Children Navigating Parental Cancer: Outcomes of a Psychosocial Intervention.

Research has evidenced a marked increase in the prevalence of cancer among younger people with up to one in five, parenting children under the age of 18 years of age. When a parent is diagnosed with cancer they experience fears and anxieties as they attempt to simultaneously manage their role as a parent, with the illness experience. Parents have expressed difficulties in knowing how to communicate appropriately with their children throughout the illness trajectory as they are primarily focused on protecting or shielding their children from knowledge of the illness. Understandably parents may become overwhelmed with significant parental stress impacting on their psychological well-being. This subsequently affects the well-being of the entire family unit, coupled with changes to routines, roles, and responsibilities. This study was carried out to examine how a group psychosocial intervention Children's Lives Include Moments of Bravery (CLIMB®) helped young children to navigate parental cancer. A qualitative research design utilizing focus group methodology, artwork and individual interviews was used to generate data from 19 participants (parents, children, and health-care professionals). Three key themes emerged from the data, navigating the diagnosis, navigating emotions and changed routines, creating spaces to talk about cancer. The findings evidenced that attending CLIMB® was a positive experience for both children and parents. It gave the children the language and opportunity to express their fears and worries. CLIMB® equipped them with tools and skills to both express and manage their negative emotions, life skills that could be transferred to other challenging life events. All techniques that created spaces to talk and appeared to have a reassuring effect on the children. The parents appreciated the professional support that the structured intervention offered to them and helped them communicate more openly with their children. Creating spaces to talk about cancer reduces mistrust and tension between parents and children, when parental cancer occurs, and hopefully minimizes future psychological and social problems.

Nurses' care practices at the end of life in intensive care units in Bahrain.

BACKGROUND: The process of dying in intensive care units is complex as the technological environment shapes clinical decisions. Decisions at the end of life require the involvement of patient, families and healthcare professionals. The degree of involvement can vary depending on the professional and social culture of the unit. Nurses have an important role to play in caring for dying patients and their families; however, their knowledge is not always sought. OBJECTIVES: This study explored nurses' care practices at the end of life, with the objective of describing and identifying end of life care practices that nurses contribute to, with an emphasis on culture, religious experiences and professional identity. Research Design and context: Grounded theory was used. In all, 10 nurses from intensive care unit in two large hospitals in Bahrain were participated. Ethical Considerations: Approval to carry out the research was given by the Research Ethics Committee of the host institution, and the two hospitals. FINDINGS: A core category, Death Avoidance Talk, was emerged. This was supported by two major categories: (1) order-oriented care and (2) signalling death and care shifting. DISCUSSION: Death talk was avoided by the nurses, doctors and family members. When a decision was made by the medical team that a patient was not to be resuscitated, the nurses took this as a sign that death was imminent. This led to a process of signalling death to family and of shifting care to family members. CONCLUSION: Despite the avoidance of death talk and nurses' lack of professional autonomy, they created awareness that death was imminent to family members and ensured that end of life care was given in a culturally sensitive manner and aligned to Islamic values.

An introduction to the biographical narrative interpretive method.

AIM: To introduce the biographical narrative interpretive method (BNIM) to nurse researchers in search of a new methodology and method. BACKGROUND: Listening to and interpreting the narratives of patients is a core feature of nursing. Research methodologies and methods frequently do not fully take into account the historical, psycho-social and biographical dynamics of people's lives. DATA SOURCES: This paper draws from the experiences of both authors who have previously utilised the BNIM method, as well as sourcing relevant literature. REVIEW METHODS: This is a methodology paper that reviews the historical context of BNIM and provides an overview of its potential application for nursing research. Discussion The core assumptions and analytic strategy of BNIM focus on three inter-related facets: the person's whole life history or story (biography), how they tell it (narrative) and the social interpretation (interpretive). BNIM uses a unique interviewing technique to elicit an uninterrupted story from participants. The BNIM analytic tool is formulaic and uses nine stages to analyse individual cases. A tenth stage helps with analysis across cases. CONCLUSION: BNIM methodology and methods empower participants to articulate the vicissitudes of their life and experiences of illness while also providing the researcher with a framework for data analysis and interpretation to give meaning to individuals' life stories. IMPLICATIONS FOR RESEARCH/PRACTICE: The BNIM interview technique and analytic framework are useful tools to help with an in-depth qualitative exploration of life stories in context.