Canadian adolescents' perspectives of cancer risk: a qualitative study.

Research examining adolescents' understandings of cancer and cancer risk is limited. Accordingly, we conducted an ethnographic study that sought to extend our limited understanding of Canadian adolescents' perspectives of cancer and cancer prevention including how adolescents conceptualize and understand cancer risk. This article addresses findings specific to adolescents' perspectives of cancer risk. Seventy-five adolescents (11-19 years old) took part in the study. Two individual open-ended interviews were planned for each adolescent with the second interview occurring 4 to 5 weeks after the first interview. The second interview was complemented by the use of photovoice. Four focus groups, composed of the adolescents who took part in the individual interviews, were also conducted. Data analysis involved both thematic and content analysis. Findings revealed that adolescents conceptualized cancer risk in terms of specific risk factors, with lifestyle factors (e.g., smoking, diet/nutrition and physical inactivity) dominating their discourse. Adolescents rationalized risky health behaviours through use of cognitive strategies that included questioning and evaluating risk information, considering the benefits costs of the cancer risk, and downplaying the impact of the cancer risk. Use of these cognitive strategies helped to make cancer risks more acceptable to adolescents. While adolescents felt that cancer could not always be prevented, they did feel it was possible for individuals to delay getting cancer by lowering the impact of cancer risks through making the right choices. Although more research in this area is needed, the findings from this study may help inform cancer prevention and risk communication programmes and policies.

Child sexual abuse and adult religious life: challenges of theory and method.

The religious consequences of child sexual abuse in adulthood remain relatively unexamined in the research literature, especially where abusers are not clergy. Some studies suggest child sexual abuse survivors may rely on religion as a source of support, though the majority document a decrease in religiosity. Given the propensity for psychological challenges among adult survivors with diminished spiritual coping, we are calling for increased research attention to religion in the context of child sexual abuse. The objectives of this article were to review the literature on intersections between child sexual abuse (perpetrated by nonclergy) and religiosity in adults and set forth relevant research approaches for future investigation. Findings revealed a comprehensive, multidisciplinary, and theoretically informed approach to research may be needed.

Forgotten survivors of intimate-partner violence: The role of gender and mothering in infant development.

Although gender and mothering are critical factors in the development of infants exposed to intimate-partner violence (IPV), the majority of research has focused on school-age and adolescent populations. The aim of this study was to investigate the moderating effect of gender in the relationship between mother-infant interaction and infant development in families of IPV. Maternal report was used to measure infants' cognitive and social functioning while mother-infant interaction quality was assessed through an observational measure. Participants consisted of 44 mothers and their infants (4-43 months of age). While male infants showed poorer fine motor, problem-solving, and personal-social skills than did their female counterparts, comparable gross motor and communication skills were demonstrated. Moderator analysis for gender indicated that the association among maternal cognitive growth fostering and gross motor skills was significantly stronger for boys than it was for girls. No other moderator effects were detected. Analysis examining age, gender by age, and infant competencies did not reveal significant effects. Implications for clinical practice are considered, with special attention paid to women as mothers.

The experience of the self in Canadian youth living with anxiety: A qualitative study.

BACKGROUND: Anxiety can create serious disruption in the life and mind of youth who are affected. Youth living with anxiety suffer a wealth of physical and psychological challenges, yet little is known about how anxiety influences the sense of the self. The purpose of this research was to explore the experience of the self in a sample of Canadian youth living with anxiety. MATERIALS AND METHODS: The qualitative research approach of hermeneutic phenomenology was used. The sample consisted of 58 Canadian youth with anxiety, 44 females and 14 males between the ages of 10 and 22. Youth took part in open-ended interviewing, ecomaps, and photovoice. Data analysis followed a staged process, informed by Max van Manen. All sources of data were included in the analysis to form thematic statements. RESULTS: Entering into the lifeworld of youth revealed that they suffered deeply. A fractured sense of self underlined their experience, setting up for a great deal of self-scrutiny and a lack of self-compassion. They experienced a profound sense of responsibility for others at the loss of being-there-for-oneself. Navigating their social sphere presented an additional challenge. However, youth were genuinely interested in self-discovery through awareness and reflection. CONCLUSIONS: The phenomenological accounts by youth on living with anxiety reinforce the challenges they experienced within themselves that give rise to a great deal of inner turmoil. Care and support to youth with anxiety requires an understanding of the ways in which the self may be fractured by their experiences with anxiety. Providing young people with an opportunity to share with others who had similar lived experiences can serve to contribute to a sense of healing for youth, while also providing a safe space in which young people can let down their guard and openly acknowledge or share their experiences without fear of stigmatization.

Childhood brain cancer and its psychosocial impact on survivors and their parents: A qualitative thematic synthesis.

PURPOSE: The multiple late-effects experienced by survivors of childhood brain tumors, are not only a source of great distress for survivors, but also for their parents and siblings. The aim of this review is to systematically identify and synthesize qualitative evidence on how survivors of childhood brain tumors and their parents experience life after surviving childhood brain tumors. METHODS: Based on literature search in seven databases, 10 qualitative studies, published between 2004 and 2014 were included. RESULTS: Surviving a childhood brain tumor was experienced as paradox for survivors and their parents. While parents and survivors celebrated making it through the cancer experience, they nonetheless encountered a world with loss and new challenges. In short, the experience of survival was a bittersweet experience for survivors and their parents. Survivors and their parents experienced change that included living with uncertainty, intensification of the parenting role, a changing social world, a different way of being, and the need for additional help. CONCLUSION: Results from this synthesis reinforce that surviving a childhood brain tumor should be viewed as a point on a continuum of living with a brain tumor. Psychosocial effects of surviving brain cancer affect the entire family unit. A need for psychosocial support is evident, although development of such supports necessitates a more full understanding of challenges face by the child affected, their parents, and siblings. The limitations noted in this synthesis reinforce that more qualitative research is needed in this subject area.

Children exposed to intimate partner violence: influences of parenting, family distress, and siblings.

The aim of this study was to investigate associations between maternal stress, parenting behavior, and sibling adjustment in relation to child trauma symptoms in families with and without a history of intimate partner violence (IPV). Maternal report was used to measure maternal stress and child trauma symptoms, whereas parenting behavior was assessed through an observational measure. Participants consisted of mothers with 2 school-age siblings recruited from the community. Results indicated that violent families reported higher levels of maternal stress and sibling trauma symptoms than nonviolent families, although no differences were found in parenting behavior. Sibling trauma symptoms and negative maternal behavior toward a sibling were strong predictors of trauma symptoms in younger siblings exposed to IPV but only modest predictors for older siblings. Moderator analyses showed that in IPV-affected families, the trauma symptoms of older siblings were related to the trauma symptoms of younger siblings when maternal stress was high.

Siblings exposed to intimate partner violence: linking sibling relationship quality & child adjustment problems.

Although the majority of families that experience intimate partner violence (IPV) have more than one child, most research to date has focused upon a single child within these families. A significant body of research has indicated siblings play an important role in children's adjustment and well-being. To address this gap, the three main goals of the present study were to compare the adjustment of older and younger siblings exposed to IPV, to describe and compare the quality of these sibling relationships from multiple perspectives, and to investigate how sibling adjustment and relationship quality influence children's adjustment. Forty-seven sibling pairs and their mothers were recruited from the community. Mothers self-reported on their violent experiences using the Conflict Tactics Scale, and also estimated the length of time their children were exposed to IPV. Mothers and children completed assessments of child adjustment and the quality of sibling relationships. Observers also assessed the quality of sibling interaction. Results indicated that adjustment between siblings was highly inter-related. On average, mothers reported sibling relationships as less positive but also as less hostile than did siblings themselves. Higher levels of sibling hostility, lower levels of sibling warmth and higher levels of disengagement each significantly predicted child adjustment; however, these effects were predicated upon the adjustment of the other sibling. The sibling relationships of children exposed to IPV made a difference in their individual adjustment, and their adjustment issues influenced how they feel about and interacted with their sibling. Sibling hostility played a stronger role in adjustment issues than sibling warmth. The nature of sibling influences and the direction of future research were discussed.

Existential anxiety and growth: an exploration of computerized drawings and perspectives of children and adolescents with cancer.

BACKGROUND: Until now, most existentially focused cancer research has been conducted within adult populations. Only a handful of qualitative investigations have captured the experiences of children with cancer relative to themes such as existential fear and finitude, meaning/meaninglessness, uncertainty, authenticity, and inauthenticity. OBJECTIVE: This article aimed to provide a deeper understanding of the existential challenges faced by children living with cancer. METHODS: An interpretive, descriptive qualitative research approach was used. Thirteen children (8-17 years) undergoing treatment for cancer participated. Children participated in individual open-ended interviews and also had the opportunity to journal their experiences in a computerized drawing tool. RESULTS: The 4 main themes that emerged in relation to the existential challenges experienced by children with cancer included (1) existential worry, (2) existential vacuum, (3) existential longing, and (4) existential growth. The drawing tool within the computer diary was found to be particularly beneficial in assisting children to express the existential challenges that they had previously been unable to articulate in words. CONCLUSION: Children moved between existential anxiety and existential growth within the cancer world. The expressive means of drawing pictures gave children a therapeutic space to explore and work at understanding the existential challenges experienced. IMPLICATIONS FOR PRACTICE: This research provides evidence that the active engagement of children's imaginations through the use of a computer-drawing tool may have significant therapeutic value for children with cancer. As well, the findings support the importance of nurses "being there" for young patients with cancer in their time of despair.