Quality of life of parents with children living at home: when one parent has cancer

Goals of work This study examined the quality of life (QoL) of cancer patients diagnosed 1-5 years previously and their spouses, with children 4-18 years living at home. Relationships between parents' QoL and the children's functioning were explored. Patients and methods 166 cancer patients and their spouses provided information on their QoL (RAND-36) and on their children's functioning (Child Behavior Checklist). Main results Male and female patients scored similarly to a norm population on five domains. Patients' QoL was clinically relevantly and/or statistically lower on social functioning, role limitations because of physical problems, and vitality than the norm. Male spouses' QoL was comparable to the norm. However, female spouses reported better physical functioning but more social problems. QoL varied according to type of cancer, treatment intensity, and recurrence. Using the QoL composite scores, a significant relationship was found between patients' psychosocial and physical functioning and spouses' psychosocial functioning. Patients' psychosocial functioning correlated moderately strongly to weakly with their reports of their younger children's and adolescents' functioning; physical functioning correlated only weakly with adolescents' functioning. The patients' functioning related weakly to moderately strongly to adolescents' self-reports of functioning. Spouses' psychosocial functioning weakly related to their and adolescents' reports of adolescents' functioning. Conclusion Cancer patients' QoL 1-5 years after diagnosis was decreased in three of eight domains; their spouses seem to be doing well. Parents' physical and psychosocial functioning related weakly to moderately strongly to their children's functioning, depending on the child's age and information source. The patients' functioning related more strongly to the children's functioning than the spouses' did

The influence of mothers' and fathers' parenting stress and depressive symptoms on own and partner's parent-child communication

This study examines how parenting stress and depressive symptoms experienced by mothers and fathers influence their own (actor effects) and the partner's (partner effects) parent–child communication. Based on the Actor-Partner Interdependence Model, data from 196 families were analyzed, with both parents rating their parenting stress and depressive feelings, and parents as well as children rating the open parent–child communication. Actor effects were found between parenting stress and open parent–child communication, whereas partner effects were prominent between depressive symptoms and open parent–child communication. The results provide no evidence for gender differences in the strength of the pathways to open parent–child communication. Our findings demonstrate the need to include both parents in studies on parent–child communication to enhance our understanding of the mutual influence among family members

Screening and referral for psychosocial distress in oncologic practice: use of the Distress Thermometer

BACKGROUND: The objectives of this study were to validate the Distress Thermometer (DT) in the Netherlands and to examine its correspondence with a 46-item Problem List, possible risk factors, and the wish for a referral. METHODS: A cross-sectional group of 277 cancer patients who were treated at 9 hospitals filled in the DT and the Hospital Anxiety and Depression Scale and rated the presence and severity of problems (response rate, 49%). RESULTS: Receiver operating characteristic analyses identified an ideal cutoff score of 5 on the DT with a positive predictive value of 39% and a negative predictive value of 95%. The Problem List appeared to be a reliable measure. Five items on the Problem List correlated strongly with the DT, 13 items had a moderately strong correlation, 26 items were correlated weakly, and 2 items were not correlated significantly. Emotional control, nervousness, pain, and physical fitness appeared to contribute independently to the DT score. The percentage of patients scoring > or =5 (n = 118 patients; 43%) who wanted (14%) or maybe wanted (29%) a referral was significantly higher than the percentage of patients with DT scores <5 (5% and 13%, respectively) who wanted or maybe wanted a referral. Intensively treated patients reported more distress than those who only underwent surgery. No other clear risk factors for distress were identified. CONCLUSIONS: The DT appeared to be a good instrument for routine screening and ruling out elevated distress. Emotional and physical problems contributed mainly to distress. Experiencing clinically elevated distress did not necessarily suggest that patients wanted a referral. Screening for distress and the wish for a referral can facilitate providing support for those patients who most need and want it

Emotional and behavioral problems in children of parents recently diagnosed with cancer: A longitudinal study

A study examines the prevalence of problems in children within four months after a parent's cancer diagnosis (T1) and six (T2) and twelve months (T3) afterwards. Sixty-nine ill parents and 57 spouses completed the Child Behavior Checklist for 57 primary school (aged 4-11 years) and 66 adolescent children (aged 12-18 years). Adolescents completed the self-report version. Children's functioning was compared to that of the norm group and a sample of families that were confronted with parental cancer between one to five years before study participation (retrospective study). Most children were reported as having a similar level as or fewer problems than was reported in the norm and retrospective studies. Reported problems decreased with time, but children who initially had more problems remained vulnerable during the year. Fathers and mothers highly agree in their perception of children's behavior, with the exception of adolescent daughters' behavior. Agreement between mothers and adolescent daughters was high, whereas agreement between fathers and adolescent sons and daughters, and mothers and adolescent sons was low to moderate. The outcomes suggest that most children do not experience problems shortly after the parent's diagnosis and were functioning over time on a level equal to or better than that of their peers. Differences in informant's perceptions appear and remain of interest

Burnout in medical residents: a review

OBJECTIVES This study aimed to review current knowledge on burnout in medical residents, including reported prevalence rates, and to establish which risk and resistance factors contribute to or prevent burnout in medical residents. METHODS We conducted a comprehensive search of the literature published between 1975 and 2005, using the Medline, EMBASE (from 1989) and PsychINFO databases. RESULTS A total of 19 studies met our inclusion criteria. Only 5 studies appeared to meet more than 2 of the Cochrane quality criteria. The different studies report widely varying burnout rates among medical residents, ranging from 18% to 82%. Predictors of burnout can be characterised as either occupational or individual. Inconsistent results were reported with regard to the effects of some of these factors on burnout. Four of the 16 occupational risk factors appeared to be strongly related to burnout. The 11 individual risk factors examined were only weakly or moderately related to burnout. CONCLUSIONS Research on burnout among medical residents is scarce. The weak quality of the studies, the wide variety and limited predictive power of the predictor variables included and the inconsistent findings illustrate the need for a more systematic design with regard to future research among medical residents. A future research model should take account of the individual, occupational and training demands experienced by medical residents