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- All Subjects: Family
- Creators: Bradley, Robert
physical health compared to children without cancer. Many studies have been done to examine the effects of emotional distress and mental health on the cancer patient, as well as the role of familial support. It was found that children with cancer may suffer from depression, anxiety, PTSD, and socio-emotional problems as a result of the trauma of being diagnosed and treated for a pervasive, life-threatening disease. Late effects may also worsen co-morbid mental health disorders. Childhood cancer patients who experience co-morbid mental health problems of depression and anxiety end up having a longer duration of recovery, as well as a worsened outcome than others with a single disorder (Massie, 2004). It was also shown that family members are affected emotionally and mentally from dealing with childhood cancer. Not only is the cancer patient at risk for PTSD during or after treatment, but also family members (National Cancer Institute, 2015). Siblings of the child with cancer may experience feelings of loneliness, fear, and anxiety, as the parent’s attention is focused on the child suffering with cancer. According to the National Cancer Institute (2015), familial problems can affect the child’s ability to adjust to the diagnosis and treatment in a positive way. However, children with strong familial and social support adjust easier to living with cancer. A common theme found in literature is that regular mental health checkups during and after cancer treatment is important for quality of life. Therefore, it is important for all childhood cancer patients and their families to receive information about mental health awareness, as well as therapeutic interventions that are developed for families caring for a child with cancer.
Method: Twenty families with children 10 years and older were recruited to participate in a 3-week equine assisted learning program at a therapeutic riding center in Phoenix, Arizona. Sessions included groundwork activities with horses used to promote life skills using experiential learning theory. The study design included a mixed-method quasi-experimental one-group pretest posttest design using the following mental health instruments: Devereaux Student Strengths Assessment, Brief Family Assessment Measure (3 dimensions), and Family Satisfaction Scale to measure child social-emotional competence, family function, and family satisfaction, respectively. Acceptability was determined using a Likert-type questionnaire with open-ended questions to gain a qualitative thematic perspective of the experience.
Results: Preliminary pretest and posttest comparisons were statistically significant for improvements in family satisfaction (p = 0.001, M = -5.84, SD = 5.63), all three domains of family function (General Scale: p = 0.005, M = 6.84, SD = 9.20; Self-Rating Scale: p = 0.050, M = 6.53, SD = 12.89; and Dyadic Relationship Scale: p = 0.028, M = 3.47, SD = 7.18), and child social-emotional competence (p = 0.015, M = -4.05, SD 5.95). Effect sizes were moderate to large (d > 0.5) for all but one instrument (Self-Rating Scale), suggesting a considerable magnitude of change over the three-week period. The intervention was highly accepted among both children and adults. Themes of proximity, self-discovery, and regard for others emerged during evaluation of qualitative findings. Longitudinal comparisons of baseline and 3-month follow-up remain in-progress, a topic available for future discussion.
Discussion: Results help to validate equine assisted learning as a valuable tool in the promotion of child social-emotional intelligence strengthened in part by the promotion of family function and family satisfaction. For mental health professionals, these results serve as a reminder of the alternatives that are available, as well as the importance of partnerships within the community. For therapeutic riding centers, these results help equine professionals validate their programs and gain a foothold within the scientific community. Additionally, they invite future riding centers to follow course in incorporating evidence into their programs and examining new directions for growth within the mental health community.
Current obesity statistics exceed national goals with Hispanics disproportionately affected. Evidence suggests a family centered methodology focusing on culture can positively improve weight loss, client satisfaction and participation. This project will evaluate use of culturally tailored resources for primary care providers to educate Hispanics on weight loss. Eight providers in a small practice in the Southwestern US were recruited to complete a pre- and postEBPAS tool after an educational session. A BMI form tracked provider use of the fotonovela intervention against preferred methods.
Feedback on time spent educating and overall perception were collected. Four providers completed the pre-EBPAS, three completed the post-, one participated in the intervention, and six contributed project feedback. Descriptive statistics revealed an aggregate provider decrease of five-points post-educational session for attitude toward adopting EBP. The BMI documentation form demonstrated a 53% (n = 8) use of the fotonovela. However, there were five undocumented fotonovelas taken/given out postintervention. Key themes noted by providers included poor timing of the project, satisfaction with workflow and resources, and overall discontent for the fotonovela. Future implications include re-evaluating the project in a practice not undergoing significant changes with specific focus on timing of the intervention.