Mixed-methods evaluation of a face-to-face educational intervention for health and social care professionals to deliver family-centred cancer supportive care when a parent with dependent children is at end of life

OBJECTIVE: To deliver and evaluate an educational intervention to equip health and social care professionals (professionals) on how best to support parents at end of life with cancer concerning their dependent children (&lt;18).METHODS: An evidence-based and theory-driven face-to-face educational intervention was developed and evaluated using three levels of Kirkpatrick's Model of Evaluation. Pre-test, post-test surveys were completed immediately before-and-after the intervention using a validated self-efficacy scale and single-item questions evaluating perceived usefulness and relevance (levels one/two). Qualitative interviews ≥ 3-months post-intervention explored if, and how the intervention impacted professionals' practice (level three). Fourteen sessions were delivered at oncology settings to 347 professionals between 2021 and 2023. Two hundred seventy four professionals completed the pre-test survey, with 239 completing the post-test survey. Fourteen professionals were interviewed between three-and 19-months post-intervention.RESULTS: Quantitative findings demonstrated a statistically significant improvement in self-efficacy post-educational intervention (p &lt; 0.001). Qualitative data highlighted professionals gained new approaches to progress end of life conversations with parents, despite some familial resistance to sharing the reality of the situation with children. Positive intervention content shaping clinical practice included the bereaved parent's lived experience, communication framework and roleplay videos. Some professionals considered a booster session and opportunities to practice conversations necessary to further consolidate learning into practice.CONCLUSIONS: Evidence and theory-driven education can positively impact professionals' provision of family-centred cancer care. Future studies should explore the impact of this educational intervention on familial outcomes. Alongside a sustainable delivery of this intervention, advanced communication skills programmes should incorporate parent-child end of life conversations.</p

‘<i>I didn’t know what was in front of me</i>’ – bereaved parents’ experience of adapting to life when a co-parent of dependent children has died with cancer

OBJECTIVE: It is not clear how the bereaved parent navigates life with the children after a co‐parent has died. The objective of this study is to explore bereaved parents' experience of managing life when a co‐parent of dependent children has died with cancer. METHODS: Twenty‐one in‐depth interviews were conducted with bereaved parents when a co‐parent died with cancer. Data were analysed thematically. RESULTS: Bereaved parents highlighted how their children was their key focus after the death of a co‐parent with cancer, as they effortfully strived to be a ‘perfect parent’. While some bereaved parents struggled to adapt to the role as a sole parent, others described the importance of maximising social networks to help with the practical aspects of parenting. However, most bereaved parents described intense feelings of loneliness as they navigated parenting alone. To help navigate this post‐bereavement period, parents considered it important for their children to openly talk about the deceased parent. Also, meeting others who have experienced similar situations was helpful for the bereaved parent and children, providing hope for the future. Results are discussed under two themes: (1) adapting to life without the parent, and (2) a desire to keep the memory alive of the parent that died with cancer. CONCLUSIONS: Bereaved parents should be encouraged to practice self‐care when a co‐parent has died from cancer so they can appropriately meet the needs of their children. Bereaved parents should be reassured that showing emotion in front of the children is helpful and could facilitate better grief experiences for the whole family

Mixed-methods evaluation of a face-to-face educational intervention for health and social care professionals to deliver family-centred cancer supportive care when a parent with dependent children is at end of life

Background: Health and social care professionals (professionals) often highlight a lack of knowledge, skills and confidence toward supporting parents at end of life (EoL) with cancer regarding their children (&lt;18 years).Objectives: To determine the effects of a face-to-face educational intervention on professionals self-efficacy to deliver family-centred cancer care when a parent with dependent children is at EoL.Design: Mixed-methods study.Method: An evidence-based 2-hour face-to-face educational intervention was developed, which included a bereaved parent’s lived experience. This intervention was delivered interdisciplinary, mainly at oncology settings (n = 14), facilitated by two expert academic nurses to 347 professionals, between September 2021 and September 2023. Quantitative surveys were completed immediately before and after the intervention by 216 professionals using a modified validated self-efficacy scale and single-item questions evaluating perceived usefulness and relevance. At ⩾ 3-months post-intervention, qualitative interviews (n = 14) explored professionals’ perceptions if and how the intervention impacted practice; analysed using reflexive thematic analysis.Results: Quantitative findings highlighted a statistically significant improvement in self-efficacy post-educational intervention (p &lt; 0.001). Qualitative data highlighted professionals were more confident in taking an active role in initiating pre-bereavement conversations with parents about their children. This included reassuring parents of the importance of telling the children about the poor prognosis, and guidance on how best to do this. Key components from the educational intervention positively shaping clinical practice, included the bereaved parent’s lived experience, the communication framework and videos emulating good practice. Findings are discussed under two themes: (1) the power of art, science and lived experience to education provision, and (2) promoting family-centred cancer care in practice.Conclusion: Professionals are ideally placed to support parents as they prepare children for the death of a parent. Evidence- and theory-driven education appeared to positively impact professionals’ provision of family-centred cancer care in practice. A more sustainable delivery model of this educational intervention is required

Children of Parents with Cancer: An evaluation of a psychosocial intervention

Over the past three decades there has been a marked increase in the prevalence of cancer among younger age groups, many of whom are parenting children. In Ireland it is estimated that 15% of people with cancer are aged between 20-50 years (National Cancer Registry Ireland (NCRI, 2016). Research has indicated that when a parent is diagnosed with cancer they face additional fears and anxieties as they attempt to simultaneously manage their role as parent, with their illness (Rauch & Moore, 2010, Semple & McCance, 2010a, O’Neill et al, 2016). Parents, at this time, primarily want to protect their children from worry and anxiety. However, managing this process is challenging and the illness experience affects the whole family unit. Research evidences that children, depending on age and gender, are at increased risk of psychological and social problems ranging from separation anxiety, depression, difficulties at school, leisure, family functioning and relationships (Visser et al, 2004, Osborn, 2007, Thastum et al 2009)

"It's part of our life now": a qualitative exploration of the social eating experiences of family members of patients living with head and neck cancer

PURPOSE: Family members (FMs) of patients with head and neck cancer (HNC) report a change in their social eating experience. They miss out on the opportunities and benefits that eating with others provides. However, few studies investigate FM’s social eating experiences, with existing research primarily focusing on the patient experience. Therefore, the aim of this study was to explore the social eating experiences of FMs of patients who have had treatment for HNC. METHODS: A qualitative research design using semi-structured interviews was used to understand FM’s social eating experiences. Key themes were inductively developed from the data using reflexive thematic analysis. RESULTS: Twelve interviews were conducted with FMs, and three key themes were identified: (1) changes and challenges experienced by FMs due to HNC patients’ social eating difficulties, (2) living with social eating changes is a balancing act, and (3) FMs’ efforts to promote social eating for a patient with HNC. FMs expressed significant changes to their social eating habits within and outside the home, indicating the need for support to meet their own emotional, psychological and social needs. CONCLUSION: FMs experience many demands and tensions, having to balance the psychological impact they experience, which are often minimised, whilst attempting to find the best ways to support, protect and encourage their loved ones to adjust and adapt to social eating changes. Therefore, interventions need to support FMs’ challenges and equip them to know how to best support patients living with HNC and themselves