Department of Behavioral Science (M.J., V.N., K.M.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Palliative, Rehabilitation & Integrative Medicine (S.A.-Y., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
J Pain Symptom Manage. 2023 Aug;66(2):160-167.e3. doi: 10.1016/j.jpainsymman.2023.04.027. Epub 2023 May 4.
Evidence-based interventions addressing the needs of couples co-parenting young children while facing an advanced cancer diagnosis are lacking. Thus, this study seeks to identify parenting-related intervention needs and delivery preferences of advanced cancer patients and their spouses/co-parents.
Twenty-one couples completed quantitative measures of cancer-related parenting concerns, relationship and family functioning, and service needs along with individual semi-structured interviews.
Patients (mean age=44 years, 48% female, 91% White) and spouses (mean age=45 years, 52% female, 91% White) reported family distress (62% of couples) and marital distress (29% of couples). Parenting concerns were generally high with patients revealing concerns particularly regarding the practical impact of the cancer on the child(ren). Spouses rated concerns about the co-parent significantly higher (P<.001) than patients. Parenting concerns were inversely associated with relationship (P<.001 for patients; P=.03 for spouses) and family functioning (P<.001 for patients). Themes identified through qualitative interviews include needs related to maintenance of family routines and traditions, childcare, transportation, meals, home maintenance, and finances. Couples who endorsed marital distress also indicated a need for conflict resolution skills. All patients and 89% of spouses would like to receive parenting-related education/services; up to 50% of couples preferred targeted, self-led readings without therapist support; and up to 50% desired counseling sessions indicating a preference towards dyadic and video conferenced intervention delivery.
The delivery of optimal supportive care involves a family-focused perspective such as screening for parenting status and referrals to social work services to address the need of tangible resources and manage parenting-related distress.
缺乏针对面临晚期癌症诊断的同时需要共同养育幼儿的夫妇的循证干预措施。因此，本研究旨在确定晚期癌症患者及其配偶/共同父母的与育儿相关的干预需求和交付偏好。
21 对夫妇完成了癌症相关育儿问题、关系和家庭功能以及服务需求的定量测量，以及个人半结构式访谈。
患者（平均年龄 44 岁，48%为女性，91%为白人）和配偶（平均年龄 45 岁，52%为女性，91%为白人）报告了家庭困扰（62%的夫妇）和婚姻困扰（29%的夫妇）。育儿问题普遍较高，患者特别关注癌症对孩子的实际影响。配偶对共同育儿的担忧程度（P<.001）明显高于患者。育儿问题与关系呈负相关（P<.001 为患者；P=.03 为配偶）和家庭功能（P<.001 为患者）。通过定性访谈确定的主题包括与维持家庭常规和传统、儿童保育、交通、膳食、家庭维护和财务有关的需求。报告婚姻困扰的夫妇也表示需要解决冲突的技巧。所有患者和 89%的配偶都希望获得与育儿相关的教育/服务；多达 50%的夫妇更喜欢没有治疗师支持的针对性、自我主导的阅读；多达 50%的夫妇希望进行咨询，表明他们更喜欢二元和视频会议的干预交付方式。
提供最佳支持性护理需要从家庭为中心的角度出发，例如筛查育儿状况并转介给社会工作服务，以提供有形资源并管理与育儿相关的困扰。
