Several studies observed a significant relationship between coping styles aimed at disengaging and distancing from cancer and increased psychological distress in people with HNC. To understand directionality of these associations and develop understanding of temporal features of the relationship between coping styles and distress, longitudinal designs could be used. This would enable evidence-based recommendations regarding psychological interventions (eg, encouraging helpful coping strategies) for individuals along their HNC care pathway.
Objectives: This study used the grounded theory to explore parents’ views of the transition into adulthood of their\ud child with a severe intellectual disability. The study also sought to explore the processes that parents engage in\ud for making psychological adjustments, to appreciate their role during this transition. This study is imperative for\ud developing a psychologically informed theory that can be understood by both parents and clinicians.\ud Methods: Twelve parents of 11 children with a severe intellectual disability were recruited for interview from\ud charitable organizations accessed by parents (e.g. Mencap). Data collection used a combination of open-ended\ud structured questions and non-directed probing. NVivo 10 software was used to assist the grounded theory\ud coding and analysis process.\ud Results: The analysis developed five processes that parents engaged in during their child’s transition into\ud adulthood: ‘defining adulthood’, ‘noticing adult development’, ‘perceiving barriers to adulthood’, ‘worrying,’ and\ud ‘making psychological adjustments’. Common to these was seen to be a core process of ‘making comparisons\ud with perceived “norms”’. Contrasting findings are critically discussed alongside extant literature. Additionally, a\ud transition model of parents’ views and adjustments is proposed, grounded in the study findings.\ud Conclusions: Parents engage in a series of interactional processes throughout the transition trajectory, which are\ud likely to influence how they make adjustments. Clinical interventions could challenge parent perceptions; encourage\ud peer support; embrace systemic ways of working with parents through their child’s transition into adulthood; and\ud use the presented model to help parents understand their experiences and any adjustment-related problems
Objective: Depression and anxiety lead to reduced treatment adherence, poorer quality of life, and increased care costs amongst cancer patients. Mindfulness-based cognitive therapy (MBCT) is an effective treatment, but dropout reduces potential benefits. Smart-message reminders can prevent dropout and improve effectiveness.However, smart-messaging is untested for MBCT in cancer. This study evaluates smart-messaging to reduce dropout and improve effectiveness in MBCT for cancer patients with depression or anxiety.Methods: Fifty-one cancer patients attending MBCT in a psycho-oncology service were offered a smart-messaging intervention, which reminded them of prescribed between-session activities. Thirty patients accepted smart-messaging and 21 did not. Assessments of depression and anxiety were taken at baseline, session-bysession, and one-month follow-up. Logistic regression and multilevel modelling compared the groups on treatment completion and clinical effectiveness. Fifteen post-treatment patient interviews explored smart-messaging use. Results:The odds of programme completion were eight times greater for patients using smart-messaging compared with non-users, controlling for age, gender, baseline depression, and baseline anxiety (OR = 7.79, 95% CI 1.75 to 34.58, p = .007). Smartmessaging users also reported greater improvement in depression over the programme (B = -2.33, SEB = .78, p = .004) when controlling for baseline severity, change over time, age, and number of sessions attended. There was no difference between groups in anxiety improvement (B = -1.46, SEB = .86, p = .097). In interviews, smartmessaging was described as a motivating reminder and source of personal connection.Conclusions: Smart-messaging may be an easily integrated telehealth intervention to improve MBCT for cancer patients.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Objectives:\ud This article critically reviewed empirical studies identifying factors that may influence parental stress when caring for a child with an intellectual disability. Understanding the factors influencing parental stress is important for several reasons, which include improving parental/child quality of life, supporting parental needs, and thus reducing potential economic burden in the long term. This review is also imperative for ensuring high quality research within this field.\ud Method:\ud AMED, CINAHL Plus (EBSCOhost), EMBASE, Medline and PsycINFO were accessed to conduct a critical literature review. A total of 17 articles were reviewed. A bespoke quality assessment tool was developed to examine the susceptibility to bias for each of the included studies.\ud Results:\ud The review outlined a range of child, parent and socio-environmental factors that may influence parental stress. More specifically, factors associated with greater parental stress included child behavioural difficulties (e.g. challenging behaviour), ineffective parental coping strategies (including avoidance and self-blame), and poor family environment (e.g. lack of cohesion amongst family members). These factors are critically discussed alongside contrasting evidence that was illuminated within this review.\ud Conclusions:\ud Parents of a child with an intellectual disability are not a homogenous group and are likely to show variability in the factors that affect their stress levels. Future clinical and research implications are proposed in light of the methodological limitations identified within the studies reviewed. For example, future research could investigate the bi-directional effects that occur between variables; how specific factors influence parental stress; and potential mediating/moderating factors of parenting stress
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