Psychosocial Interventions for Families with Parental Cancer and Barriers and Facilitators to Implementation and Use – A Systematic Review

<div><p>Background</p><p>Parental cancer has a significant impact on minor children and families. Psychosocial interventions for affected families can provide support where necessary. This systematic review aims at providing an overview of existing interventions and support programs and focuses on the systematic investigation of barriers and facilitators for using psychosocial interventions for families affected by parental cancer (PROSPERO; registration number CRD42014013020).</p><p>Methods</p><p>A search of five electronic databases (EMBASE, MEDLINE, PsycInfo, Psyndex, CINAHL) was conducted in June 2014, and updated in September 2015. We included any kind of studies reporting psychosocial support services or interventions for families affected by parental cancer. Study quality was assessed using the Mixed Method Assessment Tool. Narrative synthesis and thematic analyses were undertaken to examine the included interventions and to identify barriers and facilitators for use and implementation.</p><p>Results</p><p>A total of 36 studies covering 19 interventions and support services were included in the systematic review. Interventions focused on children, parents or several family members and analyses revealed a broad picture of theoretical background and primary aims. Several studies focused on developmental or implementation phases or descriptions of interventions. Other included studies reported results of evaluations using qualitative and quantitative methods. Results suggest that interventions are helpful and that participants improved in various outcomes. The thematic analyses indicate that barriers for use of support services refer to aspects concerning the patients and families, such as practical difficulties, perceived need for support or fear of stigma. Cancer patients who understood the need and benefit of support services may have used them more often. Additionally, intervention characteristics such as a flexible structure and accessibility were important to reach families affected by parental cancer. Disease characteristics and complications in collaborations were identified as potential barriers. The provision of information about interventions by clinicians and understanding the support as part of routine care seem to be key issues for implementation and use of psychosocial support.</p><p>Conclusion</p><p>This review identified a broad number of intervention concepts for families with minor children affected by parental cancer. Findings provide a basis for existing or future psychosocial interventions to anticipate potential barriers and facilitators to implementation and use and can help to reach a wider range of families in need for support.</p></div

Summary of the included records (N = 36 studies on N = 19 different interventions).

<p>Summary of the included records (N = 36 studies on N = 19 different interventions).</p

Flow diagram of systematic literature search.

<p>Flow diagram of systematic literature search.</p

Barriers and facilitators for using psychosocial support services in families with parental cancer.

<p>Barriers and facilitators for using psychosocial support services in families with parental cancer.</p

Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review

<div><p>Children of parents with drug and alcohol use disorders often grow up under severe stress and are at greater risk of developing psychological and social problems. However, a substantial proportion of affected children adapt to their distressing life conditions and show positive development in terms of their mental health. These children are described as resilient. One difference between resilient and maladapted children is the presence of protective factors. The aim of this systematic review is to provide an overview of the current state of the research concerning protective mental health factors in children of parents with alcohol or drug use disorders (COPAD). For that purpose, the PsychInfo, PubMed, CINAHL and ISI Web of Science databases were searched through January 2017. All the identified publications were screened using previously developed inclusion criteria. The search yielded 3,402 articles. Eleven of these publications (2003–2013) met the criteria for inclusion in the present review. Information on the studies was extracted using an extraction form. A narrative analysis was performed, and the methodological quality was examined using a checklist based on the Mixed Methods Appraisal Tool. The research identified familial, parental, child-related and biological factors that influenced mental health outcomes in affected children (N = 1,376, age range = 1–20 years). Overall, protective mental health factors are understudied in this target group. Most of the included studies were conducted in the United States and employed a cross-sectional design. A comparison of the included cross-sectional and longitudinal studies indicated consistent results related to a secure parent-child attachment. Based on the current state of the research, no causal conclusions with regard to the effectiveness of protective factors can be drawn. To develop effective prevention programs, further longitudinal studies and studies assessing the interactions between risk and protective factors are needed.</p></div

Flow of information through the different phases of the systematic review.

<p>Flow of information through the different phases of the systematic review.</p

Assessment of the methodological quality of the included studies.

<p>Assessment of the methodological quality of the included studies.</p

Inclusion criteria (IC).

<p>Inclusion criteria (IC).</p

MOESM1 of Risk and protective factors for mental health problems in preschool-aged children: cross-sectional results of the BELLA preschool study

Additional file 1: Table S1. Bivariate logistic regression analyses of risk and protective factors for MHP in preschoolers (N = 391), unweighted data. Table S2. Hierarchical multivariate logistic regression analysis of risk and protective factors for MHP in preschoolers (N = 391), unweighted data