Life-span development: a review of theory and practice for families with chronically ill members.

While the family's primacy in the patient's adaptation to chronic illness increasingly is being recognized by health professionals and social scientists, the reverse side of the coin, that is, the impact of chronicity on the family, has received little attention. A life-span development perspective is used to enrich the more traditional frameworks employed to study family development and also as a unifying framework from which to view the impact of illness on individual family members and the family as a unit. A review of selected literature reveals a profile of families most at risk for serious disruption in situations involving chronic illness. Propositions suggesting interventions directed at patients and families experiencing chronicity are derived.

African-American families with chronically ill children: oversights and insights.

From a critical review of the literature concerning African-American families' management and care of children having chronic illness, we concluded that information on culture-related experiences in such families remains seriously deficient. To present an accurate picture of African-American life as these families manage a child with a chronic illness, more comprehensive and detailed descriptions of family caregiving styles and other experiences are needed.

Adolescents completing cancer therapy: meaning, perception, and coping.

PURPOSE/OBJECTIVES: To explore and describe adolescents' experiences and associated changes in coping strategies during the time period from three to six months before cancer therapy completion to six months after completion. DESIGN: Exploratory, descriptive, longitudinal, qualitative design using grounded theory techniques. SETTING: Pediatric oncology outpatient clinics in the San Francisco Bay area and British Columbia. SAMPLE: 13 adolescents undergoing cancer therapy. METHODS: Semistructured interview conducted at four points in time (three to six months prior to completion of chemotherapy, at time of completion, three months after completion, and six months after completion). Subjects' responses were tape-recorded, transcribed verbatim, and analyzed using constant comparative techniques. FINDINGS: Themes emerged from the data in three categories: meaning and perception of the experience of completing cancer therapy (task accomplishment, movement toward a normal life); coping strategies before completion of therapy (positive thinking, not thinking about treatments, "busy-ness," reinterpretation, and "philosophical stance"); and coping strategies after completion of therapy (negotiation, cognitive reliving, selective forgetting). CONCLUSIONS: Completion of cancer therapy is an event that is uniquely perceived by adolescents, and they employ different coping strategies before and after completion. IMPLICATIONS FOR NURSING PRACTICE: Knowledge of adolescents' experiences of completing chemotherapy will assist nurses in offering support to the patient as well as to the parents who must support their child. Further longitudinal studies with larger samples are needed, as are studies comparing and contrasting the views of the adolescents and the parents.

The phenomenon of hand holding as a coping strategy in adolescents experiencing treatment-related pain.

The purpose of this study was to understand the phenomenon of hand holding as a coping strategy used by adolescents to deal with treatment-related pain. The convenience sample consisted of 20 adolescents whose ages were 11 to 19 years: 10 had cancer and 10 had renal disease (this served as the comparison group). Using a descriptive design, a semistructured interview was conducted with each adolescent. To supplement and support interview data, structured observations were conducted as adolescents underwent painful treatments (eg, blood draws, shunt placement, peripheral chemotherapy, lumbar punctures, and bone marrow aspirations). Data were analyzed using descriptive statistics and qualitative analytic techniques similar to those delineated by Strauss and Corbin. The results of this study indicated that subjects in both the cancer and the renal disease group perceived hand holding to be a very effective coping strategy in ameliorating treatment-related pain. Overwhelmingly the patients preferred to hold their mother's hand. When the mother was unavailable, they preferred to hold a specific nurse's hand. Hand holding functioned to reduce tension associated with impending treatments, as a source of distraction, and as a source of security. Accordingly, adolescents' subjective experience of treatment-related pain was reduced when they felt more secure, less tense, and were distracted.

What teachers want to know about students with cancer.

This article reports the results of a survey of classroom teachers in elementary and high schools in the San Francisco Bay Area. The teachers were asked to respond to questions about their informational needs and concerns related to students in their classroom who were diagnosed with cancer or receiving cancer treatment. Findings indicated that classroom teachers perceive themselves to be ill prepared to address the needs of the student with cancer. Specific concerns clustered around information deficits regarding the students' physiological and physical vulnerability, physical limitations/alterations following treatment, psychological responses to cancer treatment, and peer interactions. Utilizing data from the survey, a conceptual approach and collaborative intervention scheme were developed.

Application of the life-span developmental perspective to nursing research with adolescents.

Phenomena of interest to nurse researchers include the responses of persons across the life span to changes in their lives related to conditions of health and illness. The topic of this article is the life span stage known as adolescence, and the article is grounded in the premise that questions related to the effects of chronic illness at different points in the adolescent life course (i.e., early, middle, and late adolescence) are best studied from a life-span developmental perspective. First, the traditional developmental theories, the commonly held world views from which they emerged, and their relative contributions to research with adolescents are reviewed. The life-span developmental perspective is then discussed, with particular emphasis on its usefulness in guiding research aimed at answering questions that address change in the behavioral responses of adolescents to conditions of health and illness.

Life-span development: a review of theory and practice for families with chronically ill members.

While the family's primacy in the patient's adaptation to chronic illness increasingly is being recognized by health professionals and social scientists, the reverse side of the coin, that is, the impact of chronicity on the family, has received little attention. A life-span development perspective is used to enrich the more traditional frameworks employed to study family development and also as a unifying framework from which to view the impact of illness on individual family members and the family as a unit. A review of selected literature reveals a profile of families most at risk for serious disruption in situations involving chronic illness. Propositions suggesting interventions directed at patients and families experiencing chronicity are derived.