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DOI: 10.1055/a-2546-6981
Die psychosoziale Situation von Eltern krebskranker Kinder in der Nachsorge – Ergebnisse einer qualitativen Studie
The psychosocial situation of parents of children with cancer during aftercare – Results of a qualitative study
Zusammenfassung
Ziel der Studie
Krebs im Kindes- und Jugendalter kann mit Spätfolgen sowie langfristigen Beeinträchtigungen verbunden sein. Auch nach Abschluss der Therapie können Herausforderungen im Alltag und Belastungen für die Familie bestehen. Das Ziel der vorliegenden Studie war es die Erfahrungen von Eltern ehemals krebskranker Kinder nach Abschluss der Therapie hinsichtlich der Rückkehr in den Alltag, psychosozialer Belastungen und Bewältigungsstrategien zu untersuchen.
Methodik
In einer qualitativen Interviewstudie wurden semistrukturierte Interviews mit Eltern von ehemals krebskranken Kindern bis 17 Jahre durchgeführt. Insgesamt wurden 30 Eltern (n=20 Mütter, n=10 Väter) telefonisch zu ihren Erfahrungen befragt. Die Daten wurden anschließend transkribiert und mit dem Programm MAXQDA nach dem Prinzip der qualitativen Inhaltsanalyse ausgewertet.
Ergebnisse
Viele Eltern berichteten nach Abschluss der Therapie von Erschöpfung sowie Veränderungen und Beeinträchtigungen bei der Rückkehr in das Alltags- und Familienleben. Dabei benötigen die Verarbeitung der Erkrankung sowie die Neuorientierung Zeit. Sorgen bezüglich der Gesundheit des Kindes und die Angst vor einem Rezidiv können insbesondere während der Nachsorgeuntersuchungen belastend sein. Hilfreiche Aspekte im Umgang mit der Erkrankung sind eine offene Kommunikation und Aktivitäten zum Ausgleich.
Diskussion
Obwohl sich der Alltag mit zunehmender Zeit normalisiert, bestehen weiterhin Einschränkungen und Belastungen für die gesamte Familie. Aus den Ergebnissen lassen sich somit Ansatzpunkte für die Versorgung von Familien mit krebskranken Kindern in der Nachsorge ableiten.
Schlussfolgerung
Neben der medizinischen Nachsorge sollten Familien mit krebskranken Kindern bei Bedarf psychosoziale Unterstützung erhalten, um sie bei der Bewältigung des Alltags und von Belastungen zu begleiten.
Abstract
Objective
Pediatric cancer can lead to late effects and long-term impairments. Even after the end of acute treatment, challenges in daily life and psychosocial distress may persist for all family members. The aim of the current study was to investigate the experiences of parents of childhood cancer survivors after the end of acute treatment regarding returning to daily life, psychosocial stressors and coping strategies.
Methods
In a qualitative study, we conducted semistructured interviews with parents of childhood cancer survivors up to 17 years of age. In total 30 parents (n=20 mothers and n=10 fathers) were interviewed regarding their experiences. Data were transcribed verbatim and analyzed with the program MAXQDA. For the analysis qualitative content analysis was used.
Results
Many parents reported changes and impairments returning to daily life after the end of acute pediatric cancer treatment. Worries regarding the health of their child and fears of relapse can be distressing especially during follow-up care examinations. Some parents also reported a support needs due to psychological distress. Facilitating aspects for coping with the disease are an open communication and leisure activities.
Discussion
Although daily life becomes normal with passing time, there can still be impairments and stressors for the whole family. Several recommendations for follow-up healthcare of families with childhood cancer survivors can be inferred.
Conclusion
Next to medical follow-up care, families of childhood cancer survivors should receive psychosocial support after the end of acute treatment to help them settle in their daily life and cope with stressors.
Publikationsverlauf
Eingereicht: 01. November 2024
Angenommen: 25. Februar 2025
Artikel online veröffentlicht:
01. April 2025
© 2025. Thieme. All rights reserved.
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Literatur
- 1 Erdmann F, Kaatsch P, Grabow D. et al. German Childhood Cancer Registry – Annual Report 2019 (1980-2018). Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) at the University Medical Center of the Johannes Gutenberg University Mainz. 2020
- 2 Pritchard-Jones K, Pieters R, Reaman GH. et al. Sustaining innovation and improvement in the treatment of childhood cancer: lessons from high-income countries. Lancet Oncol 2013; 14: e95-e103
- 3 Gatta G, Botta L, Rossi S. et al. Childhood cancer survival in Europe 1999-2007: results of EUROCARE-5 – a population-based study. Lancet Oncol 2014; 15: 35-47
- 4 Dickerman JD. The late effects of childhood cancer therapy. Pediatrics 2007; 119: 554-568
- 5 Erdmann F, Frederiksen LE, Bonaventure A. et al. Childhood cancer: Survival, treatment modalities, late effects and improvements over time. Cancer Epidemiol 2021; 71: 101733
- 6 Michel G, Brinkman TM, Wakefield CE. et al. Psychological Outcomes, Health-Related Quality of Life, and Neurocognitive Functioning in Survivors of Childhood Cancer and Their Parents. Pediatr Clin North Am 2020; 67: 1103-1134
- 7 Vrijmoet-Wiersma CM, van Klink JM, Kolk AM. et al. Assessment of parental psychological stress in pediatric cancer: a review. J Pediatr Psychol 2008; 33: 694-706
- 8 Kearney JA, Salley CG, Muriel AC. Standards of Psychosocial Care for Parents of Children With Cancer. Pediatr Blood Cancer 2015; 62: S632-S683
- 9 Ljungman L, Hoven E, Ljungman G. et al. Does time heal all wounds? A longitudinal study of the development of posttraumatic stress symptoms in parents of survivors of childhood cancer and bereaved parents. Psychooncology 2015; 24: 1792-1798
- 10 Schepers SA, Sint Nicolaas SM, Maurice-Stam H. et al. Parental distress 6 months after a pediatric cancer diagnosis in relation to family psychosocial risk at diagnosis. Cancer 2018; 124: 381-390
- 11 Wikman A, Mattsson E, von Essen L. et al. Prevalence and predictors of symptoms of anxiety and depression, and comorbid symptoms of distress in parents of childhood cancer survivors and bereaved parents five years after end of treatment or a child's death. Acta Oncol 2018; 57: 950-957
- 12 Wakefield CE, McLoone J, Goodenough B. et al. The psychosocial impact of completing childhood cancer treatment: a systematic review of the literature. J Pediatr Psychol 2010; 35: 262-274
- 13 Ljungman L, Cernvall M, Gronqvist H. et al. Long-term positive and negative psychological late effects for parents of childhood cancer survivors: a systematic review. PLoS One 2014; 9: e103340
- 14 Roser K, Erdmann F, Michel G. et al. The impact of childhood cancer on parents' socio-economic situation – A systematic review. Psychooncology 2019; 28: 1207-1226
- 15 Peikert ML, Inhestern L, Krauth KA. et al. Returning to daily life: a qualitative interview study on parents of childhood cancer survivors in Germany. BMJ Open 2020; 10: e033730
- 16 Hoven E, Gronqvist H, Poder U. et al. Impact of a childʼs cancer disease on parents' everyday life: a longitudinal study from Sweden. Acta Oncol 2017; 56: 93-100
- 17 Inhestern L, Paul V, Winzig J. et al. Children with cancer and their families after active treatment: analyses of biopsychosocial needs and implications for healthcare – a study protocol. BMJ open 2022; 12: e055633
- 18 Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care 2007; 19: 349-357
- 19 Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Social science & medicine 2022; 292: 114523
- 20 VERBI Software. MAXQDA 2022. Berlin, Germany: VERBI Software; 2021
- 21 Mayring P. Qualitative content analysis: theoretical foundation, basic procedures and software solution. Klagenfurt. 2014
- 22 Gise J, Cohen LL. Social Support in Parents of Children With Cancer: A Systematic Review. J Pediatr Psychol 2022; 47: 292-305
- 23 Harper FW, Peterson AM, Albrecht TL. et al. Satisfaction with support versus size of network: differential effects of social support on psychological distress in parents of pediatric cancer patients. Psychooncology 2016; 25: 551-558
- 24 Peikert ML, Inhestern L, Krauth KA. et al. Fear of progression in parents of childhood cancer survivors: prevalence and associated factors. J Cancer Surviv 2022; 16: 823-833
- 25 Yang Y, Zhang Y, Liang L. et al. Fear of progression and its associated factors in parents of children undergoing cancer treatment: A cross-sectional study. Psychooncology 2022; 31: 1737-1744
- 26 Pai AL, Greenley RN, Lewandowski A. et al. A meta-analytic review of the influence of pediatric cancer on parent and family functioning. J Fam Psychol 2007; 21: 407-415
- 27 van Gorp M, Maurice-Stam H, Teunissen LC. et al. Psychosocial function of Dutch children with cancer and their caregivers during different phases of the COVID-19 pandemic. Pediatr Blood Cancer 2022; 69: e29535
- 28 Steele AC, Mullins LL, Mullins AJ. et al. Psychosocial Interventions and Therapeutic Support as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62: S585-S618
- 29 Boman K, Lindahl A, Björk O. Disease-related Distress in Parents of Children with Cancer at Various Stages After the Time of Diagnosis. Acta Oncologica 2003; 42: 137-146
- 30 Barrera M, Desjardins L, Prasad S. et al. Pilot randomized psychosocial trial of a screening intervention in pediatric oncology. Psychooncology 2022; 31: 735-744
- 31 Harju E, Hendriks MJ, Roser K. et al. Healthcare professionals' opinions on psychological screening in follow-up care for childhood cancer survivors. Swiss Med Wkly 2020; 150: w20356