Role of Parenting Variables and Health-Related Quality of Life in Pediatric Cancer

The purpose of the current study was to assess the relationship between parenting capacity variables, namely parental overprotection, perceived child vulnerability, and parenting stress, and socioecological factors, including family socioeconomic status and parental marital status, and parent-proxy report of child health-related quality of life. Participants were 89 parents of children, ages two to 16 (M = 6.5 years, 57% male, 80.9% Caucasian), who were diagnosed with pediatric cancer. Parent participants completed a demographic form, the parent-proxy report of the Pediatric Quality of Life Inventory 3.0 Cancer Module (PedsQL), Parent Protection Scale (PPS), Child Vulnerability Scale (CVS), and Parenting Stress Index/Short Form (PSI/SF). A medical chart review was also conducted. Participants were recruited while attending outpatient appointments at the cancer center of a midwestern children's hospital. After controlling for theoretically important demographic factors, results revealed that parent-proxy report of health-related quality of life was negatively related to family socioeconomic status, parental overprotection, perceived child vulnerability, and parenting stress. No significant relationship was found between parent marital status and health-related quality of life. However, older child age also emerged as a significant predictor of poor child health-related quality of life. Overall, these results support the transactional relationship between parent and child adjustment to pediatric cancer. The evident contributions of socioeconomic status, parental overprotection, perceptions of vulnerability, and parenting stress to child disease-specific health-related quality of life may warrant assessment of these variables in parents of children who have been recently diagnosed with cancer.Department of Psycholog

Communicating breast cancer risk information to young adult women: A pilot study

Objective To examine the effectiveness of a health promotion flyer to increase awareness of breast cancer risk and physical activity as a risk reduction strategy in young adult women. Methods Young adult women (N = 123) viewed one of five health promotion flyers online and then completed measures of perceived breast cancer risk (PR) and perceived informativeness (PI) and a qualitative thought-listing activity. Results Differences were observed in PI such that the control and low risk/low information messages were significantly less informative than the others. Qualitative analyses revealed two general themes: message content and flyer design. Additional analyses of the flyer design comments revealed four sub-themes: negative thoughts about the image, positive thoughts about the image, misunderstanding breast cancer risk information, and social comparison. Exploratory analyses controlling for message type indicated that image appraisal predicted PI such that those who commented on the image found the flyer to be less informative. Discussion Results suggest that the flyer was informative but did not impact young women’s breast cancer risk perceptions. Additionally, the image may have distracted young women from the intended message. Evaluating the acceptability of images used in health promotion materials is recommended before testing the effectiveness of the intervention

Phase I of the Detecting and Evaluating Childhood Anxiety and Depression Effectively in Subspecialties (DECADES) Study: Development of an Integrated Mental Health Care Model for Pediatric Gastroenterology

Background: Children with gastrointestinal symptoms have a very high rate of anxiety and depression. Rapid identification of comorbid anxiety and depression is essential for effective treatment of a wide variety of functional gastrointestinal disorders. Objective: The objective of our study was to determine patient and parent attitudes toward depression, anxiety, and mental health screening during gastroenterology (GI) visits and to determine patient and parent preferences for communication of results and referral to mental health providers after a positive screen. Methods: We augmented standard qualitative group session methods with patient-centered design methods to assess patient and parent preferences. We used a variety of specific design methods in these sessions, including card sorting, projective methods, experience mapping, and constructive methods. Results: Overall, 11 families (11 patients and 14 parents) participated in 2 group sessions. Overall, patients and their parents found integrated mental health care to be acceptable in the subspecialty setting. Patients’ primary concerns were for the privacy and confidentiality of their screening results. Patients and their parents emphasized the importance of mental health services not interfering with the GI visit and collaboration between the GI physician, psychologist, and primary care provider. Conclusions: Patients and their families are open to integrated mental health care in the pediatric subspecialty clinic. The next phase of the DECADES study will translate patient and parent preferences into an integrated mental health care system and test its efficacy in the pediatric GI office. [J Participat Med 2018;10(3):e10655

Differences in adjustment by child developmental stage among caregivers of children with disorders of sex development

<p>Abstract</p> <p>Background</p> <p>The current study sought to compare levels of overprotection and parenting stress reported by caregivers of children with disorders of sex development at four different developmental stages.</p> <p>Methods</p> <p>Caregivers (<it>N </it>= 59) of children with disorders of sex development were recruited from specialty clinics and were asked to complete the Parent Protection Scale and Parenting Stress Index/Short Form as measures of overprotective behaviors and parenting stress, respectively.</p> <p>Results</p> <p>Analyses of covariance (ANCOVAs) were conducted to examine differences between caregiver report of overprotection and parenting stress. Results revealed that caregivers of infants and toddlers exhibited more overprotective behaviors than caregivers of children in the other age groups. Further, caregivers of adolescents experienced significantly more parenting stress than caregivers of school-age children, and this effect was driven by personal distress and problematic parent-child interactions, rather than having a difficult child.</p> <p>Conclusions</p> <p>These results suggest that caregivers of children with disorders of sex development may have different psychosocial needs based upon their child's developmental stage and based upon the disorder-related challenges that are most salient at that developmental stage.</p