Infertility and Identity: A Closer Look Into Experiences of Emerging Young Adult Childhood Cancer Survivors.

Objective: While medical advances are enabling more children with cancer to live into adulthood, a large majority of them suffer from the late effects of treatment and about 30% experience infertility. Infertility impacts both male and female survivors complicating typical development for emerging young adults (EYAs) who typically spend this developmental period actively constructing their identities related to family and gender roles, attaining professional skills, and establishing social views. As literature is limited on identity formation and coping with infertility in young survivors, this study aimed to understand the experiences of childhood cancer survivors who are faced with infertility as a late treatment effect while reconstructing their identity. Method: A qualitative descriptive approach was used to explore the experiences and effects of childhood cancer complications on the identity development of six emerging adults (ages 18-29). Guided by the theoretical framework of identity development data were collected using semistructured interviews. Results: Four distinct themes emerged after the data analyses: restricted exploration and uncertain future, challenges to intimacy and communication, restructuring identity through redefining roles, and coping through familial support. Conclusions: Findings indicate that developmental processes of identity formation are complicated by the challenges stemming from infertility and require specific efforts to reconstruct core identity and redefine desired parental roles. Experimentation and self-discovery may be restricted for EYA cancer survivors as they reevaluate their views on intimate relationships, communication, potential professional roles, and family composition. Practical recommendations for multidisciplinary team members to support this growing population are discussed.

Bringing Inclusion Into Pediatric Primary Health Care: A Systematic Review of the Behavioral Health Treatment of Racial and Ethnic Minority Youth.

INTRODUCTION: Currently, pediatric behavioral health care accounts for one of the fastest growing health care expenditures. Children representing racial and ethnic minority groups are still found to experience significant behavioral health needs. Primary health care represents the first level of contact with the health care system. METHOD: The purpose of this systematic review was to synthesize articles discussing the behavioral health needs and treatment of racial and ethnic minority in primary care settings. RESULTS: Results yielded 40 articles meeting the inclusion criteria. Themes included: provider screening, provider selected treatments, prevalence and need, and stigma and patient-provider communication. CONCLUSIONS: Themes were discussed through the Ecological Systems Theory lens. Study limitations included its exclusion of intellectual disabilities like Autism Spectrum Disorder, lack of literature utilizing large minority samples, and lack of attention to the intersection between race and/or ethnicity alongside other demographics of concern like gender, age, social class, and geographical location.

Development of an educational module on provider self-care.

Intensive care providers who care for traumatized populations often face multiple traumas for extended periods and are vulnerable to developing lasting symptoms of compassion fatigue and secondary traumatization. Symptoms are often not recognizable until compassion fatigue or secondary traumatization negatively affects the providers' ability to care for their patients. More attention needs to be given to the care of the provider to ensure high-quality patient care, decrease turnover in the profession, and increase productivity. This article provides a framework for the development of an educational module for healthcare providers' self-care. This educational module created the opportunity to share with providers (a) how to explore their own professional experience; (b) how to recognize the different symptoms of compassion fatigue, primary traumatization, and secondary traumatization; (c) factors related to grief reactions; and (d) personal and professional strategies to decrease compassion fatigue and secondary traumatization.

Relational and Spiritual Coping Among Emerging and Young Adult Cancer Survivors.

Cancer presents uncertainties for individuals of any age; however, emerging and young adults (EYA) are challenged to cope with developmental tasks in addition to cancer-related stressors. Guided by the double ABC-X model and biopsychosocial-spiritual framework, the current study investigates coping strategies used by this population and the role of psychological resources (perception of parental care/control and spirituality) on their coping ability. Recruited from online social media, 210 EYA cancer survivors self-reported demographic, medical information, and completed the Brief Cope scale. In addition, spirituality reliance, perceived parental care, and parental control were measured and examined in relation to coping ability. While nearly half of participants experienced positive adaptation in relation to multiple stressors, hierarchical multiple regression revealed the developmental nature of coping and indicated that higher spirituality reliance and higher degree of parental care were predictive of adaptive coping among EYA cancer survivors. Content analyses of the open-ended questions confirmed these results. In order to facilitate adaptive coping, attention must be paid to the unique biopsychosocial-spiritual and developmental needs of young cancer survivors while encouraging family support and spirituality reliance as significant tools in coping. Practical recommendations for nursing support and healthcare teams are discussed.

Following Bariatric Surgery: an Exploration of the Couples' Experience.

BACKGROUND: Bariatric surgery is the most effective intervention for morbid obesity, resulting in substantial weight loss and the resolution of co-morbid conditions. It is not clear what impact bariatric surgery and the subsequent life-style changes have on patients' couple relationships. The purpose of this phenomenological study was to examine the lived experience of couples after one member of the couple underwent bariatric surgery. METHODS: This study utilized a phenomenological approach of semi-structured interviews of the couples jointly (n = 10 couples). Colaizzi's method of analysis for phenomenological studies was utilized to elucidate the central themes and distill the essence of the participants' experience. RESULTS: All of the couples felt their post-operative success was due to a joint effort on both members of the couples' part. The participant couples described the following five emerging thematic experiences: (a) changes in physical health, (b) changes in emotional health, (c) changes in eating habits, (d) greater intimacy in the relationship, and (e) the joint journey. CONCLUSIONS: This research provides greater insight into the experience of the couple than has been previously reported. The use of qualitative research techniques offer new approaches to examine the biopsychosocial outcomes and needs of bariatric surgery patients. Further research is warranted in order to develop culturally appropriate interventions to improve the patient's surgical and biopsychosocial outcomes.

Exploring the phenomenon of spiritual care between hospital chaplains and hospital based healthcare providers.

Hospital chaplaincy and spiritual care services are important to patients' medical care and well-being; however, little is known about healthcare providers' experiences receiving spiritual support. A phenomenological study examined the shared experience of spiritual care between hospital chaplains and hospital-based healthcare providers (HBHPs). Six distinct themes emerged from the in-depth interviews: Awareness of chaplain availability, chaplains focus on building relationships with providers and staff, chaplains are integrated in varying degrees on certain hospital units, chaplains meet providers' personal and professional needs, providers appreciate chaplains, and barriers to expanding hospital chaplains' services. While HBHPs appreciated the care received and were able to provide better patient care as a result, participants reported that administrators may not recognize the true value of the care provided. Implications from this study are applied to hospital chaplaincy clinical, research, and training opportunities.

Prevalence of overweight and obesity, and dieting attitudes among Caucasian and African American college students in Eastern North carolina: A cross-sectional survey.

A cross-sectional survey was used to investigate the rates of overweight and obesity (BMI >/= 25), and eating attitudes among college students. Data were collected at a large southeastern university. Adolescents (ages 18-25) self-reported weight and height (to calculate BMI), and, in addition to demographic information, completed the eating attitudes (EAT 26) scale to assess dieting tendencies. Significance of the mean BMI differences between gender and ethnic background were assessed by one-way analysis of variance (one-way ANOVA). Chi-square was used to determine whether the rate of those with BMI>/=25 between gender and ethnic background was statistically significant. While 52.7% of the students' BMI were within the normal weight category, 15.2% were underweight, 21.3% were overweight, and 10.8% were obese. The rate of BMI>/=25 differed by gender and ethnicity, with males and African Americans having higher rates. About 12 % of the participants reported disturbed eating behavior, which is lower than previously reported. Even so, results support the generally held belief that disturbed eating attitudes and unhealthy dieting are common among college students, especially among females. At the same time, disturbed eating attitudes are not just the domain of young female students; about 10% of college males reported disturbed eating attitudes. Findings of this study call for obesity prevention/intervention and lifestyle modification outreach programs among college students. Weight status and unhealthy eating behaviors of college students should be a concern to health care professionals. While obese young adults will likely remain obese throughout their adult life, excessive dieting among students, which is linked to eating disorders and other health hazards, does not provide healthy and adequate alternatives for maintaining a normal BMI. Implications for obesity prevention programs are discussed.

Individual and familial correlates of body satisfaction in male and female college students.

OBJECTIVE: This study investigates the relative contributions of global self-esteem, body mass index (BMI), dieting behaviors, and perceived parental control and care on body satisfaction among a nonclinical sample of college students. PARTICIPANTS AND METHODS: Participants (49 males and 299 females) reported weight and height (to calculate BMI) and completed the EAT 26 test. Perceived parental care and control, global self-esteem, and body satisfaction were measured and examined in relation to BMI and dieting behavior. RESULTS: High BMIs were associated with lower body satisfaction for both genders; dieting behavior, self-esteem, and perceived parental care and control demonstrated a unique gender-specific association among variables in prediction of body satisfaction and dieting behavior for each gender. CONCLUSIONS: Body satisfaction as a part of global self-esteem is constructed differently by males and females. Various aspects of parenting (care and control) are associated with self-esteem and body satisfaction for each gender, influencing dieting behavior.

Secondary traumatization in pediatric healthcare providers: compassion fatigue, burnout, and secondary traumatic stress.

The primary aim for this research was to explore the overlap and differences between the concepts related to secondary traumatization: posttraumatic stress disorder (PTSD), secondary traumatic stress (STS), compassion fatigue (CF), and burnout (BRN). A secondary aim for this research was to examine the impact of secondary traumatization and some of the personal and professional elements that affect how pediatric healthcare providers experience PTSD, STS, CF, and BRN. An online survey was sent via e-mail to numerous list serves for healthcare providers who had worked on PICU, NICU, or PEDS units within the last year. The analyses revealed that a significant overlap existed between the terms of STS, PTSD, BRN, CS, and CF for PICU, NICU, and PEDS providers. However, a hierarchical linear regression revealed a significant amount of unique contributions to the variance in CF based on each of the measured concepts. Despite previous literature that indicates that the terms STS and CF can be used interchangeably, the two most prominent measures utilized in the assessment of CF and STS are actually capturing at least some unique elements. Given these results, future researchers should examine and conceptualize the difference in etiology, prevalence, symptoms, and treatment efficacy for CF and STS as separate but related entities and then return their focus to understanding secondary traumatization in healthcare providers.