Audrey E. Nelson

Consensus statements: The Family Management Style Framework and its use with families of children with cancer

amilies face many challenges when a child hasa chronic illness such as childhood cancer. The chal-lenges may include physiological changes in the childdue to treatment, interruption in the child’s develop-mental progress, alterations of the family’s day-to-dayactivities, and revisions in future goals. In the mid1980s, Knafl and Deatrick launched a program ofstudy to understand ways in which families respond tosuch challenges when a child has a chronic illness.This research has led to the description of 5 patternsof response to chronic illness, or 5 family managementstyles (FMS): Thriving, Accommodating, Enduring,Struggling, and Floundering (Knafl, Breitmayer,Gallo, & Zoeller, 1996). More recently, Deatrick andcolleagues have been applying the FMS Framework inwork with families who have a child with cancer tobetter understand their experience and to tailor inter-ventions for the family during the child’s cancer illnesstrajectory.The preconference workshop at the 26th AnnualConference of the Association of Pediatric OncologyNursing, held in 2002, focused on the developmentand application of FMS to families of children withcancer. After the workshop, the presenters reviewedthe concepts and developed summary consensusstatements. The consensus statements are as follows:1. Childhood cancer is represented by differenttypes of illness situations and disease manage-ment strategies.2. Health care professionals follow specific treat-ment protocols and tend to expect the child andfamily to react similarly to the informationpresented to them.3. A one-size-fits-all approach, however, is inade-quate, given that different families have differentneeds.4. Variationinfamilyresponsetochildhoodcancerresults from differences in how families and insome cases family members define and managethe illness situation.5. It is important to identify each individualfamily member’s needs and how these differentneeds contribute to the total family’s responseto the child’s cancer diagnosis and treatmentplans.Downloaded from jpo.sagepub.com

Depressive symptomatology in parents of children with chronic oncologic or hematologic disease

This study identified the frequency of depressive symptomatology in parents of children who were recently diagnosed with a chronic oncologic or hematologic disorder and explored the relationship between intrusion coping, avoidance coping, parental perceptions of support, perceptions of the severity of the childs illness, and depressive symptomatology. A repeated measures design involving a convenience sample of 32 parents (23 mothers and 9 fathers) completed questionnaires within 6 months of their childs diagnosis (Time 1) and 21 parents (17 mothers and 4 fathers) who completed them a second time approximately 12 months later ( Time 2). Fourteen of the 32 parents at Time I and 7 (all mothers) of the 21 parents at Time 2 had scores indicating depressive symptomatology. No significant change in mean depression scores occurred between Time 1 and Time 2. Avoidance coping was the only variable that significantly predicted depressive symptomatology at Time 1. These findings have significance for health care p...

Proceedings of APON's 7th Annual State of Science and Practice Preconference Session: Complementary and alternative medicine in pediatric oncology: Research progress, challenges, and directions

Complementary and alternative medicine (CAM) therapies are becoming widely used as adjunct therapy for children with cancer. Many parents and children want relief from symptoms related to the disease as well as from conventional cancer therapy. The CAM treatments may include biological supplements (eg, herbs, bee pollen, shark cartilage), manual healing/physical therapy (eg, massage, spinal manipulation, ultrasound), mind–body control (eg, hypnosis, meditation, yoga), bio-electromagnetic field manipulation (eg, therapeutic touch), or nutritional modifications. Even though CAM therapies are being sought by parents, there is minimal scientific evidence that explains how or why CAM treatments produce desired outcomes. Thus, health care providers’ assessment protocols need to include seeking information from the parent as to whether any CAM treatment is being used for the child who is receiving cancer treatment. The presenters at the 2004 preconference session wrote the following articles from their presentations. Post-White described common CAM therapies and an overview of knowledge from research on use of CAM therapies in adults. She also summarized CAM intervention studies in pediatric oncology. Hawks outlined CAM research initiatives in the Children’s Oncology Group and emphasized the importance of the nurse’s role in the research study. As a nurse practitioner who is a teacher of various mind–body control therapies, Ott described her use of selected mind–body therapies for pediatric patients. The session concluded with O’Mara, who identified the challenges in designing and implementing CAM clinical trials and emphasized the importance of collaborative efforts of cooperative groups to advance knowledge of CAM interventions in clinical trials. These presenters collaborated to develop the final article in this series, which describes the future directions of CAM therapies research with children who have cancer treatment. The preconference session was supported by a grant from the National Cancer Institute and National Institute of Nursing Research (1R13-CA-89535-05). This was an opportunity to explore CAM research for children with cancer and CAM therapy use in clinical practice.

Pilot Feasibility Study of Psychosocial Intervention for Mothers During Their Child's SCT

had a bone marrow transplant. The research question for this study is: What concerns do adolescent BMT patients have about their sexuality ? A qualitative research approach will be utilized to guide this study. The focus group interview technique combines elements from both group process theory and qualitative research to explore feelings and opinions of a small group. This approach allows the researcher to describe experiences from the viewpoint of the individual without imposing a specific theoretical or conceptual framework prior to data collection. Participants will be recruited from a comprehensive bone marrow transplant center by determining participant interest. The study will be explained and consent will be obtained from patients or parents. A purposive sampling technique will be used. Adolescents between 14 and 18 years of age who have had a BMT, are at least 2 months post transplant, and are English-speaking will be approached. Two groups of three to five girls and two groups of three to five boys will be interviewed. The interviews will be audiotaped. After the audiotapes have been transcribed, the computer program Ethnograph (Sage Publications Software, Thousand Oaks, CA) will be used to number each line of the data and later to sort

Using method triangulation to understand mothers' responses during the child's stem cell transplantation

of 63%) to index the major components of the SRS. Six of the questionnaires (Stressor Scale for Pediatric Oncology NursesSSPON, Jalowiec Coping Scale-JCS Group Cohesion Scale-GCS, Organizational Commitment Scale-OCS, Measure of Job Satisfaction-MJS, Intent to Leave-ITL) have established reliability and validity in samples of pediatric oncology nurses. The final scale, role-related meaning (RRMS) was developed for this study and achieved a Cronbach’s