Objective and Subjective Factors as Predictors of Post-Traumatic Stress Symptoms in Parents of Children with Cancer – A Longitudinal Study

BACKGROUND: Parents of children with cancer report post-traumatic stress symptoms (PTSS) years after the child's successful treatment is completed. The aim of the present study was to analyze a number of objective and subjective childhood cancer-related factors as predictors of parental PTSS. METHODS: Data were collected from 224 parents during and after their child's cancer treatment. Data sources include self-report questionnaires and medical records. RESULTS: In a multivariate hierarchical model death of the child, parent's perception of child psychological distress and total symptom burden predicted higher levels of PTSS. In addition, immigrants and unemployed parents reported higher levels of PTSS. The following factors did not predict PTSS: parent gender, family income, previous trauma, child's prognosis, treatment intensity, non-fatal relapse, and parent's satisfaction with the child's care. CONCLUSIONS: Although medical complications can be temporarily stressful, a parent's perception of the child's distress is a more powerful predictor of parental PTSS. The vulnerability of unemployed parents and immigrants should be acknowledged. In addition, findings highlight that the death of a child is as traumatic as could be expected

Parental stress before, during, and after pediatric stem cell transplantation: a review article

Goals of work: Pediatric stem cell transplantation (SCT) is a stressful treatment for children with relapsed or high-risk malignancies, immune deficiencies and certain blood diseases. Parents of children undergoing SCT can experience ongoing stress related to the SCT period. The aim of this article was to present a literature review of articles on parental distress and adaptation before, during, and after SCT and to identify risk and protective factors. Materials and methods: The review was conducted systematically by using PubMed, Web of Science, PsychInfo, and Picarta databases. Eighteen articles met our inclusion criteria: publishing date between January 1, 1990 and January 1, 2009; studies concerning parents of children undergoing SCT; studies examining the psychological adjustment and/or stress reactions of parents as primary outcomes and studies available in English. Main results: Highest levels of parental stress are reported in the period preceding SCT and during the acute phase. Stress levels decrease steadily after discharge in most parents. However, in a subgroup of parents, stress levels still remain elevated post-SCT. Parents most at risk in the longer term display highest levels of stress during the acute phase of the SCT. Conclusions: Psychosocial assessment before SCT, during the acute phase and in the longer term, is necessary to identify parents in need for support and follow-up care

Multiprofessional follow-up programmes are needed to address psychosocial, neurocognitive and educational issues in children with brain tumours

AIM: The aim of this study was to coordinate the structured psychosocial, neurocognitive and educational follow-up of children treated for brain tumours with the medical protocol and apply the model in two Swedish healthcare regions. METHODS: We invited all children living in the two regions, who had been diagnosed with a brain tumour from October 1, 2010, through June 30, 2012, to participate along with their parents. The follow-up programme evaluated the emotional status of the parents and patients and assessed the children's general cognitive level, working memory, speed of performance, executive functions and academic achievement from diagnosis through to adult care. RESULTS: During the study period, 61 children up to the age of 17.1 years were diagnosed with a brain tumour, but 18 of these were excluded for various reasons. The majority of the mothers (70%) displayed significantly poor emotional status, as did 34% of the fathers and 21% of the children. The majority of the children (57%) also showed poor neurocognitive performance and needed special adaptations at school (66%). CONCLUSION: Our findings indicate the need for coordinated, multiprofessional follow-up programmes, well anchored in the healthcare organisation, for children diagnosed with brain tumours

Risk factors contributing to truck drivers’ non-driving occupational accidents

Abstract Purpose: The purpose of this paper is to identify various individual factors and combinations thereof that can contribute to truck drivers’ occupational accidents, particularly connected to work performed outside the cab in various work environments. Design/methodology/approach: In total, 74 accidents were analysed through in-depth interviews with truck drivers. These interviews were conducted employing the critical incident technique, and analysed utilising a qualitative content analysis approach. Findings: The contributing factors identified were categorised into 14 categories. In all, 13 of these were grouped into four sections reflecting the drivers’ work outside the cab: “Goods and equipment”, “Loading/unloading area”, “Loading/unloading tasks”, and “Organisation”. A single risk factor was associated with 40 accidents while the other 34 involved combinations of factors. Research limitations/implications: Although the tasks performed by truck drivers in different countries are probably similar, one limitation might be that all the accidents characterised occurred in one country: Sweden. Practical implications: The findings reveal that complex combinations of risk factors often contribute to accidents. In addition to the transportation company itself, other stakeholders, such as clients, and designers and manufacturers of technology, may influence the occupational safety of truck drivers. Different stakeholders who could contribute to managerial decision making that is designed to prevent accidents are identified and discussed. Originality/value: This investigation contributes to an in-depth understanding of the causes of accidents in the transportation industry. The findings are discussed from the perspective of the stakeholders and safety management in an attempt to identify key stakeholders who can improve accident prevention