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At least 307 records · Page 17Linked to original sources
PubMed1989

Reducing distress during invasive medical procedures: relating behavioral interventions to preferred coping style in pediatric cancer patients.

The hypothesis that matching childrens' preferred coping styles (repression, sensitization) with behavioral interventions (distraction, sensory information) during invasive medical procedures will reduce self-reports of fear and pain, anticipatory heart rate, and observable signs of distress was tested in 28 children with cancer. A significant coping style by intervention interaction for the self-report of experienced pain was found. However, those groups using an intervention that matched their preferred coping style actually reported higher experienced pain ratings. Trends for differences between coping style on factors indicative of the chronicity of the disease were found. Chronicity, which reflects the degree of past experience with invasive medical procedures, may be a more important factor than preferred coping style in pain management of these patients.

Adaptation, Psychological↗
PubMed1995

Physician and parent behavior during invasive pediatric cancer procedures: relationships to child behavioral distress.

Observed 51 children with cancer, their parents, and their physicians during routine bone marrow aspirations and lumbar punctures. Child distress was measured via the Observational Scale of Behavioral Distress (OSBD); adult behaviors were coded via the Child Adult Medical Procedure Interaction Scale (CAMPIS). In general, physicians were less verbally interactive than parents both before and during the procedure. As expected, several parent behaviors were positively related to child distress. However, physician behaviors were uniformly negatively related to child distress. Findings are discussed in terms of the physician-patient relationship and the possible role of physicians as change agents in reducing child distress during invasive procedures.

Adolescent↗
PubMed1998

The effect of Achievement orientation on response to success and failure in pediatric cancer patients.

OBJECTIVE: To assess the effects of different cognitive orientations focused on social comparison or self-comparison, followed by success or failure feedback, on mood, task persistence, and task difficulty choice in children with cancer. METHOD: Children with cancer (N = 79) and a group of age-matched controls (N = 72 were randomly assigned in a 2 (Achievement Orientation) x 2 (Feedback) between-subjects design. RESULTS: Between-group differences revealed that children with cancer chose more difficult tasks for the future than those in the comparison group, while the comparison subjects chose to persist longer with the problems than did children with cancer, with no significant differences on measures of mood. CONCLUSIONS: The beneficial effects of achievement orientation as a clinical manipulation may not be as robust as expected with a medically ill population, due to the apparent stability of achievement orientations.

Achievement↗
PubMed1998

Posttraumatic stress disorder among mothers of pediatric cancer survivors: diagnosis, comorbidity, and utility of the PTSD checklist as a screening instrument.

OBJECTIVE: To examine posttraumatic stress disorder (PTSD) in mothers of survivors of childhood cancer. Comorbidity of anxiety and depressive disorders, prevalence of subclinical PTSD, and the utility of a self-report measure as a screening instrument for PTSD were also investigated. METHOD: Mothers (n = 65) completed a questionnaire self-report PTSD checklist (PCL-C). Mothers were administered several modules of the SCID: nonpatient edition by telephone, including the PTSD, Generalized Anxiety, and Major Depressive Disorder modules. RESULTS: We diagnosed 6.2% of the sample with current PTSD. An additional 20% had subclinical PTSD. One of four mothers with PTSD diagnoses had a comorbid diagnosis of an anxiety and depressive disorder. The PCL-C evidenced diagnostic utility as a screening instrument. However, a moderate number of false-positives would result if the recommended cut-off on the instrument was used. CONCLUSIONS: The PCL-C had diagnostic utility in screening mothers of childhood cancer survivors. The presence of comorbid diagnoses such as anxiety and depression should be examined.

Adaptation, Psychological↗
PubMed2001

Psychological adaptation and social support of parents of pediatric cancer patients: a prospective longitudinal study.

OBJECTIVE: To investigate levels of support and the concurrent and prospective effects of support on the psychological functioning of parents of children with cancer in a prospective longitudinal study. METHODS: Parents' (n = 128) self-perceived level of psychological distress, quantity of support, and dissatisfaction with support were assessed, at diagnosis, at 6, and at 12 months. RESULTS: Parents received most support at diagnosis. Self-perceived quantity decreased with time, but parents indicated they remained equally satisfied. Support significantly predicted concurrent and prospective distress of fathers, but not of mothers. Dissatisfaction with support and negative interactions were consistent risk factors for fathers. Mothers who adjusted well psychologically received more support and were less dissatisfied than mothers who remained clinically distressed. Nevertheless, no persisting effect of support was found. CONCLUSIONS: Findings illustrate that social support varies with the stress situation and with gender. Identification of vulnerable parents at diagnosis on the basis of their perception of received quantity of and dissatisfaction with support seems difficult. Intervention efforts aimed at mobilization of needed support may be efficacious.

Adaptation, Psychological↗
PubMedDate not supplied

Changes in maternal distress and child-rearing strategies across treatment for pediatric cancer.

OBJECTIVES: To examine longitudinal changes in perceived stress, affective distress, and self-reported parenting strategies among mothers of children with cancer over the initial 6 months of diagnosis and treatment, and to examine relationships between changes in distress and subsequent parenting strategies. METHOD: Questionnaire data were gathered regarding parental perceived stress, caregiver burden, affective distress, and parenting strategies from 65 mothers of children (mean age = 8.3 years) with cancer at 2-5, 12-14, and 22-24 weeks postdiagnosis. RESULTS: Consistent with other studies in the literature, maternal affective distress decreased over the time course of the study. Perceived stress also decreased, while caregiver burden remained relatively stable. Parental consistency fluctuated over the study period, while other parenting strategies (i.e., control, nurturance, and responsiveness) remained stable. CONCLUSIONS: Although maternal affective distress decreased following the initial diagnosis of cancer, sources of stress (e.g., caregiver burden) may remain stable, indicating the need for interventions to bolster parental coping resources.

Child↗
PubMed1984

The efficacy of random digit dialing in selecting matched controls for a case-control study of pediatric cancer.

A study of random digit dialing as a method of control selection was conducted as part of a matched case-control study of risk factors for neuroblastoma. The study was conducted in 1981-1982 in the Greater Delaware Valley region. Participation involved parents submitting to a 2-4-hour telephone interview. Potential control telephone numbers were selected by substituting the last two digits of the case family's telephone number with randomly selected digits. Successive random telephone numbers were called until a family with a child matching the case by year of birth plus or minus three years and race who agreed to participate was identified. A total of 3,245 telephone numbers were dialed to select controls for 101 cases, an average of 32.1 telephone numbers per case. Among 1,908 residential households contacted, 25.5% refused to give information about household characteristics. Of households with known characteristics, 45% had children under 25 years of age and 14.9% had a child eligible for the study. Among 181 households invited to participate, 101 agreed. For 18.6% of all calls, residential respondents were randomly offered $10 as an inducement to participate. This inducement did not significantly influence participation rates among families invited to participate.

Adult↗
PubMed1984

Confidentiality of medical records in pediatric cancer care. Myths, perceptions, and reality.

Confidentiality is a complex requirement and impossible to enforce within the scientific-medical setting. Legal constraints include a patchwork of federal, state, and local laws and regulations. The setting of the teaching hospital brings its own multifaceted breaches in confidentiality. Insurance and third party payment claims necessitate opening of the patient's records. But research medicine in particular broadly disseminates large amounts of detailed information about patients, creating a situation in which it is not possible to avoid revealing the patient's identity. A distinction must be made between the breach of confidentiality in connection with dissemination of the label of the diagnosis, and breach of confidentiality in relation to details of care and clinical investigation. The problem in relation to confidentiality of diagnosis is intimately entwined with the patient's self-concept. The problem in connection with details of care and clinical investigation is the consequence of the antipathy between the physician-scientist-investigator and the physician-healer-priest. These two roles are not truly compatible and, therefore, the problem of confidentiality could be greatly alleviated if the records for those two separate roles (clinical investigator and personal physician) were kept separately.

Child↗
PubMedDate not supplied

Inherited susceptibility for pediatric cancer.

The percentage of childhood cancers that are caused by a clearly inherited predisposition varies significantly from only a few percent to more than 50% with individual tumor types. Recent advances in genetic testing and studies of cohorts of cancer patients have demonstrated the likelihood of identifying a cancer susceptibility mutation for numerous childhood cancers. Inherited predisposition to cancer is frequently the result of dominant constitutional mutations in tumor suppressor genes, which can be inherited from an affected parent or occur de novo during gametogenesis. In this article, we review the childhood malignancies that are associated with at least a 10% likelihood of being caused by a genetic susceptibility to cancer and therefore warrant consideration for a genetic evaluation; these malignancies include retinoblastoma, adrenocortical carcinoma, atypical teratoid and malignant rhabdoid tumors, optic pathway tumors, juvenile myelomonocytic leukemia, malignant peripheral nerve sheath tumors, vestibular schwannomas, endolymphatic sac tumors, hemangioblastomas, medullary thyroid cancer, pheochromocytomas, and paragangliomas. Children with other malignancies may also warrant genetic evaluation if there is the co-occurrence of malignancy and two or more congenital anomalies, or malignancy and a significant family history of related cancers. We also review the importance of the correct genetic diagnosis in order to ensure appropriate treatment and ongoing cancer surveillance for the child with cancer and closely related family members (e.g., parents and siblings).

Child↗