Parent Distress, Parent-Child Interactions, Child Distress and Child Cooperation during Cancer Treatment–Related Port Starts: A Caring Perspective Public Deposited

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  • March 20, 2019
  • Bai, Jinbing
    • Affiliation: School of Nursing
  • Children reported more suffering from cancer treatment−related painful procedures than cancer itself. Appropriate parent interaction behaviors can help children cope with these painful procedures. Swanson’s Theory of Caring provides a framework to formulate parent interaction behaviors. This dissertation consisted of three separate papers to investigate parent-child interactions during cancer treatment−related port starts. The first paper reviewed 15 extant observational coding systems of parent-child interactions during painful procedures. These measures had at least an acceptable reliability and some evidence for validity. Only two coding systems were informed with clear theoretical foundations. Parent nonverbal behaviors were under-represented especially for older children (ages 3–18 years). Four of the coding systems were evaluated well-established measures. The second paper reported the development of the Parent Caring Response Scoring System (P-CaReSS) by the hybrid approach of inductive and deductive coding and tested its psychometric properties. The 18-item P-CaReSS assesses parent verbal (11 items), nonverbal (6 items), and emotional behaviors (1 item). It is feasible to develop an observational measure based on Swanson’s Theory of Caring. The P-CaReSS has acceptable inter-rater reliability and construct validity for use during cancer painful procedures. The third paper explored the change of parent interaction behaviors over time and the temporal relationships between parent interaction behaviors and child distress during repeated port starts procedures. We found that more parents significantly displayed nonverbal caring behaviors over time and parent verbal caring behaviors did not change significantly. Sequential analyses showed that children were significantly less likely to display verbal and behavioral distress following parent caring behaviors than at any other time. If a child is already engaged with distress, parent verbal and nonverbal caring behaviors can significantly reduce child verbal and behavioral distress. This dissertation adds new knowledge to current literature in two ways−validating the impact of theory-based parent caring behaviors on child treatment−related responses by sequential analyses and providing new solutions to design evidence-based interventions during cancer procedures. Future studies are needed to explore the moderators of the relationships between parent-child interaction behaviors and intervention programs can be developed to facilitate parents to use caring verbal and nonverbal behaviors.
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Rights statement
  • In Copyright
  • Harper, Felicity
  • Santacroce, Sheila
  • Penner, Louis
  • Swanson, Kristen
  • Knafl, George
  • Hudson-Barr, Diane
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2016

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