Kids Alive! Support for Children of Parents with Cancer: An Exemplar Program for Children of Parents with Cancer

Cancer in a parent or caregiver is an event that affects the whole family. The roles and responsibilities of the diagnosed parent, as well as those of each family member, are affected at the time of diagnosis and throughout the progression of the illness. According to the American Cancer Society, there will be an estimated 1,665,540 new cancer cases diagnosed and 585,720 cancer deaths in 2014. This staggering statistic means there are a number of cancer diagnoses that will directly affect thousands of parents and their children. Past research suggests this upheaval in the system is particularly stressful on children and can lead to a number of responses including anxiety, depression, distress, and other negative reactions. Despite the large number of parents and caregivers diagnosed with cancer in the United States each year, there are relatively few support groups aimed at supporting children affected by parental cancer. Support groups provide opportunities to serve this population in a number of advantageous ways by providing safety, support, and a sense of community. Additionally, support groups allow this population of young people to express their fears and worries, connect to others going through similar circumstances, and explore their parent's diagnosis in a context that is helpful and developmentally appropriate. Past research has found that children who do not receive support during this life-changing event can be negatively affected throughout the life span. On the other hand, this event can be a time to build a child's resilience and provide the structure through which they may thrive in adversity. Support groups offer the opportunity to address this difficult event and lead to positive results. Kids Alive! is one such group that has been proactive in support for children of parents diagnosed with cancer since 1995. Kids Alive!, a support group that runs out of Porter Hospital in Denver Colorado, uses Joseph Campbell's Hero's Journey to structure monthly groups. The Hero's Journey, described in Campbell's The Hero with a Thousand Faces (1949), focuses on a set pattern that all heroes must go through during their journey towards an ultimate victory and self-discovery. Kids Alive! incorporates this journey into a curriculum aimed at helping children explore their thoughts and feelings around their parent's cancer and leads to a realization that they are not alone on this journey. Over the course of eight months, children in Kids Alive! receive support and solidarity that leads to life-changing experiences and an understanding of what a diagnosis of cancer in a parent can mean. Kids Alive! consists of professionals and volunteers who take time to recognize and support this underserved population. The program has led to positive outcomes for nearly two decades and consistently increases the numbers of children and families served. The purpose of this paper is to describe the Kids Alive! program as an exemplar program that addresses these problems by utilizing protective factors research has found in this population. Further, this paper will discuss areas of future research while providing the model of an effective program aimed at serving an important population. Additionally, the model of Kids Alive! will be described through this paper in a way that allows for other oncology settings to consider this relatively simple program that provides consistently positive results.

Confirming the Association Between Affective Disturbance and Perceived Cognitive Dysfunction Among Breast Cancer Patients: A Meta-Analysis of Available Literature

Purpose: Breast cancer is the most frequently diagnosed cancer among women worldwide. While undergoing chemotherapy treatment for breast cancer, patients often report experiencing "chemobrain." Previous literature reports correlations between psychological distress and these perceived cognitive problems. The aim of the present study was to examine the strength of the association between affective disturbance and subjective cognitive dysfunction.Methods: This study included a meta-analysis of the literature reporting a correlation between mood and subjective cognitive dysfunction. Eight studies with 1344 breast cancer patients treated with chemotherapy were selected based on stringent study inclusion criteria. Studies reporting a correlation coefficient between mood and subjective cognitive dysfunction were included.Results: In these data, there was no significant correlation between affective disturbance and subjective cognitive dysfunction. A random effects model yielded an overall weighted mean effect size of 0.12.Conclusion: Although this meta-analysis did not confirm the correlation between mood and subjective cognitive dysfunction, there was a clear association between these factors in the original disaggregated analyses, and they are clearly impactful from the time of diagnosis through long-term after care. The clinical implications of the present study and future directions for research are discussed.

Psychosocial Distress Screening in a Community Cancer Center: An Examination of Gender Differences

Objective: The aim of this study was to gain a better understanding of the needs of male and female oncology patients within a community cancer setting to inform the provision of psychosocial services. Data obtained from 835 single-page measures of oncology patient distress were collected and analyzed to examine the relationship between gender and reported level of distress, the source of this distress, and requests for follow-up from psychosocial service providers.Method: Patients in medical and radiation oncology were given a distress screener tool that included a distress thermometer, a problem checklist, and a list of psychosocial service providers with whom the patient could request to speak.Results: Women reported higher levels of distress than men (p=.003). Women were also more likely than men to endorse practical problems as the cause of their distress (p=.003). A marginally significant relationship between gender and requesting the cancer resource navigator was also found (p=. 059)Conclusion: Gender is a salient factor in reported distress among cancer patients. Although no single variable can entirely explain an individual's response to cancer, male and female patients do appear to have distinctive, gender-specific needs. Psychosocial interventions that account for differences related to gender-role may be particularly beneficial. These results also illustrate the utility of consistent screening practices to better understand and meet the psychosocial needs of oncology

Psychosocial Distress Screening in a Community Cancer Center: An Exploratory Study of Distress Screening Across the Cancer Treatment Continuum

Purpose: The primary goal of this exploratory study is to demonstrate that distress screening across the course of cancer treatment is possible and provides valuable information about patient needs over time. Distress screening is aligned with guidelines from national accrediting organizations and may lead to improved health-related quality of life, satisfaction with medical care, and possibly survival.Methods: Medical, surgical, and radiation oncology patients completed a screening instrument before their appointments during a six-month period. Patients indicated their level of distress on four domains (practical, emotional, health and social concerns). De-identified data was collected, aggregated and descriptive statistics were analyzed.Results: Approximately 3000 screens were collected and 1500 cancer patients were screened. Of patients who indicated distress, 54% demonstrated a distress level of five or greater. Distress level eight was the most frequent level of distress indicated. The Cancer Dietitian was the most commonly requested healthcare team provider. The Health Concern domain was most frequently endorsed.Conclusion: NCCN, IOM and COC guidelines recommend distress screening in all cancer treatment centers, however implementation has proven difficult. This study adds to the literature about distress in cancer patients, demonstrates the feasibility of repeated distress screening and provides a model program demonstrating the implementation of repeated distress screening at a community cancer center. Findings highlight the importance of supportive oncology services due to the prevalence of high levels of distress. Findings demonstrate the importance of the Cancer Dietitian in supportive cancer care. Additionally, the research reveals a potential perceived stigma in seeking psychosocial oncology services.