Purpose This paper describes parental perspectives on the helpfulness and meaningfulness of a behavioral health music therapy intervention targeted to adolescents/young adults (AYA) with cancer undergoing stem cell transplantation. We demonstrate how qualitative methods may be used to understand critical aspects of an intervention and mechanisms by which the intervention impacts the target AYA outcomes resilience and quality of life. Methods A qualitative descriptive design was used to obtain parents’ perspectives. Maximum variation purposive sampling was used to sample 16 parents whose AYA had been randomized to the intervention group. A semi-structured, open-ended interview was conducted between 100 and 160 days following their AYA’s transplant. Results Results are grouped into three categories: (1) helpfulness and meaningfulness of the intervention to AYA adjustment to the transplantation experience; (2) helpfulness and meaningfulness of the intervention for parents; and (3) AYA ability to participate in the intervention during acute phase of transplantation. Conclusions Parents observed and interacted with their AYA who participated in a targeted, behavioral intervention. Thus parents were able to describe mechanisms through which the intervention was helpful and meaningful for the AYA and indirect personal benefits for themselves. The results suggest the importance of the targeted outcomes identified in the Resilience in Illness Model and mechanisms of action in the Contextual Support Model of Music Therapy and identifies approaches for future study.

Aim This paper is a report of an analysis of the concept of connectedness. Background Previous attempts to conceptualize patient–provider relationships were limited in explaining how such relationships are fostered and maintained, and how they influence patient outcomes. Connectedness is a concept that may provide insights into the advantages of patient–provider relationships; however, the usefulness of this concept in health care is limited by its conceptual ambiguity. Although connectedness is widely used to describe other social relationships, little consistency exists among its definitions and measures. Data Sources Sources identified through CINAHL, OVID, PubMed, and PsychINFO databases, as well as references lists of selected articles, between 1983 and 2010. Review Methods A hybrid concept analysis approach was used, involving a combination of traditional concept analysis strategies that included: describing historical conceptualizations, identifying attributes, critiquing existing definitions, examining boundaries, and identifying antecedents and consequences. Results Using five distinct historical perspectives, seven attributes of connectedness were identified: intimacy, sense of belonging, caring, empathy, respect, trust, and reciprocity. A broad definition of connectedness, which can be used in the context of patient–provider relationships, was developed. A preliminary theoretical framework of connectedness was derived from the identified antecedents, attributes, and consequences. Conclusion Research efforts to advance the concept of connectedness in patient–provider relationships have been hampered by a lack of conceptual clarity. This concept analysis offers a clearer understanding of connectedness, provides recommendations for future research, and suggests practice implications.

Background The growing number of childhood cancer survivors makes examination of their current physical and mental health status and health behaviors an important concern. Much of what is known about the long-term outcomes of childhood cancer survivors comes from the Childhood Cancer Cohort Study (CCSS) which uses sibling controls. Procedure Using data from the 2009 Behavioral Risk Factor Surveillance System survey, 651 childhood cancer survivors and 142,932 non-cancer peer controls were identified. The two groups were compared on a variety of physical and mental health status and health behavior variables using ANCOVA and binary logistic regression. Results While controlling for differences in age, sex, and minority status, survivors significantly (p ≤0.001) had poorer socioeconomic outcomes, more comorbid conditions, lower life satisfaction, less social and emotional support, poorer general health, and reported more days per month of poor physical and mental health than non-cancer individuals. Survivors were more likely to report being a current smoker (odds ratio [OR] = 2.33; 95% confidence interval [CI], 1.98 to 2.73; p<0.001); tested for human immunodeficiency virus (HIV) (OR = 1.79; 95% CI, 1.52 to 2.11; p<0.001); and that at least one HIV situation applied to them (OR = 2.06; 95% CI, 1.55 to 2.74; p<0.001). No significant differences were found between groups in regards alcohol use and diet. Conclusions Results support and extend previous findings reported by the CCSS. New findings regarding survivors’ increased likelihood to engage in risky behaviors proposes new directions for future research.

These preliminary data offer clinicians insight into parent perceptions about the cancer experience, specifically SCT for their AYA child, and can be used to inform and shape clinical care. Findings reinforce the importance of offering AYAs opportunities to experience independence and mastery and engage in meaningful communication during transplant.