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Item The benefits of family-centered care for parental self-efficacy and psychological well- being in parents of children with cancer(Edições Universitárias Lusófonas, 2019) Salvador, Ágata; Crespo, Carla Alexandra Mesquita; Barros, Luísa; HEI-LAB (FCT) - Digital Laboratories for Environments and Human InteractionsObjectives The purpose of this study was to examine the direct and indirect links between the perception of family-centeredcare (FCC) and psychological well-being via the perceived self-efficacy of parents of children with cancer. This study alsosought to identify the potential moderators of these links (treatment status and patient age).Methods This cross-sectional study was conducted at the pediatric oncology wards of two Portuguese public hospitals. Theconsecutive sample comprised 251 parents (87.6% mothers) of children/adolescents (8−20 years old) diagnosed with cancer.Participants completed self-report questionnaires measuring their perception of family-centered care (family-centered ser-vices and providing general information), perceived self-efficacy (regarding healthcare and parenting role) and psychologicalwellbeing.Results Results from the Structural Equation Modeling suggested that parents’perception of FCC was indirectly, but notdirectly, linked to psychological well-being via perceived self-efficacy. Multi-group analyses suggested that this mediationmodel was valid across treatment status (on vs. off-treatment) and patient age groups (children vs. adolescents).Conclusions These findings highlighted that, through the implementation of FCC, healthcare professionals may promoteparents’perceived self-efficacy and, consequently, their psychological well-being. Results also suggest that FCC mayequally operate on parents’psychosocial functioning, regardless of treatment status or patient age. Overall, our findingsreinforced the benefits of FCC practices in pediatric oncology wards.Item Do parents of children with cancer want to participate in treatment decision-making?(Edições Universitárias Lusófonas, 2020) Salvador, Ágata; Crespo, Carla Alexandra Mesquita; Roberto, Magda Sofia; Barros, Luísa; HEI-LAB (FCT) - Digital Laboratories for Environments and Human InteractionsPurpose: This study aimed to describe parents’ preferences regarding their role in treatment decision-making when a child has cancer and examines whether their preferences were related to the parents (sex and education level), patients’ characteristics (age group and treatment status), and healthcare context features (parents’ perception of family-centered care). Methods: Two-hundred and twenty-eight parents of children/adolescents with cancer were recruited from two Portuguese pediatric oncology wards. Participants provided sociodemographic and clinical information. The Control Preferences Scale for Pediatrics was used to assess the parents’ preferred role in treatment decision-making. The Measure of Process of Care assessed the parents’ perception of family-centered care (family-centered services and providing general information subscales). Results: Results showed that parents preferred a passive-collaborative role (44.8%), followed by collaborative (27.8%), passive (20.9%) and active-collaborative (6.5%). None preferred an active role. Chi-square test showed that most of the parents preferring an active-collaborative role had higher education degrees, while those preferring a passive role had lower education degrees. Additionally, groups did not differ according to the parents’ sex, patients’ age and treatment status. A multivariate analysis of variance showed that parents preferring an active-collaborative role reported lower scores on family-centered services compared to those preferring passive-collaborative and passive roles. Finally, no differences were found concerning providing general information scores. Conclusions: This study’s findings may guide professionals in identifying parents’ preferences regarding their participation in treatment decision-making process. Mapping their preferences may support professionals in promoting desirable levels of parental involvement when decisions are necessary in pediatric oncology context.Item Family management of pediatric cancer: Links with parenting satisfaction and psychological distress(Edições Universitárias Lusófonas, 2018) Salvador, Ágata; Crespo, Carla Alexandra Mesquita; Barros, Luísa; HEI-LAB (FCT) - Digital Laboratories for Environments and Human InteractionsResearch has long acknowledged the disruptions posed by pediatric cancer diagnosis and treatment to family life. Nonetheless, the mechanisms through which the family response influences parents’ mental health in this adverse context are not fully understood. The main goal of the present study was to examine the direct and indirect links, via parenting satisfaction, between family condition management and psychological distress of parents of children with cancer. Participants were 201 parents (86.6% mothers) of children/adolescents diagnosed with cancer who completed selfreport questionnaires assessing family condition management (family life difficulty and parental mutuality), parenting satisfaction and psychological distress (anxiety and depression). Structural equation modeling was used to test the proposed mediation model. The results showed that parenting satisfaction mediated the association between both the family condition management dimensions (family life difficulty and parental mutuality) and depression. Specifically, greater family life difficulties and lower parental mutuality were associated with lower parenting satisfaction, which, in turn, was associated with higher levels of depression. Additionally, greater family life difficulties and lower parental mutuality were directly linked to higher levels of anxiety. Multigroup analyses suggested that the model was valid across patient age groups (children vs. adolescents) and treatment status (on vs. off-treatment). These findings reinforce the need for family- and parent-based interventions in the pediatric oncology field. Interventions that target families’ difficulties and promote their resources are likely to foster parenting satisfaction and psychological adjustment.Item Parents’ psychological well-being when a child has cancer: Contribution of individual and family factors(Edições Universitárias Lusófonas, 2019) Salvador, Ágata; Crespo, Carla Alexandra Mesquita; Barros, Luísa; HEI-LAB (FCT) - Digital Laboratories for Environments and Human InteractionsObjective: The aim of the present study was to examine the contribution of individual (positive reappraisal) and family factors (parenting satisfaction, couple relationship quality, and family life difficulty) to the psychological well-being of parents of children/adolescents diagnosed with cancer. Method: This cross-sectional study was conducted at two pediatric oncology wards in Portugal. Two-hundred and five parents of pediatric cancer patients completed self-report questionnaires assessing the use of positive reappraisal as a coping strategy (Ways of Coping Questionnaire), parenting satisfaction (Parenting Sense of Competence Scale), relationship quality (Perceived Relationship Quality Components Inventory), family life difficulty (Family Management Measure), and psychological well-being (Ryff’s Psychological Well-being scales). Sociodemographic and clinical data were also assessed. Results: Standard multiple regression analysis showed a significant contribution of both individual and family-level factors to parents’ psychological well-being. Specifically, the use of positive reappraisal as a coping strategy, parenting satisfaction, and relationship quality were associated with higher psychological well-being; conversely, family life difficulty was linked to lower psychological well-being. Conclusions: The findings of this study provide an important contribution to the identification of parents at higher risk for poor psychological well-being. Screening and addressing both individual- and family-level aspects may be crucial to foster parents’ mental health when a child is diagnosed with an oncological disease.