Psychosocial Interventions for Families with Parental Cancer and Barriers and Facilitators to Implementation and Use – A Systematic Review

Abstract

BackgroundParental cancer has a significant impact on minor children and families. Psychosocial interventions for affected families can provide support where necessary. This systematic review aims at providing an overview of existing interventions and support programs and focuses on the systematic investigation of barriers and facilitators for using psychosocial interventions for families affected by parental cancer (PROSPERO; registration number CRD42014013020).MethodsA search of five electronic databases (EMBASE, MEDLINE, PsycInfo, Psyndex, CINAHL) was conducted in June 2014, and updated in September 2015. We included any kind of studies reporting psychosocial support services or interventions for families affected by parental cancer. Study quality was assessed using the Mixed Method Assessment Tool. Narrative synthesis and thematic analyses were undertaken to examine the included interventions and to identify barriers and facilitators for use and implementation.ResultsA total of 36 studies covering 19 interventions and support services were included in the systematic review. Interventions focused on children, parents or several family members and analyses revealed a broad picture of theoretical background and primary aims. Several studies focused on developmental or implementation phases or descriptions of interventions. Other included studies reported results of evaluations using qualitative and quantitative methods. Results suggest that interventions are helpful and that participants improved in various outcomes. The thematic analyses indicate that barriers for use of support services refer to aspects concerning the patients and families, such as practical difficulties, perceived need for support or fear of stigma. Cancer patients who understood the need and benefit of support services may have used them more often. Additionally, intervention characteristics such as a flexible structure and accessibility were important to reach families affected by parental cancer. Disease characteristics and complications in collaborations were identified as potential barriers. The provision of information about interventions by clinicians and understanding the support as part of routine care seem to be key issues for implementation and use of psychosocial support.ConclusionThis review identified a broad number of intervention concepts for families with minor children affected by parental cancer. Findings provide a basis for existing or future psychosocial interventions to anticipate potential barriers and facilitators to implementation and use and can help to reach a wider range of families in need for support.

User Survey of Nanny Angel Network, a Free Childcare Service for Mothers with Cancer

“…A meta-analysis completed in 2016 that analyzed various psychosocial interventions and support systems for parents with cancer and their families reported interventions focused on increasing family communication, enhancing child adjustment, improving mood, and reassuring parenting skills, with no evaluation of the services and no description of any childcare services 24 . Moreover, although interventions were created to provide on-site childcare in clinics for patients undergoing hiv treatment, a home service was never included 20 .…”

On a journey for survival : everyday life during radiation therapy from the perspectives of women with breast cancer and their families

“…A systematic review of psychosocial interventions for families with parental cancer showed that interventions were considered helpful, with improvements in the participants in various outcomes (Inhestern, Haller, Wlodarczyk, & Bergelt, 2016). The interventions were mainly aiming at improving the communication between family members and at supporting children's adaptation to and understanding of cancer, and they consisted of counseling or conversations and were either family centered or person centered (Inhestern et al, 2016).…”

“…The interventions were mainly aiming at improving the communication between family members and at supporting children's adaptation to and understanding of cancer, and they consisted of counseling or conversations and were either family centered or person centered (Inhestern et al, 2016). The findings also showed that the interventions have to be flexible, easy to access, and offered as a routine care to reach a broader range of families in need of support.…”

“…The findings also showed that the interventions have to be flexible, easy to access, and offered as a routine care to reach a broader range of families in need of support. However, the variability in study populations and intervention design makes it difficult to generalize findings from the studies (Inhestern et al, 2016). When evaluating family interventions in oncological care addressing the whole family, improvements were seen in quality of life, psychological health, and depressive symptoms in parents as well as children (John, Becker, & Mattejat, 2013;Thastum, Munch-Hansen, Wiell, & Romer, 2006).…”

“…However, research is starting to better comprehend the needs of families where a family member is diagnosed with breast cancer and to consider the family as a unit that includes both the patient and family members (Dieperink et al, 2017). Overall, women and their family members express a need for encouraging and open 25 communication and collaborative support from health care professionals following a breast cancer diagnosis .A systematic review of psychosocial interventions for families with parental cancer showed that those interventions were considered helpful (Inhestern et al, 2016). The interventions were mainly aiming at improving the communication between family members and at supporting children's adaptation to and understanding of cancer, and they consisted of counselling or conversations and were either family centred or person centred.…”