Contributing Factors of a Good Death for Children With Cancer From Bereaved Parents' Perspectives in South Korea.

Achieving a good-quality death for children with cancer is as paramount as saving their life, given its implications for both the children's end-of-life quality and the grief journey of their parents. This study explored factors contributing to a good death for children with cancer, as perceived by bereaved parents in South Korea. A retrospective survey was conducted, involving 58 bereaved parents of a child who died of cancer. t-tests and regressions were performed to identify factors related to deceased children associated with parents' reports of a good death for children with cancer. The results revealed significant correlations between parents' age, income, religious affiliation, time elapsed since death, child's age at death, and cancer recurrence with several aspects of a good death. These findings underscore the importance of assessing characteristics of both parents and their children to enhance the quality of death experienced by children with cancer in South Korea.

Comparing Perceptions of Addiction Treatment between Professionals and Individuals in Recovery.

Background: The purpose of this qualitative study was to compare and contrast the differing perspectives of service users and professionals regarding the current substance use disorders (SUD) services provided in Summit County, Ohio. Seven focus groups were conducted with 44 participants (52.3% male, mean age 46 years), including 15 individuals in recovery, 16 direct service providers, and 13 executive directors. The participants were asked about three areas: (1) effective treatment for SUD, (2) challenges for persons with SUD, and (3) suggestions for improving SUD treatment outcomes. The data were analyzed and coded according to major themes. Results: While there were numerous emergent themes that were concordant between service use and professionals, several differing themes between the groups were also identified. First, participants disagreed on the effectiveness of medication-assisted treatment/Medications for Opioid Use Disorder. Second, professionals identified trauma, stigma, "one-size-fits-all" approach to treatment, and limitations set by managed care act as barriers to treatment, whereas individuals in recovery reported difficulty dealing with feelings, feeling of being rushed into recovery, and the lack of long-term recovery plans as the most significant barriers. Lastly, in order to improve treatment outcomes, professionals emphasized the importance of education unlike individuals in recovery who identified sober supports as the most important factor. Conclusion: This study identified challenges in SUD recovery and highlights essential areas for consideration when developing and implementing SUD treatment. The findings can be used as guidelines to provide better services to individuals with SUDs.Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2022.2058706 .

A photovoice study on the bereavement experience of mothers after the death of a child.

This study explored the bereavement experience of mothers after losing a child to cancer in Korea, using photovoice. The mothers took photos reflecting five subject areas they selected: (a) if I had one more day with my child, (b) memories with my child, (c) dreaming of my child's healthy future, (d) what gave me strength, and (e) fulfilling my child's wishes for the future. The findings show that mothers who lost a child to cancer need bereavement care to promote well-being. This study can help pediatric oncology providers develop bereavement interventions that address parental grief and improve quality of life.

Changes in Relationships in Bereaved Families: Perspectives of Mothers Who Lost a Child to Cancer.

The loss of a child greatly affects the dynamics of interpersonal relationships in bereaved families. This study explored the relationships in bereaved Korean families from the perspectives of mothers after the death of a child due to cancer. We conducted in-depth interviews with 15 bereaved mothers of a deceased child with childhood cancer. Thematic analysis identified 12 subthemes related to bereaved mothers' struggles in grief within three significant themes based on family relationships: (a) relationship with husband; (b) relationship with surviving child or children; and (c) relationships with extended family members. Findings highlight bereaved mothers' need to build supportive family relationships while acknowledging bereaved family members' different grieving styles and their own challenges in grieving the loss of a child.

Maternal Depressive Symptoms, Adolescent Daughters' Substance Use, and Father Residence in Minority Families.

Background: Maternal depression has been linked to substance use in adolescents, but the mechanisms of the relationship between maternal depression and adolescent substance use are less clear. Specifically, previous literature has overlooked the role of fathers as a potential protective or exacerbating factor in buffering this relationship. Objectives: The goal of this study was to investigate the association between maternal depressive symptoms and adolescent substance use, exploring father's residential status as a moderator for adolescents living with a mother with depressive symptoms. Method: Paper-and-pencil surveys were administered to a sample of 176 mothers and their adolescent daughters aged 14-18, predominantly identifying as African American/Black. Participants included a subset of mothers with HIV. Results: The results revealed that maternal depressive symptoms were not directly associated with adolescent substance use. However, father's residential status was found to be a significant moderator in the relationship between maternal depressive symptoms and adolescent substance use. Specifically, when fathers were involved in the daughter's life (residential or non-resident), substance use was higher in adolescents of mothers with high depressive symptoms than in those of mothers with low depressive symptoms. Conclusion: The results suggest that varied family dynamics are critical to understanding engagement in substance use among adolescent girls, including the influence of both mothers and fathers.

Experiences of Korean mothers of children with cancer: A Photovoice study.

Using Photovoice, a participatory action research methodology, we investigated Korean mothers' lives postdiagnosis of their child with cancer. Photovoice was used to understand the mothers' perceptions of how they have adapted to their children's illnesses. Five mothers of children with cancer participated in five sessions of the Photovoice project, during which they took and shared photographs and narratives about their experiences and joined weekly group discussions on their selected themes. The following themes and subthemes emerged: "What I would like to do (taking a break, socializing with friends, spending time with other family members, developing my career)," "My child and food (whatever my child wants to eat, love of family)," "My days for my child (doing what my child wants to do, being a playmate, changing for my child)," and "Power sources for me (family, courage of children, mom is strong, hope)." Having a child with cancer greatly affects the mother's social and work lives as well as emotional well-being. Services and programs such as respite care, parenting education, and psychological support are recommended based on the study findings.

Sexual intercourse among adolescent daughters of mothers with depressive symptoms from minority families.

This study investigated the association between maternal depressive symptoms and adolescent engagement in sexual intercourse in a non-clinical sample of mothers and their adolescent daughters from minority families. The current study explores ways in which maternal depression, family factors, and adolescent sex interact. Data were from a cross-sectional study of 176 mother-daughter dyads, including a subset of mothers with HIV. Logistic regression analyses revealed that among mothers who were not current marijuana users, more maternal depressive symptoms was associated with daughters' engagement in sexual intercourse. Neither parent-child conflict nor parental involvement significantly mediated the relationship between maternal depressive symptoms and adolescent sex. This study provides the first empirical evidence that non-clinical depressive symptoms in mothers are associated with adolescent engagement in sexual intercourse.

Parentification, substance use, and sex among adolescent daughters from ethnic minority families: the moderating role of monitoring.

Guided by structural family systems theory, this study explored the relationship between parentification and adolescent daughters' sexual risk engagement and substance use. We also explored how adolescent reports of parental monitoring moderated the relationship between parentification and adolescent risk. Data were from a cross-sectional, cross-generational study of 176 mother-daughter dyads from low-income, inner-city, ethnic minority families. In this sample, which included a subset of mothers with HIV, parental physical symptoms were associated with slightly higher levels of parentification. Parentification was associated with adolescent daughters' intention to have sex (but not substance use) in a direction opposite to prediction. Higher parentification was associated with lower intention to have sex. Parental monitoring did not moderate relationships between parentification and adolescent risk. These findings highlight that despite the negative influence hypothesized in structural family systems theory, parentification was not associated with risk engagement of high-risk adolescent daughters in ethnic minority families with low income.

Caregiving Stress Experienced by Parents of Adult Children with Intellectual Disabilities During COVID-19 in Korea.

Many of community supports and resources were shattered in the COVID-19 pandemic, leaving parents to navigate caring for their adult child with intellectual disabilities with little support. This study explored caregiving stress experienced by parents of adult children with intellectual disabilities during the COVID-19 pandemic in Korea. In-depth interviews were conducted with 19 parents of an adult child with intellectual disabilities. Thematic analysis yielded two themes: caregiving burden and deteriorating health. Parents bore the brunt of the caregiving burden, spending much of their time helping their adult child with daily activities and managing their challenging behaviors, leaving the caregivers struggling physically and mentally. The heightened caregiver burden and associated deteriorating health among these parents raise serious concerns, indicating a need for immediate support to alleviate these issues and help parents navigate caring for their adult child with intellectual disabilities during the COVID-19 pandemic.

Worries of childhood cancer survivors in young adulthood.

PURPOSE: Childhood cancer survivors worry about many issues related to their cancer history. As they grow older, additional issues may emerge. This study of a sample of Korean young adults aims to understand childhood cancer survivors' worries. METHOD: A purposeful sample of 28 childhood cancer survivors was recruited through survivor and parent-advocacy foundations and support groups in Korea. Qualitative in-depth interviews were conducted over the phone or in person. Participants ranged in age from 20 to 36, were diagnosed before age 19, and had completed treatment at the time of the study. RESULTS: Through qualitative interviews, survivors' worries were identified in the following five themes: romantic relationships and marriage, fertility and the health of future children, work and social life, family, and physical health. CONCLUSIONS: The study's findings support the importance of understanding the worries of childhood cancer survivors in young adulthood and the need for developing services and programs to help survivors acquire the appropriate social skills and coping strategies to mitigate their worries.

Child neglect: definition and identification of youth's experiences in official reports of maltreatment.

OBJECTIVE: The purpose of this study was to describe the nature of neglect in child welfare clients, to describe these experiences, to examine its typologies, and to understand how different types of neglect co-occurred with each other and with other types of maltreatment. METHODS: Case record abstraction was conducted on the child welfare case records of an urban, ethnically-diverse sample of youths (n=303) identified as maltreated by a very large public child welfare agency. We utilized the Maltreatment Case Record Abstraction Instrument (MCRAI) which was based on the work of Barnett et al. (1993) as modified by English and LONGSCAN (1997). Thirteen items of parental behavior deemed neglectful were coded and organized into 5 subtypes of neglect (care neglect, environmental neglect, medical neglect, educational neglect, supervisory neglect). RESULTS: Neglect was present in 71.0% of the sample as compared to the 41.0% classified as neglected by CPS records. Neglect was accompanied by other types of maltreatment in 95% of the cases. Children who were neglected had more reports of maltreatment and experienced a greater number of different types of maltreatment than those who were maltreated, but not neglected. The most common type of neglect was supervisory neglect (72.5%) followed by environmental neglect (61.6%). With the exception of medical neglect, all types of neglect were significantly correlated with each other. CONCLUSIONS: The abstraction resulted in rich data showing that under a one-word label of neglect, the nature of neglect that the youngsters actually experienced was quite diverse and heterogeneous in its phenomenology. Furthermore, neglect is pervasive for children in the child welfare system and official classifications underestimate its occurrence. Neglect does not happen in isolation; children who are reported as neglected are likely to experience other forms of maltreatment. PRACTICE IMPLICATIONS: Official classifications should not be used in determining interventions for children and families. Interventions for neglected youngsters should be individualized to address the complexity of children's experiences.

Emotional abuse in a sample of multiply maltreated, urban young adolescents: issues of definition and identification.

OBJECTIVE: The main purpose of this paper is to use the Brassard and Donovan [Brassard, M. R. & Donovan, K. L. (2006). Defining psychological maltreatment. In M. M. Freerick, J. F. Knutson, P. K. Trickett, & S. M. Flanzer (Eds.), Child abuse and neglect: Definitions, classifications, and a framework for research (pp. 151-197). Baltimore, MD: Paul H. Brookers Publishing Co., Inc.] framework to examine and describe the nature of emotional abuse experienced by a sample of urban, ethnically diverse male and female youth (N=303) identified as maltreated by a very large public child welfare agency. METHODS: Case record abstraction was conducted on the DCFS records of these maltreated youth using the Maltreatment Case Record Abstraction Instrument (MCRAI) which was based on the work of Barnett et al. [Barnett, D., Manly, J. T., & Cicchetti, D. (1993). Defining child maltreatment: The interface between policy and research. In D. Cicchetti & S. L. Toth (Eds.), Advances in applied developmental psychology: Child abuse, child development and social policy (pp. 7-73). Norwood, NJ: Ablex Publishing Corp.] as modified by English and LONGSCAN [English, D. J., & the LONGSCAN Investigators. (1997). Modified maltreatment classification system (MMCS). Retrieved from http://www.iprc.unc.edu/longscan/]. Fifteen items of parental behavior deemed emotionally abusive were coded and organized into four subtypes of emotional abuse (spurning, terrorizing, isolating, exploiting/corrupting) using the Brassard and Donovan (2006) framework. RESULTS: Using this coding system, almost 50% of the sample were found to have experienced emotional abuse in contrast to 9% identified at the time of referral by DCFS. Most of the emotionally abused youth also experienced physical abuse (63%) and/or neglect (76%) as well. The most frequent subtype of emotional abuse experienced was terrorizing. Most youth experienced more than one subtype. CONCLUSIONS: Emotional abuse, while frequent, was seldom the focus of the child protection services investigation. The nature of this abuse was not minor, but rather likely to be dangerous to the mental health and well-being of these children. Further more emotional abuse, in this sample of young adolescents, at least, was likely to be accompanied by other forms of maltreatment, especially physical abuse and/or neglect. These findings have important implications for practice and the direction of future research. PRACTICE IMPLICATIONS: All those who interact with child welfare clients must recognize the prevalence of emotional abuse in maltreated children so that appropriate interventions are instituted. Screening for emotional abuse should be part of all intake referrals and when confirmed should be noted in official records. When children are placed, foster parents (both kin and non-kin) need training on the prevalence and consequences of emotional abuse, and strategies to help their foster children recover from the aftermath. When children remain with maltreating parents, emotional abuse should be a focus of the interventions designed to help maltreating parents with more effective parenting strategies and also should be a focus of the interventions designed to help the child recover from the consequences of maltreatment.