade kontroll över situationen. Vid bristande delaktighet upplevde föräldrarna ökad oro och ångest. Slutsatsen av litteraturstudiens resultat belyser att det krävs ett gott samarbete mellan förälder och vårdpersonal för att föräldrarna ska känna trygghet. Fler möjligheter till stöd för föräldrarna behövs. De stödgrupper som finns anses inte tillräckliga. Därför rekommenderas fortsatt forskning med syfte att undersöka föräldrars upplevelser för att ge sjuksköterskan, men även övrig vårdpersonal, större kunskap i att främja föräldrarnas välbefinnande under denna påfrestande tid. / When a child develops cancer, the whole family is affected. Children that have been diagnosed with cancer, have a long health care process ahead of them with treatments that could result in major side effects. To be a parent with a child who suffers from cancer, is psychologically strenuous. The purpose was to describe how parents are affected by having a child undergoing cancer treatment. The methodology applied for the study was a literature review where searches were done in two different databases with a health care focus. The searches resulted in nine scientific articles, which were reviewed and then merged into a result. The result describes the parent’s experiences in the following categories: that the family and relations are affected, travel to and from the hospital, to be strong and find hope and to be responsible for the child when returning home. It was revealed that it is important that the parents participate in their child’s care because it made them feel important and in control of the situation. When participation was lacking, the parents experienced anxiety and apprehension. The conclusion on the results from the literature review highlights the need for good collaboration between parents and health care staff for the parents to feel secure. Multiple options for support to the parents are required. The support groups that exist today are not considered adequate. It is therefore recommended that research continues to examine parents experiences, with aim of giving the nurse as well as other health care staff, greater understanding on how to support the parents well-being during this demanding time period.