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      The Effect of Educational-Spiritual Intervention on The Burnout of The Parents of School Age Children with Cancer: A Randomized Controlled Clinical Trial

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          Abstract

          Background:

          Parents of children with cancer experience high levels of stress and discomfort. Religious beliefs are important sources of comfort and support for many cancer patients and their families. The present study aimed to assess the effect of educational-spiritual intervention on burnout of the parents of the children with cancer.

          Methods:

          In this randomized clinical trial, 135 parents of children with cancer were randomly assigned into intervention and control groups. Data were collected through SMBQ (Shirom and Melamed Burnout Questionnaire) from both groups, before, immediately after and one month after the intervention. Educational-spiritual programs were held for six weeks, one session every week. The data were analyzed by SPSS using independent t-test, and repeated measure ANOVA.

          Results:

          The results showed that the mean burnout score before the intervention in the intervention group was 4.28±0.61 and in the control group it was 4.23±0.50; most of the parents reported moderate to high burnout. But, there was a significant difference between the intervention and control groups immediately after and one month after the intervention (t=10.16, P<0.0001). The mean burnout score in the intervention group was less than the control group. Results also showed that there was a significant difference between the two groups in terms of parental burnout in three times of measurements (F=58.62, P<0.0001).

          Conclusion:

          This study indicated that educational-spiritual intervention was effective on reduction of the burnout of the parents of the children with cancer. Due to high burnout of most of the parents, offering such a program could be beneficial for them. More studies in this regard are recommended.

          Trial Registration Number: IRCT2014061818144N1

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          Most cited references17

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          Cancer Facts & Figures—2013

          (2013)
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            Posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in families of adolescent childhood cancer survivors.

            To describe rates and concordance of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in adolescent childhood cancer survivors and their mothers and fathers. Participants were 150 adolescent survivors of childhood cancer, 146 mothers, and 103 fathers who completed the Impact of Events Scale-Revised, the Posttraumatic Stress Disorder Reaction Index, and the PTSD module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. PTSS are common in families of childhood cancer survivors. Parents reported more symptomatology than former patients. Mothers and fathers had relatively equal rates of current PTSD and levels of PTSS. Nearly 30% of mothers met diagnostic criteria since their child's diagnosis, with 13.7% currently experiencing PTSD. Nearly 20% of families had at least one parent with current PTSD. Ninety-nine percent of the sample had at least one family member reexperiencing symptoms. Both PTSD and PTSS help in understanding the experience of adolescent cancer survivors and their families. Within families of childhood cancer survivors, it is likely that some member may be experiencing treatable bothersome memories, arousal, or avoidance specific to the cancer experience.
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              How parents of children receiving pediatric palliative care use religion, spirituality, or life philosophy in tough times.

              How parents of children with life threatening conditions draw upon religion, spirituality, or life philosophy is not empirically well described. Participants were parents of children who had enrolled in a prospective cohort study on parental decision-making for children receiving pediatric palliative care. Sixty-four (88%) of the 73 parents interviewed were asked an open-ended question on how religion, spirituality, or life philosophy (RSLP) was helpful in difficult times. Responses were coded and thematically organized utilizing qualitative data analysis methods. Any discrepancies amongst coders regarding codes or themes were resolved through discussion that reached consensus. Most parents of children receiving palliative care felt that RSLP was important in helping them deal with tough times, and most parents reported either participation in formal religious communities, or a sense of personal spirituality. A minority of parents, however, did not wish to discuss the topic at all. For those who described their RSLP, their beliefs and practices were associated with qualities of their overall outlook on life, questions of goodness and human capacity, or that "everything happens for a reason." RSLP was also important in defining the child's value and beliefs about the child's afterlife. Prayer and reading the bible were important spiritual practices in this population, and parents felt that these practices influenced their perspectives on the medical circumstances and decision-making, and their locus of control. From religious participation and practices, parents felt they received support from both their spiritual communities and from God, peace and comfort, and moral guidance. Some parents, however, also reported questioning their faith, feelings of anger and blame towards God, and rejecting religious beliefs or communities. RSLP play a diverse and important role in the lives of most, but not all, parents whose children are receiving pediatric palliative care.
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                Author and article information

                Journal
                Int J Community Based Nurs Midwifery
                Int J Community Based Nurs Midwifery
                IJCBNM
                International Journal of Community Based Nursing and Midwifery
                Shiraz University of Medical Sciences (Iran )
                2322-2476
                2322-4835
                January 2016
                : 4
                : 1
                : 90-97
                Affiliations
                [1 ]Community Based Psychiatric Care Research Center, Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Shiraz University of Medical Science, Shiraz, Iran
                [2 ]Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Science, Shiraz, Iran
                [3 ]Community Based Psychiatric Care Research Center, Department of Mental Health and Psychiatric Nursing, Faculty Member of Nursing and Midwifery, Shiraz University of Medical Science, Shiraz, Iran
                [4 ]Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
                [5 ]Department of Biostatistics, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
                Author notes
                Corresponding author: Noushin Beheshtipour, MS; Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Zand St., Nemazee Sq., 7193613119, Shiraz, Iran Tel: +98 711 6474258; Fax: +98 711 6474252; beheshti64@ 123456yahoo.com
                Article
                IJCBNM-4-90
                4709819
                26793734
                8c1781c9-4fa4-4ef4-adc4-5338c0fefdaf
                Copyright: © International Journal of Community Based Nursing and Midwifery

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 April 2015
                : 29 June 2015
                : 24 August 2015
                Categories
                Original Article

                burnout,cancer,parents,spirituality
                burnout, cancer, parents, spirituality

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