'I Grew Up A Lot Earlier': Understanding Resilience And Distress In Children Whose Parents Have Cancer.

Summary: Most research into the long-term effects of parental cancer on children has focussed on negative impacts, such as, increased rates of anxiety, depression and low self-esteem. However, researchers are discovering increasingly that many children go on to experience positive outcomes, or 'post-traumatic growth'. This week Michael Bouwman talks with Dr Cheryl Koopman, who believes it is the differences in children's responses to their parents' cancer that we need to study, in order to build on children's resilience, rather than assuming that all children will go on to experience a negative trajectory. Participants in Cheryl's research reported four major types of post-traumatic growth: improved character or a feeling that one has become a better person; increased appreciation and gratefulness for life; a strengthening of family relationships, and a desire to pursue a cancer-related career path, such as becoming an oncologist. Cheryl believes we need to carefully assess each child's reaction to having a parent with cancer, and tailor interventions to reflect individual differences. In addition to helping children with their distress, she advocates helping them tap into sources of resilience, such as family relationships and larger extended networks, and thoughtfully prompting them to think about ways they can grow as people. First broadcast: 29 January, 2010.

Interviewee: Dr Cheryl Koopman, Associate Professor (Research), Department of Psychiatry and Behavioral Sciences, Stanford University, California USA

Article: Wong, ML., Cavanaugh, CE., Macleamy, JB., Sojourner-Nelson, A., Koopman, C. (2009) Posttraumatic growth and adverse long-term effects of parental cancer in children, Family, Systems & Health, 27(1):53-63

ippshr podcast 096: understanding resilience and distress in children whose parents have cancer

'I Really Would Like To Hear Your Story': Incorporating Clinical Empathy Into The Ward.

Summary: Whilst medical schools are increasingly recognising the importance of empathy training, the hidden curriculum - the reality of clinic care - often overrides empathy training when medical students begin work in the wards. This week, Hamish Holewa talks with Dr Rebecca Garden, who believes this is a concern, given the strong evidence that patients do better medically and are more likely to collaborate in their treatment programs when they are collaborating with empathic doctors. She says we need to teach health professionals to be as conscious of emotions as possible, and to respond to emotions in themselves and their patients, in order to deliver effective patient centred care. Rebecca stresses that the critical point in building a collaborative relationship with a patient is reached when doctors check back with patients to make sure they've 'got it right', as it gives doctors an opportunity to learn more about the factors influencing their patient's health and allows the patients to be the authority on their own story of illness. She also suggests that clinical empathy can actually be energising for health professionals and need not impose on the efficiency of a busy clinical environment. First broadcast: 5 February, 2010.

Interviewee: Dr Rebecca Garden, Assistant Professor Center for Bioethics & Humanities SUNY Upstate Medical University, Syracuse, NY, USA

Article: Garden, R. (2009) Expanding Clinical Empathy: An Activist Perspective, JGIM: Journal of General Internal Medicine, 24(1):122-5

ippshr podcast 097: incorporating clinical empathy into the ward

'A Fine Line': The Everyday Lives Of Families Who Have A Child With Type 1 Diabetes

Summary: Three years after a child's diagnosis of type 1 diabetes, family members are likely to feel skilful and knowledgeable about the disease and how to manage it, but still want medical reassurance that future complications won't arise. Families struggle with the unpredictability of blood sugar levels, and with getting the timing right with 'letting go' and allowing the child to manage the diabetes themselves. This week, Michael Bouwman talks with Dr Anne Wennick, whose third part of a longitudinal study shows that children with diabetes become quickly skilful at managing their diabetes on their own, but confusion arises when the responsibility is either shifted or not shifted, to the parents, when the child gets home from school. Children also must deal with the widespread lack of understanding about their medical condition: Anne describes a school teacher asking a child to put away their cell phone when they were actually administering a dose of insulin through their insulin pump; and a child having to go to the bathroom to treat an insulin reaction with sugar, rather than being allowed to do so in the classroom. Anne believes we need to support families in fostering their child's independence and find ways to bring families with diabetes together. First broadcast: 12 February, 2010.

Interviewee: Dr Anne Wennick, Senior Lecturer in Pediatric Nursing, Faculty of Health and Society, Malmo University, Malmo, Sweden

Article: Wennick, A., Lundqvist, A., Hallstrom, I. (2009) Everyday Experience of Families Three Years after Diagnosis of Type 1 Diabetes in Children: A research paper, Journal of Paediatric Nursing, 24(3):222-30


ippshr podcast 098: the everyday lives of families who have a child with type 1 diabetes

Summary: Ambulance workers witness death and injury on a daily basis, and have a much greater risk of developing post-traumatic stress disorder (PTSD) than people in the general community. But what gives some incidents, and not others, the power to evoke traumatic emotions, and how can we support paramedics? This week Hamish Holewa talks to Dr Janice Halpern, who says the results of her study surprised her, as well as the paramedics in her study, by showing that poignant incidents arousing intense compassion, such as the death of a baby, children being harmed by their parents, or deaths of an innocent victim or a strikingly senseless one, were particularly powerful. She says we think of traumatic incidents as very intense and demanding. However, it's often the very quiet, motionless incidents, where there isn't a lot of action, and where there is often nothing to do, that result in overwhelming feelings. Janice says we need to educate ambulance workers and their supervisors to recognise and tolerate vulnerable feelings, as many dismiss their own emotions and avoid seeking support, believing what they have witnessed is not severe enough to be 'critical'. Others fear the stigma associated with vulnerable emotions, and believe that, as professionals, no incident should distress them. First broadcast: 19 February, 2010.

Interviewee: Dr Janice Halpern, Assistant Professor, Department of Psychiatry, University of Toronto, Canada

Article: Halpern, J., Gurevich, M., Schwartz, B., Brazeau, P. (2009) What makes an incident critical for ambulance workers? Emotional outcomes and implications for intervention, Work & Stress, 23(2): 173-189

ippshr podcast 099: 'Nothing I could do': accepting distress and vulnerability in ambulance workers

Summary: To commemorate the 100th IPP-SHR Podcast, this week’s podcast is a collection of interviews that were conducted by Michael Bouwman and Hamish Holewa, at the 8th Annual Psychosocial Oncology Conference New Zealand, 2009. Michael Bouwman spoke to Associate Professor David Perez about his paper titled "Putting the patient in the centre of cancer care", looking from a clinician's view of important patient care issues. Michael also spoke to Helen Neser and Gay Dungey about their workshop titled, "Integrating the bunker into mind, body and spirit - A radiation therapy and health professional's perspective". PhD Student Andu Iordache talked to Michael about his presentation "Making the case for using dream talk in cancer care". Michael also talked to Amy Munro about her paper about the online forum, LifeBlood LIVE, which is an forum for haematology patients. Sarah Hunter spoke to Michael about her paper, "The impact of premature menopause and fertility damage from cancer treatment". Anna Holmes discussed her paper, "Bearing witness to suffering - letting go of control". Richard Egan talked about his paper titled, "Spirituality: who cares?” And Hamish Holewa spoke to Susan Comber, a social worker at the Head and Neck Cancer Clinic, Auckland City Hospital. First broadcast: 26 February, 2010.

ippshr podcast 100: 8th Annual 2009 PONZ - Psychosocial Oncology New Zealand Conference

Overcoming The Fear Of Exercise: Helping Patients With Chronic Obstructive Pulmonary Disease Stick With Rehab.

Summary: Fear of exercise puts many patients with chronic obstructive pulmonary disease (COPD) off participating in pulmonary rehabilitation programs. The concerns are real, given that pulmonary rehabilitation programs always involve exercise, and most patients with COPD have experienced severe difficulty in breathing after exertion. However there are stong therapeutic benefits from participating in programs. People with COPD often become socially isolated and withdrawn, and the programs have been shown to give patients more energy, more control over their symptoms, an increased capacity to exercise and engage in activities they enjoy, as well as reducing mortality and hospital admissions. This week, Hamish Holewa talks to Dr Cathy Bulley, who has found that the referring practitioner's level of enthusiasm and knowledge about pulmonary rehabilitation programs has a significant effect on whether patients participate in them. She believes rehabilitation teams need to actively promote their programs and create leaflets outlining the benefits. Cathy says patients are more likely to continue with programs if they feel socially supported and if their self-confidence continues to grow. She believes we need to do more research into the factors that keep people going to rehabilitation programs and to understand what keeps them motivated long-term. First broadcast: 12 March, 2010.

Interviewee: Dr Catherine Bulley, Physiotherapy Lecturer, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom

Article: Bulley, C., Donaghy, M., Howden, S., Salisbury, L., Whiteford, S., Mackay, E. (2009) A prospective qualitative exploration of views about attending pulmonary rehabilitation, Physiotherapy Research International, 14(3): 181-192


ippshr podcast 101: helping patients with chronic obstructive pulmonary disease stick with rehab

Children Living With Grandparents: An Under-Recognised and Under-Resourced Phenomenon.

Summary: The number of grandparents becoming primary carers of their grandchildren is growing in the UK, the USA and Australia, a phenomenon which is both under-recognised and under-resourced. This week, Hamish Holewa talks with Professor Barbara Horner, who has found that while most children's emotional and material wellbeing improves with grandparent care, there are psycho-social risk factors for the children, and financial and environmental stresses for grandparents, that need to be addressed. She says most children cared for primarily by grandparents come from disturbed families where they are at risk. Living with their grandparents gives them a much greater sense of safety and security - feeling that they are needed, loved, and that they belong. However, Barbara also stresses that many children need help with unresolved losses, such as the death of parents and abrupt separations from families through court rulings and crisis situations. She says many children feel confused and anxious about the past because they do not have 'the whole story'. Barbara's research also shows that children have an intuitive understanding of the stresses on their ageing grandparents, who may need to refinance to support the children, and change their own plans for the future. First broadcast: 26 March, 2010.

Interviewee: Dr Barbara Horner, Director, Centre for Research on Ageing, Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia

Article: Downie, JM., Hay, DA., Horner, BJ., Wichmann, H., Hislop, AL. (2010) Children living with their grandparents: resilience and wellbeing, International Journal of Social Welfare, 19(1): 8-22

ippshr podcast 102: children living with grandparents: under-recognised and under-resourced

"IPP-SHR Podcasts" are an exploration of psycho-social health research topics with leading researchers from around the globe.

"Research Notes" is a complementary podcast which explores the practicalities, issues and methodology associated with conducting psycho-social health research.

IPP-SHR PODCASTS 09

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