Shortman R I, Beringer A, Penn A, Malson H, Lowis S P, Sharples P M
Department of Neuropsychology, Frenchay Hospital, Bristol, UK.
Child Care Health Dev. 2013 Sep;39(5):743-9. doi: 10.1111/cch.12005. Epub 2012 Sep 13.
Brain tumours are the second most common form of childhood cancer, accounting for over 20% of all cases in European children. Understanding the impact of diagnosis and treatment of a brain tumour on the family is an essential pre-requisite to identifying ways to provide effective support.
(1) To explore the impact of having a child with a brain tumour on the main caregiver in the family; (2) to describe mothers' experiences of coping with their child's illness, including personal barriers and strengths; and (3) to identify causes of stress and sources of support to inform improvements in care delivery.
Participants were drawn from a group of caregivers enrolled in a longitudinal study of outcome following diagnosis of a childhood brain tumour. Six caregivers took part, two from each of the high-, medium- and low-impact groups based on their Impact on Families Scale scores. Semi-structured interviews were used, with questions covering: (1) impact of the diagnosis on main caregiver and family; (2) personal barriers and strengths; and (3) causes of stress and sources of support. Interviews were transcribed verbatim and coded manually into five themes, which comprised 19 subthemes.
Coping methods and provision of help and support were major preoccupations for main caregivers from all impact groups. Caregivers in the high-impact group reported less conflict. High- and medium-impact group caregivers had experienced less 'hindrance and heartache', than those with low impact scores, suggesting that the stress associated with diagnosis and treatment of the tumour may have increased cohesion and acceptance within these families.
Families of children diagnosed with a brain tumour experience considerable negative impact and may perceive themselves as struggling to cope. Provision of help and support, within and outside the extended family, including from health, education and other services, is perceived as helpful.
脑肿瘤是儿童癌症的第二大常见形式,占欧洲儿童所有病例的20%以上。了解脑肿瘤的诊断和治疗对家庭的影响是确定提供有效支持方法的重要前提。
(1)探讨家中有患脑肿瘤孩子对家庭主要照顾者的影响;(2)描述母亲应对孩子疾病的经历,包括个人障碍和优势;(3)确定压力来源和支持来源,为改善护理提供参考。
参与者来自一组参与儿童脑肿瘤诊断后长期预后研究的照顾者。六名照顾者参与,根据他们在家庭影响量表上的得分,高、中、低影响组各两名。采用半结构化访谈,问题涵盖:(1)诊断对主要照顾者和家庭的影响;(2)个人障碍和优势;(3)压力来源和支持来源。访谈逐字记录并手动编码为五个主题,包含19个子主题。
应对方法以及帮助和支持的提供是所有影响组主要照顾者的主要关注点。高影响组的照顾者报告的冲突较少。高影响组和中影响组的照顾者比低影响组的照顾者经历的“阻碍和心痛”更少,这表明与肿瘤诊断和治疗相关的压力可能增强了这些家庭的凝聚力和接受度。
被诊断患有脑肿瘤的儿童家庭经历了相当大的负面影响,可能认为自己难以应对。大家庭内外包括健康、教育和其他服务提供的帮助和支持被认为是有帮助的。