|Title:||A study investigating the impact and coping of families during cancer children's hospitalization|
|Advisors:||Kong Wong, Kit Fong Sarah (SN)|
Wong, Kam Yuet Frances (SN)
|Subject:||Sick children -- China -- Family relationship.|
Tumors in children -- China.
Children -- Hospital care -- China.
Parent and child -- China.
Hong Kong Polytechnic University -- Dissertations
|Department:||School of Nursing|
|Pages:||xiv, 260 pages : color illustrations|
|Abstract:||Background: Advanced therapy for childhood cancer is often associated with repeated and prolonged hospitalization, which is considered as an immensely stressful experience for the whole family. The whole family experiences great hardships during a cancer child's hospitalization, with negative impact that can put the family into crisis or threaten its integrity. Some families adapt well, while others continue to experience extremely serious problems. Positive family adaptation can be attributed mainly to the dynamic balance between the inherent stressors and coping strategies. Pediatric oncology nurses are the best persons to support families during a cancer child's hospitalization. Family assessment during the interactions with families is the fundamental step for nursing support. In Mainland China, there is a paucity of literature exploring family impact and coping during a child's hospitalization for cancer treatment. Limited attention and care have been given to the entire family, whose needs and stress have been ignored or assessed inaccurately by healthcare providers. The population of families with children hospitalized in pediatric oncology units is a considerable target group demanding special attention in Mainland China. Nurses need broader knowledge and in-depth information pertaining to these families in order to provide better family care services during children's hospitalization for cancer treatment. Aim: The aim of this study was to understand family adaptation by investigating family impact and coping during a cancer child's hospitalization in Mainland China. Design: This study employed a mixed method, and pediatric oncology departments in four hospitals in Mainland China were involved. In the quantitative survey, 253 parents from different families with children hospitalized for cancer treatment completed the questionnaires, including a demographics questionnaire, the Family Impact Module of the Pediatric Quality of Life Inventory, the Hospitalization Impact and Coping Scale, and the Coping Health Inventory for Parents. The quantitative data were analyzed using descriptive analysis, multiple linear regression, confirmatory factor analysis and exploratory factor analysis. The qualitative section involved semi-structured individual interviews with 19 parents recruited from those who had completed the quantitative survey. The verbatim transcripts were analyzed using directed content analysis.|
Findings: The quantitative survey revealed that families were affected moderately by their children's hospitalization. Social functioning was affected the most, followed by the extra burden and psychological impact. In terms of family coping, one strategy, 'effort to maintain positive and active parental care', was regarded as the most helpful, followed by 'maximizing quality and quantity of child care'. The identified predictors of family impact were the total number of days of all admissions and the severity of a child's disease. The predictors of family coping effectiveness were the number of readmissions, family with a religious background, and age of the hospitalized child. To understand family issues in detail, some parents were interviewed. Four themes emerged from the nineteen sets of parents' interviews: family impact, family coping, family adaptation and unmet family needs. The findings have contributed to the in-depth understanding of family adaptation, while also provided important operational data for guiding the development and improvement of family-centered care in clinical settings in Mainland China. Conclusion: This study has generated insights into family adaptation by investigating how families were affected by and coped with their cancer children's hospitalization in Mainland China. The findings, which delineated the challenges the families had encountered, their coping strategies and the effectiveness of these, the characteristics of mal-adapted and bon-adapted families, and unmet family needs, have provided in-depth information for clinical nurses to support families to achieve bon-adaptation and improve the quality of clinical service. Success in fostering positive family adaptation requires a strengthening of family attributes and synergistic efforts by the healthcare providers, hospitals, the government and other communities.
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