Léonor Fasse

Describing and understanding depression in spouses of cancer patients in palliative phase

The cancer patients relatives and family constitute one of the patients main sources of support throughout the disease. In recent years, several studies have emphasized the psychological vulnerability of spouses‐caregivers with a high proportion suffering from anxiety and depression symptoms. The literature underlines several factors of detrimental outcomes but critical aspects of the spousal relationship as attachment were neglected.

How do researchers conceive of spousal grief after cancer? A systematic review of models used by researchers to study spousal grief in the cancer context.

Although spouses bereaved after cancer are considered vulnerable people, there have been few empirical studies to explore grief specifically in this context.

Dual Process Model of Coping with Bereavement in the test of the subjective experiences of bereaved spouses: an interpretative phenomenological analysis

The Dual Process Model of Coping With Bereavement (DPM) was developed to better understand the dynamic coping processes adopted by bereaved people. In the present study, we investigated the daily subjective experiences of widowed people and examined whether they recognized themselves in the model. Thirteen out of the 16 interviewed widowed persons reported that their bereavement experience basically fitted the model. However, they also identified discrepancies. Interviews with six bereaved spouses were subjected to an interpretative phenomenological analysis. Three main issues were identified: (a) the interdependence versus distinctiveness of coping processes, (b) the conscious and intentional nature of coping strategies, and (c) the very nature of respite in the grief experience. The results indicated that, although relevant, the DPM did not always match the grieving experiences reported by the widowed individuals. Clinical and research perspectives are discussed.

Understanding grief in children who have lost a parent with cancer: How do they give meaning to this experience? Results of an interpretative phenomenological analysis

ABSTRACT Though the adjustment of bereaved children is increasingly investigated through quantitative studies, their intimate representations regarding the loss of their parent remain unknown. This qualitative study aims at exploring how they give meaning to this experience. Nondirective interviews with bereaved children were conducted and submitted to an interpretative phenomenological analysis. Fourteen children (8 boys, 6 girls, mean age = 8.5 years) were recruited. Seven major themes depicting their grief experience were identified. The importance of the surviving parent is critically highlighted. Findings suggest that the remaining parent could become a fundamental actor in providing grief support for the bereaved children.

How do professionals assess the quality of life of children with advanced cancer receiving palliative care, and what are their recommendations for improvement?

BackgroundIt is known that information regarding the quality of life of a patient is central to pediatric palliative care. This information allows professionals to adapt the care and support provided to children and their families. Previous studies have documented the major areas to be investigated in order to assess the quality of life, although it is not yet known what operational criteria or piece of information should be used in the context of pediatric palliative care. The present study aims to: 1) Identify signs of quality of life and evaluation methods currently used by professionals to assess the quality of life of children with cancer receiving palliative care. 2) Collect recommendations from professionals to improve the evaluation of quality of life in this context.MethodsWe selected a qualitative research design and applied an inductive thematic content analysis to the verbal material. Participants included 20 members of the Department of Hematology-Oncology at CHU Sainte-Justine from various professions (e.g. physicians, nurses, psychosocial staff) who had cared for at least one child with cancer receiving palliative care in the last year.ResultsProfessionals did not have access to pre-established criteria or to a defined procedure to assess the quality of life of children they followed in the context of PPC. They reported basing their assessment on the child’s non-verbal cues, relational availability and elements of his/her environment. These cues are typically collected through observation, interpretation and by asking the child, his/her parents, and other members of the care. To improve the assessment of quality of life professionals recommended optimizing interdisciplinary communication, involving the child and the family in the evaluation process, increasing training to palliative care in hematology/oncology, and developing formalized measurement tools.ConclusionThe formulation of explicit criteria to assess the quality of life in this context, along with detailed recommendations provided by professionals, support the development of systematic measurement strategy. Such a strategy would contribute to the development of common care goals and further facilitate communication between professionals and with the family.