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Purpose: The present study assesses the relationship between patient dignity in advanced cancer and the following variables: psychological distress, preparatory grief, and sociodemographic and clinical characteristics. Methods: The sample consisted of 120 patients with advanced cancer. The self-administered questionnaires were as follows: the Preparatory Grief in Advanced Cancer Patients (PGAC), the Patient Dignity Inventory–Greek (PDI-Gr), the Greek Schedule for Attitudes toward Hastened Death (G-SAHD), and the Greek version of the Hospital Anxiety and Depression Scale (G-HADS). Results: Moderate to strong statistically significant correlations were found between the 4 subscales of PDI-Gr (psychological distress, body image and role identity, self-esteem, and social support) with G-HADS, G-SAHD, and PGAC ( P < .005), while physical distress and dependency was moderately correlated with depression. Multifactorial analyses showed that preparatory grief, depression, and age influenced psychological distress, while preparatory grief, depression, and performance status influenced body image and role identity. Conclusions: Preparatory grief, psychological distress, and physical symptoms had significant associations with perceptions of dignity among patients with advanced cancer. Clinicians should assess and attend to dignity-distressing factors in the care of patients with advanced cancer.

Background: The Zarit Burden Interview is one of the most common tools used in the research field measuring burden. The aims of the present study were to translate and validate the Zarit Burden on caregivers of adults with intellectual disabilities in Greece. Methods: One hundred and eighty family caregivers of adults with intellectual disabilities were recruited. All participants completed: the Zarit Burden Interview and the revised 15-item Bakas Caregiving Outcomes Scale. Reliability was assessed by the internal consistency and test/retest of the instrument. Validity was assessed with construct validity using Bakas Caregiving Outcomes Scale and known groups validity. Results: Factor analysis resulted in a 4-factor model. Construct validity has shown satisfactory correlations with Bakas Caregiving Outcomes Scale (p

Accessible summaryWhat is known on the subject The care of an adult son or daughter with psychosis is filled with overwhelming demands caused by the symptomatology and illness exacerbations. Parents display disenfranchised grief over multiple losses and report increased levels of emotional burden. Most studies use quantitative methods and rely on pre-existing theoretical frameworks to investigate, through psychometric measures, the effects of being a carer. Meaning attributions to the disorder, and changes in parent–child relations over time, are poorly understood. What this paper adds to existing knowledge This hermeneutic phenomenological study illuminates the subjective experience of parenting a son or daughter with psychosis, as it is lived and described by parents of young adults with psychosis. Findings suggest that the parents' perceptions of their child changes over the course of the disorder, leading to a redefinition of the parent–child relationship, causing alternations in attachment. Findings illuminate the parents' profound guilt over having contributed or not prevented the disorder, over not being ‘good’ parents and feeling ambivalent towards an ‘intimate stranger.’ Guilt is compensated by absolute dedication to the son or daughter's care, at the expense of their own well-being. What are the implications for practice Interventions for parents must be available as soon as possible, both during hospitalization and after discharge. Professionals should provide a therapeutic space, where parents could express intimate thoughts and feelings, address guilt, fear and resentment issues, be assisted in their parenting role as well as in the reconstruction of a sense of self and self-esteem. Professionals are invited to facilitate illness acceptance, provide accurate information, assist parents to redefine their relationship to the child and facilitate the integration of the traumatic experience into their personal and family narrative. Professionals must develop in depth awareness of their biases and attitudes, have an ongoing training on how to respond to the parents’ needs, facilitate therapeutic change and accompany families through the course of their adult child's illness trajectory. AbstractIntroduction Children who are diagnosed with psychosis often rely on their parents for prolonged care. The impact of such care is partially understood as most studies use quantitative methods and pre-existing theoretical frameworks that limit their investigation to emotional burden, and emotional responses. Aim Explore the parents’ lived experience of caring for a child with psychosis. Method A hermeneutic phenomenological design was used with a sample of 16 parents of children with psychotic disorders who were hospitalized or attended the outpatient clinic of a large psychiatric Greek hospital. Results Identified themes were as follows: (i) the psychosis experience, (ii) redefinition of the parent–child relationship over the course of the disorder and (iii) challenges of parenting a child with psychosis. Discussion ‘Caring for an intimate stranger’ reflects the parents’ overall experience, involving changes in the parent–child relationship, ambivalence towards caretaking and profound guilt, compensated by self-sacrifice parenting practices. Implications for practice: Findings highlight the necessity to train mental health professionals to provide individualized information; facilitate family communication; address the parents’ guilt, ambivalence, meaning attributions that compromise adjustment; and support them through the challenges of parenting a son or daughter with psychosis.

The purpose of this study was to explore the sources, nature, and effectiveness of mutual support among nurses who are exposed to the death of children and to compare the experiences between a group of pediatric oncology nurses and a group of critical care nurses. Semistructured interviews were conducted with sixteen pediatric oncology nurses and twenty-three critical care nurses. Qualitative analysis was used to analyze the data. Findings revealed that (1) nurses relied more on their colleagues for support than on their relatives and friends; (2) the nature of the support they sought involved informational, clinical/practical, emotional, and meaning-making support; and (3) different forms of mutual support were encouraged in the two units, depending on individual needs and the unit's goals, philosophy, and implicit rules about expected behavior in the face of death and dying. Educational and clinical implications are briefly discussed.

The aim of the study was to describe the challenges donor and non-donor parents encounter before, during, and after the organ donation decision, and to identify parents' needs and expectations from health care professionals. A further aim was to propose evidence-based recommendations for effectively introducing the option of donation, and supporting families through the grieving process. This study was undertaken as part of a larger research project investigating the experiences of Greek parents who consented or declined organ and tissue donation, using a qualitative methodology for data collection and analysis. The experiences of 22 Greek bereaved parents of 14 underage brain dead children were studied through semi-structured interviews. Parents' decision-making process was described as challenging and fraught with difficulties both before and after the donation period. Identified challenges were clustered into: (a) personal challenges, (b) conditions of organ request, and (c) interpersonal challenges. Parents' main concern following donation was the lack of information about transplantation outcomes. Findings led to a list of recommendations for nurses and other health professionals for approaching and supporting parents in making choices about paediatric organ donation that are appropriate to them, and for facilitating their adjustment to the sudden death of their underage child.

This descriptive study explored and compared the grief responses and experiences of Greek physicians and nurses who provide care to children dying of cancer. Interviews were conducted with 14 oncologists and 16 pediatric oncology nurses. Data were subjected to a combination of qualitative and quantitative methods of analysis. For both groups, the dying process and death of children were highly stressful experiences and triggered a grieving process. Differences, however, were observed in terms of the way these two groups (a) perceived the loss of the child and (b) expressed or avoided their grief. It became apparent that health professionals' grieving process was affected by how they perceived their role, interventions, and contribution in the care of the dying child, which in turn was influenced by the social and cultural context in which care is provided to children with cancer. Findings suggest that despite the distress caused by children's death, both nurses and physicians identified specific rewards they reaped from caring for children who are terminally ill.