ABSTRACT
BACKGROUND: In order to improve the survival of children with cancer, novel therapies must be identified. Promising agents are tested in phase 1 trials in order to identify appropriate dosing and describe toxicity in children. The identification and referral of candidate patients for phase 1 trials rely heavily on medical providers who must balance their own perceptions of phase 1 trials with the desires and willingness of the patient and his/her family. OBJECTIVE: The goal of the present study was to evaluate and compare physician and nurse perceptions regarding the beliefs, expectations, and perceived benefits of phase 1 clinical trials. METHODS: A survey consisting of 21 questions was sent to 419 physicians and nurses practicing pediatric oncology at 30 different institutions. With the exception of 10 demographic questions, items were either rank ordered or rated on 5-point Likert scales. RESULTS: Ninety-four physicians and 122 nurses completed the online survey. Physicians and nurses differed in their knowledge of the goals and medical effects of phase 1 clinical trials. CONCLUSIONS: Physicians and nurses hold positive beliefs regarding phase 1 clinical trials and support their role in the treatment of children with cancer. Education is necessary to increase nurses' knowledge of the goals and outcomes. IMPLICATIONS FOR PRACTICE: These findings suggest that continued education of nurses as well as physicians about the goals, execution, and monitoring of phase 1 therapy would be worthwhile.
Subject(s)
Attitude of Health Personnel , Clinical Trials, Phase I as Topic/psychology , Clinical Trials, Phase I as Topic/standards , Nurses/psychology , Oncology Service, Hospital , Physicians/psychology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Neoplasms/therapy , Perception , Referral and Consultation/statistics & numerical data , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Examine longitudinal relationships between spiritual coping and psychological adjustment among adolescents with chronic illness. METHODS: Adolescents (N = 128; M = 14.7 years) with cystic fibrosis or diabetes completed measures of spiritual coping and adjustment at 2 time points â¼2 years apart; parents also reported on adolescent adjustment. Prospective relationships between spiritual coping and adjustment were evaluated with an autoregressive cross-lagged path model. RESULTS: Positive spiritual coping predicted fewer symptoms of depression and less negative spiritual coping over time, whereas negative spiritual coping predicted more positive spiritual coping. Depressive symptoms predicted higher levels of negative spiritual coping and conduct problems over time. The results did not vary by disease. CONCLUSIONS: Positive spiritual coping may buffer adolescent patients from developing depression and maladaptive coping strategies. Results also highlight the harmful role of depression in subsequent behavior difficulties and maladaptive coping. Addressing spiritual beliefs and depressive symptoms in pediatric medical care is warranted.
Subject(s)
Adaptation, Psychological , Cystic Fibrosis/psychology , Diabetes Mellitus, Type 1/psychology , Spirituality , Adolescent , Depression/psychology , Female , Humans , Longitudinal Studies , Male , Prospective Studies , Stress, Psychological/psychologyABSTRACT
OBJECTIVES: To explore the relationship between executive function (EF) and social skills in youth with sickle cell disease (SCD). METHODS: 20 youth with SCD completed objective tests of EF (Tasks of Executive Control; Animal Sorting subtest from the Developmental Neuropsychological Assessment-Second Edition), an IQ screener, and paper-and-pencil measures of social skills (Social Skills Improvement System [SSIS]). Primary caregivers completed paper-and-pencil measures of EF (Behavior Rating Inventory of Executive Function) and social skills (SSIS). RESULTS: EF scores from the Behavior Rating Inventory of Executive Function related to parent- and child-reported social skills such that EF deficits correlated with poorer overall and domain-specific social skills. Similarly, EF scores from the Animal Sorting test related to child-reported social skills. Worse parent-reported EF predicted worse parent-reported social skills above the variance accounted for by IQ. CONCLUSIONS: EF is related to social skills and may be necessary for successful social interaction among youth with SCD. These results provide rationale and guidance for future larger-scale investigations of EF and social skills among children with SCD.
Subject(s)
Anemia, Sickle Cell/psychology , Executive Function , Interpersonal Relations , Social Skills , Adolescent , Child , Female , Humans , Male , Neuropsychological TestsABSTRACT
There is a growing literature examining positive outcomes following traumatic experiences. Although the diagnosis of a child with cancer poses extraordinary challenges for the family, awareness is growing that such a life-changing event can be a catalyst for positive growth. The current mixed methods study investigated benefit finding in fathers (N = 25) of childhood cancer survivors. Benefit finding included positive changes resulting from adversity. Participants completed a benefit finding measure and an interview describing their experience and benefits from the challenges faced during their child's cancer journey. Findings indicated that fathers endorsed high levels of benefit finding (mean = 4.1 out of 5) specifically in personal growth, spiritual change, and relationships with others. Our study extends the literature by examining how their child's cancer journey contributed to specific domains of paternal benefit finding. These results support the use of a positive psychology framework for understanding effects of a child's cancer diagnosis on caregivers.