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Background: Parents with cancer face elevated psychological distress, often exacerbated by parenting responsibilities. Affect-Focused Psychodynamic Therapy (AFPT) has shown efficacy in improving emotion regulation, psychological well-being and self-compassion, but its feasibility and preliminary effect in this population remains unexplored.

Objective: The aim of this study was to evaluate the feasibility, acceptability, safety, and preliminary effects on symptoms of depression and anxiety, of AFPT delivered via videoconferencing for parents with cancer.

Methods: The intervention consisted of 10 sessions of AFPT, specifically affect phobia therapy. Qualitative data were collected through post-intervention interviews and analysed using inductive content analysis. Quantitative data were collected through self-report questionnaires at pre-intervention, post-intervention, and at 6-month follow-up measuring symptoms of depression and anxiety (primary outcome), parenting concerns, emotion regulation, self-efficacy, adaptive affective functioning, closeness in the family and self-rated health. Quantitative data were analysed using dependent-samples t-tests, with Cohen's d for effect sizes, and McNemar tests.

Results: Fifteen mothers with cancer participated in the study. Results demonstrated efficient recruitment, acceptable study procedures, complete retention, and a relevant and beneficial intervention rated 8.4/10 in helpfulness. Moreover, findings showed significant reductions in symptoms of depression (Cohen's d = 1.29) and of anxiety (Cohen's d = 1.06) from pre- to post-intervention, maintained at 6-month follow-up, together with improvements in a majority of the secondary outcomes.

Conclusions: Videoconferencing AFPT appears feasible, acceptable, and safe to use for mothers with cancer, with promising preliminary effects in reducing psychological distress. These findings support further evaluation of the intervention to determine its efficacy in this population using a randomized controlled trial.

Background: Women with cancer tend to report higher levels of psychological distress than men with cancer. A deeper understanding of how modifiable psychological factors are related to psychological distress in mothers with cancer could inform targeted prevention strategies. The aim of this study was to investigate how the modifiable psychological factors; parenting concerns, self-efficacy, and emotion regulation strategies, are associated with symptoms of depression, anxiety, stress, and posttraumatic stress in mothers with cancer.

Methods: In 2023, 222 mothers with cancer, aged 25-60 years, with varying time since diagnosis were included in a longitudinal observational study. Data were collected at inclusion and one year later. Outcome measures were symptoms of depression, anxiety, stress, and PTSD, assessed using Depression, Anxiety and Stress Scale (DASS-21) and PTSD Checklist for DSM-5 (PCL-5) questionnaires. Sociodemographic and health-related variables were used as covariates and parenting concerns, self-efficacy, and emotion regulation strategies (cognitive reappraisal and expressive suppression) were used as explanatory variables in the hierarchical linear regression models.

Results: After controlling for sociodemographic and health-related variables, baseline symptom levels were the strongest predictors of symptoms of depression, anxiety, stress, and PTSD at one-year follow-up. With exception of parenting concerns in relation to depressive symptoms, modifiable psychological factors did not predict the outcomes after adjusting for the contribution of baseline symptoms.

Conclusions: Baseline symptom severity emerged as a strong predictor across all outcomes, as such early assessment of psychological symptoms may be particularly important for mothers with cancer. Future research should aim to diversify the study population to better capture differences in psychological symptoms across various cancer types, cancer stage, and age groups.

Purpose: Up to 40 % of parents of children with cancer experience relationship distress; a significantly higher proportion compared to the general population. Despite this elevated risk, there are few in-depth qualitative studies investigating relationship distress in the paediatric oncology context. Therefore, this study aimed to explore how parents of children with cancer experience relationship distress to thereby generate an in-depth understanding of the phenomenon.

Method: A sample of 25 parents (17 mothers, 8 fathers) who had experienced relationship distress related to their child's cancer participated in semi-structured interviews exploring relationship dynamics, communication, conflict management, and relational changes following the child's diagnosis. The interviews were audiorecorded, transcribed verbatim, and analysed using inductive content analysis.

Results: Three categories and nine subcategories were identified. In addition to these, one overarching theme emerged. The first category 'Pressure on the relationship', illustrated factors that placed strain on the couple relationship. The second category 'When unity fails' included parents' experiences of challenges in dealing with the situation together as a couple. The third category 'Fractured togetherness' highlighted relationship deterioration as a result of the cancer experience. The theme 'Fighting together, yet drifting apart' linked the categories by illustrating the process of experiencing joint hardships, of trying to manage these together, but ending up with a wounded relationship.

Conclusion: This study contributes with an in-depth understanding of relationship distress in parents of children with cancer. Thereby, it can contribute to the development of currently limited interventions to support parents' couple relationships in paediatric oncology care.

Purpose:

In-depth exploration of how the couple relationship is affected by parental cancer in couples with dependent children.

Methods:

Semi-structured interviews were carried out with a convenience sample of 17 parents with cancer who were in a couple relationship and had children aged 18 years or younger. Data were analysed using qualitative content analysis.

Results:

The content analysis resulted in three categories representing areas in the couple relationship that had changed following the cancer diagnosis: Altered communication; Adapting to new roles; and A change in sex life, intimacy and fertility. The results illustrate a significant increase in the need for constructive communication when couples face a range of emotionally-charged topics that were made difficult to talk about due to the children being present. The results also showed that the experience of cancer had forced couples to adapt to new roles in their relationship, and in the family, in order to manage the complex practical issues of simultaneously being parents and dealing with cancer. Lastly, both physical and psychological aspects of cancer had affected the couples' sex life, intimacy and fertility including decreased sexual engagement and changed conditions impacting family planning.

Conclusions:

Results highlight the specific areas that are challenging for couples facing cancer who are parents of dependent children. Couples may need support to cope with these challenges due to the complexity of parenthood when managing cancer as a couple.

Background: Breast cancer is the most common cancer diagnosis among women in Sweden, and 20% of cases are women younger than 50 years. For many of these women, the diagnosis occurs during a period of active parenting, when they are responsible for the emotional and practical care of young children. This dual burden, coping with a life-threatening illness while maintaining a caregiving role, can lead to increased emotional strain, altered family dynamics and challenges in communication and support. The aim of this qualitative study was to explore the parenting experiences of women with breast cancer who have minor children, focusing on challenges, needs and interactions with the healthcare services

Methods: A self-selected sample of 131 mothers, living in Sweden, aged 25-60 years, who were diagnosed within the past five years participated. Participants were recruited via social media, patient organizations and oncology clinics. An online questionnaire was used to collect data between January and May 2023, which consisted of, among other things, sociodemographic information and an open-ended question about parenthood. The responses to the open-ended question were analysed using conventional content analysis.

Results: The analysis resulted in five categories: a significant impact on mothering and an increased emotional burden; challenges in communication within the family; a broad range of experiences of healthcare support from significantly lacking to positive experiences; the need for emotional and practical support from family, partners, relatives and school and the emotional and social impact on the children.

Conclusion: The findings highlight that there is a clear need for more accessible and structured support from the healthcare services to address the unique needs of mothers with breast cancer and their children, ensuring better communication, psychosocial care and practical assistance throughout the illness trajectory.

Background

When a parent is diagnosed with cancer, it often affects both family life and the couple relationship significantly. However, research on factors that influence relationship functioning over time in this population is limited.

Aims

To investigate the development of relationship functioning and factors associated with relationship functioning over a 1-year period among parents with cancer.

Methods

In this longitudinal study, 180 parents with cancer, aged 24–60 years, with dependent children completed online surveys at 2 time-points: at inclusion (T1) and 1 year later (T2). Data included self-reported sociodemographic, physical health and psychological factors, and relationship functioning. The outcome was relationship functioning at T2 assessed using 4 subscales (Dyadic cohesion, Dyadic satisfaction, Sensuality, and Sexuality) of the validated self-assessment scale Quality of Dyadic Relationship Scale-36 (QDR). Linear regression analyses were conducted to identify factors associated with the outcome.

Results

All aspects of relationship functioning statistically declined over time, except sexuality. After adjusting for multiple T1 factors, completion of cancer treatment predicted higher Dyadic cohesion; poor self-rated health predicted lower Dyadic satisfaction; higher age, being a mother and attachment-related anxiety predicted lower Sensuality; and lower age of youngest child, anxiety and attachment-related anxiety predicted lower Sexuality.

Conclusions

Cancer significantly impacts relationship functioning among parents with cancer who have dependent children, with significant declines in Dyadic cohesion, Dyadic satisfaction, and Sensuality over time. A number of sociodemographic, physical health and psychological factors were shown to predict lower relationship functioning. Addressing these factors may help identify and support parents with cancer who are at risk of, or who perceive, difficulties in their couple relationship.

  Introduction

Overall childbirth experience scores are used both in research and in clinical settings. Since it is still not fully understood what assessment of childbirth experience on a single-item numeric rating scale or visual analog scale represents, the aim of this study was to explore women's reasoning and thoughts when rating overall childbirth experience numerically.

Material and Methods

A qualitative interview study of 26 women was conducted using a think-aloud technique at a university referral hospital in Sweden. A manifest qualitative content analysis was performed to generate categories and sub-categories representing how women decided which single value should represent their experience of giving birth.

Results

Two main categories emerged from the analysis. The first, Strategies for choosing a number, reflects variations in how the women approached the rating scale itself and includes five sub-categories, each relating to a different strategy: (1) Comparison, (2) Start from the maximum value, (3) Start from the middle, (4) Weigh certain experiences more heavily, and (5) A means to an end. The second category, Specific factors considered in the rating, includes four sub-categories, representing groups of factors contributing to the final childbirth experience score: (1) The time period, (2) Events linked to strong emotions, (3) Perceived support, and (4) Previous expectations. What the women included in their overall childbirth experience was hence translated into a number, using strategies from the first category and factors from the second category.

Conclusions

The considerable variations in how women approach the rating scale, and what they include in the assessment of overall childbirth experience, suggest that not only the childbirth experience itself but also the reasoning when evaluating it, is multifaceted. A standardized phrasing of the question and a clear purpose for the evaluation is warranted to strengthen the validity of the measurement. When used clinically for identifying women in need of support after childbirth, the rating should be followed by a conversation about the experience of giving birth, independent of the value chosen.

Background Parents given a diagnosis of cancer must balance the demands of their illness and caregiving responsibilities. This can result in parental stress and have a negative impact on the well-being of the whole family. A greater understanding of the experiences of parents with cancer is necessary to provide adequate support.

Objective The aim of this study was to explore parenting concerns and challenges among parents with cancer who were caring for dependent children younger than 18 years.

Methods Semistructured interviews were carried out with 22 parents with cancer. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis.

Results Parental concerns and challenges affected parents in their parental role and their everyday family life. Three overarching themes described the struggles in balancing life as a parent and as a patient: navigating dual roles as a parent with cancer, impact of cancer on parenting, and impact on family life. Parents’ primary focus was on their children’s well-being, and they struggled to manage their own expectations of parenting and the demands on their role in the family.

Conclusion The results highlight the complexity of being a parent with cancer while caring for dependent children. To support parents during the cancer journey, it is important to understand the consequences of their illness on their parental role and the family.

Implications for Practice Supporting parents to feel secure in their parental role and providing support to them during their cancer journey should be integrated into routine cancer care, where parenting concerns and challenges are addressed.

Background:

No web-based interventions addressing sexual problems are available for young adult survivors of childhood cancer.

Aim:

This study aimed to test the efficacy of a web-based psychoeducational intervention, Fex-Can Sex, to alleviate sexual problems in young adults treated for cancer during childhood.

Method:

This randomized controlled trial tested the effects of a 12-week, self-help, web-based intervention. Young adults (aged 19-40) reporting sexual dysfunction were drawn from a population-based national cohort of childhood cancer survivors and randomized to either an intervention group (IG, n = 142) or a wait-list control group (CG, n = 136). The primary outcome was 'Satisfaction with sex life' assessed by the PROMIS (R) SexFS v 2.0. Secondary outcomes included other SexFS domains, body image (BIS), emotional distress (HADS), health-related quality of life (EORTC QLQ-C30), and sex-related self-efficacy. Surveys were completed at baseline (T0), directly after the intervention (T1), and three months later (T2). The effects of the intervention were tested using t-test and linear mixed models, including intention-to-treat (ITT) and subgroups analysis. Adherence was based on log data extracted from the website system. The intervention included an open-ended question about perceived sexual problems.

Results:

No effect of the intervention was found in the primary outcome. Regarding secondary outcomes, the IG reported less vaginal dryness (Lubrication subscale) than the CG at T1 (p = 0.048) and T2 (p = 0.023). Furthermore, at T1, the IG reported less emotional distress than the CG (p = 0.047). Subgroup analyses showed that those with greater sexual problems at T0 improved over time (T1 and T2), regardless of group allocation. Overall, adherence to the intervention was low and participants' activity levels did not change the results. Additionally, some members of the IG reported increased understanding and acceptance of their sexual problems.

Conclusion:

The Fex-Can Sex intervention shows potential to improve sexual function, especially among those with greater dysfunction. To increase adherence and effect, we recommend the intervention to be further developed including more tailored content.

Clinical trial registration: ISRCTN Registry, trial number: 33081791 (registered on November 27, 2019).

Background: Despite the challenges that caring for a child with cancer brings for parents, little knowledge is available concerning the effects on the parents' couple relationship. Furthermore, few interventions have been designed to support parents in their couple relationship. The aim of this paper was, therefore, to explore parents' experiences of their couple relationship while having a dependent child with cancer and the support they received from a family-based intervention, the Family Talk Intervention (FTI).

Methods: Data for this paper were taken from semi-structured interviews performed in a pilot study of the FTI in the context of pediatric oncology. In total, 22 couples were interviewed after participating in the FTI. The interviews were transcribed and analyzed using qualitative content analysis.

Results: Parents described how maintaining a couple relationship while living with childhood cancer could be very challenging and was not given the highest priority. The FTI was considered a way of providing important support to the couple and a chance for them to sit down together and listen to each other's perspectives on the situation. Parents described that the FTI had helped them gain an increased mutual understanding, sometimes also helping them to realize that they needed more extensive professional support in their relationship.

Conclusions: Living with childhood cancer and upholding a healthy couple relationship is challenging for parents. The FTI has the potential to support couples, mainly by providing opportunities for parents to communicate with each other. However, some couples may be in need of a tailored clinical intervention.