Fathers and Perceptions of God Play an Important Role in Psychological Adjustment Among Emerging Adults in Guatemala and the United States

Ashdown, Brien K.; Faherty, Amanda N.; Brown, Carrie M.; Hanno, Olivia; Belden, Alexandra; Weeks, P

doi:10.1080/00221325.2018.1502148

Cited by 4 publications

(5 citation statements)

References 32 publications

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“…This qualitative study was conducted in three pediatric cancer centers, Unidad Nacional de Oncologia Pediatrica (UNOP) in Guatemala, Parirenyatwa Hospital in Zimbabwe, and King Hussein Cancer Center (KHCC) in Jordan. Guatemala is an upper-middle–income country 23 in Central America, with a collectivist culture 24 and a predominantly Christian and Mayan population including 24 ethnic communities. Jordan is an upper-middle–income country, 23 with a culture heavily influenced by Arab-Islamic heritage, 25 , 26 and a large refugee population.…”

Section: Methodsmentioning

confidence: 99%

Stigma in Pediatric Cancer: An Exploratory Study of Osteosarcoma and Retinoblastoma in Guatemala, Jordan, and Zimbabwe

Graetz,

Velasquez,

Chitsike

et al. 2024

JCO Glob Oncol

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PURPOSE Stigma is an understudied barrier to health care acceptance in pediatric oncology. We sought to explore the stigma experience, including its impact on cancer treatment decision making, and identify strategies to mitigate stigma for patients with osteosarcoma and retinoblastoma in Guatemala, Jordan, and Zimbabwe. METHODS Participants included caregivers, adolescent patients (age 12-19 years), and health care clinicians. A semistructured interview guide based on The Health Stigma and Discrimination Framework (HSDF) was adapted for use at each site. Interviews were conducted in English, Spanish, Arabic, or Shona, audio-recorded, translated, and transcribed. Thematic analysis focused on stigma practices, experiences, outcomes, drivers, mitigators, and interventions. RESULTS We conducted 56 interviews (28 caregivers, 19 health care clinicians, nine patients; 20 in Guatemala, 21 in Jordan, 15 in Zimbabwe). Major themes were organized into categories used to adapt the HSDF to global pediatric cancer care. Themes were described similarly across all sites, ages, and diagnoses, with specific cultural nuances noted. Pediatric cancer stigma was depicted as an isolating and emotional experience beginning at diagnosis and including internalized and associative stigma. Stigma affected decision making and contributed to negative outcomes including delayed diagnosis, treatment abandonment, regret, and psychosocial fragility. Overcoming stigma led to positive outcomes including resilience, treatment adherence, pride, and advocacy. Identified stigma drivers and mitigators were linked to potential interventions. CONCLUSION Participants describe a shared stigma experience that transcends geography, cultural context, age, and diagnosis. Stigma manifestations have the potential to impact medical decision making and affect long-term psychological outcomes. Stigma assessment tools and interventions aimed at stigma mitigation including educational initiatives and support groups specific to pediatric cancer should be the focus of future research.

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Section: Methodsmentioning

confidence: 99%

Stigma in Pediatric Cancer: An Exploratory Study of Osteosarcoma and Retinoblastoma in Guatemala, Jordan, and Zimbabwe

Graetz,

Velasquez,

Chitsike

et al. 2024

JCO Glob Oncol

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show abstract

“…Guatemala is a small diverse country with 24 principal ethnic groups and a collectivist culture in which identity is centered in the family or community group rather than in individual traits. 9 UNOP uses a multidisciplinary approach known as “medicina integral” which provides psychosocial services and resources to help cover expenses for families with children in treatment. The childhood cancer survival rate in Guatemala is ~65%.…”

Section: Methodsmentioning

confidence: 99%

“…This study was conducted at Unidad Nacional de Oncología Pediátrica (UNOP) in Guatemala, which is funded through a public‐private partnership and is Guatemala's only national pediatric cancer center. Guatemala is a small diverse country with 24 principal ethnic groups and a collectivist culture in which identity is centered in the family or community group rather than in individual traits 9 . UNOP uses a multidisciplinary approach known as “medicina integral” which provides psychosocial services and resources to help cover expenses for families with children in treatment.…”

Section: Methodsmentioning

confidence: 99%

“… 7 These findings highlight the need to extend research on hope in pediatric oncology beyond HICs to settings with different customs and beliefs. The purpose of this analysis was to explore hopes and concerns of parents of children with cancer, including a range of prognoses, during diagnostic conversations in Guatemala, a collectivist, 9 upper‐middle income country. 10…”

Section: Introductionmentioning

confidence: 99%

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Understanding hope at diagnosis: A study among Guatemalan parents of children with cancer

Williams

Rivas²,

Fuentes³

et al. 2023

Cancer Medicine

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Background In high‐income countries, hope facilitates parental coping and builds the clinical relationship between families of children with cancer and their clinicians. However, the manifestation of hope in low‐ and middle‐income countries (LMICs) remains poorly understood. Our study explores Guatemalan parents' experiences with hope during the pediatric oncology diagnostic process and aims to identify discrete actions clinicians take to support hope. Methods This qualitative study utilized audio‐recordings of the diagnostic process and an additional semi‐structured interview for 20 families of children with cancer at Unidad Nacional de Oncología Pediátrica in Guatemala. Spanish audio‐recordings were translated into English, transcribed, and coded using a priori and novel codes. Thematic content analysis using constant comparative methods explored parents' hopes and concerns. Results At diagnosis, Guatemalan parents expressed both hopes and concerns related to the entire cancer continuum. Throughout the diagnostic process, hope grew as concerns were alleviated. Clinicians supported hope by creating a supportive environment, providing information, affirming religious beliefs, and empowering parents. These strategies helped parents shift their focus from fear and uncertainty toward hope for their child's future. Parents expressed that establishing hope improved mood, promoted acceptance, and enabled them to care for themselves and their children. Conclusion These results confirm the relevance of supporting hope in pediatric oncology settings in LMICs and suggest that culture informs hope‐related needs. Supporting hope is critical across cultures and can be integrated into clinical conversation using the four processes identified by our results.

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“…Here, I provide suggestions from my experiences guiding 26 undergraduates while conducting psychological research in Guatemala. This work has resulted in five publications (including nine undergraduate co-authors), various conference presentations, and other ongoing projects with another seven student collaborators (García Egan et al, 2014; Faherty et al, 2016; Ashdown and Buck, 2018; Ashdown et al, 2018; Rohner et al, 2019).…”

mentioning

confidence: 99%

Fathers and Perceptions of God Play an Important Role in Psychological Adjustment Among Emerging Adults in Guatemala and the United States

Cited by 4 publications

References 32 publications

Stigma in Pediatric Cancer: An Exploratory Study of Osteosarcoma and Retinoblastoma in Guatemala, Jordan, and Zimbabwe

Stigma in Pediatric Cancer: An Exploratory Study of Osteosarcoma and Retinoblastoma in Guatemala, Jordan, and Zimbabwe

Understanding hope at diagnosis: A study among Guatemalan parents of children with cancer

Involving Undergraduates in Publishable International Research: Experiences in Latin America

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