Abstracts
Résumé
Cadre de recherche : La récidive d’un cancer chez l’enfant nécessite de nouvelles significations et stratégies pour que la famille puisse faire face à cette phase. La manière dont les hommes gèrent les situations de maladie infantile est influencée par les normes sociales, les croyances et les valeurs culturelles. Ainsi, l’anthropologie médicale et les masculinités ont été choisies comme cadres théoriques de cette étude.
Objectifs : Cet article examine les expériences des pères d’enfants atteints d’une récidive de cancer.
Méthodologie : La recherche narrative a été menée auprès de 13 pères brésiliens. Les données ont été recueillies au moyen d’entretiens approfondis semi-structurés, puis traitées par une analyse thématique inductive.
Résultats : Une synthèse narrative thématique a été élaborée : « les bons jours, les mauvais jours : oscillation entre la résignation de la mort et l’espoir de guérison ». L’annonce de la récidive en conjonction avec les signes d’aggravation clinique de l’enfant a rapproché les pères des limites du traitement et de la finitude de la vie, bien qu’ils aient aussi présenté un espoir de guérison. Les pères ont hésité entre l’élaboration de stratégies centrées sur les émotions et l’adoption de comportements et de stratégies pour se réengager dans la vie. En plus de maintenir l’espoir, les pères ont mobilisé les ressources suivantes : la religion, la spiritualité et le soutien émotionnel et instrumental.
Conclusion : La culture, en particulier les masculinités, influence et est influencée par les expériences paternelles tout au long d’une récidive de cancer de l’enfant.
Contribution : Mieux connaître les particularités des expériences masculines facilite le développement d’interventions spécifiques aux pères. Les soins palliatifs peuvent leur apporter des avantages, puisqu’ils les aident à prendre conscience de la finitude et à débuter un processus de deuil anticipé, contribuant à donner un sens à l’expérience et à se résigner à un éventuel décès.
Mots-clés :
- cancer,
- culture,
- enfant,
- paternité,
- père,
- masculinités,
- recherche qualitative
Abstract
Research Framework: Childhood cancer relapse requires new meanings and new strategies for the family to cope with this phase. The way men deal with situations of childhood illness is influenced by social norms, beliefs, and cultural values. Therefore, medical anthropology and masculinities were chosen as theoretical frameworks of this study.
Objectives: This article examines the experiences of fathers of children with cancer relapse.
Methodology: Narrative research conducted with 13 Brazilian fathers. Data were collected through in-depth interviews, using a semi-structured script and then processed through inductive thematic analysis.
Results: A thematic narrative synthesis was elaborated: “Good days, bad days: oscillating between the resignation of death and the hope of healing”. The news of the relapse in conjunction with the child’s signs of clinical worsening brought the fathers closer to the limits of treatment and the finitude of life, although they also presented with hope for a cure. As a result, fathers wavered between building emotion-centred strategies and adopting life-engaging behaviours and strategies. In addition to maintaining hope, fathers mobilized the following resources: religion, spirituality, and emotional and instrumental support.
Conclusion: Culture, especially masculinities, influence and is influenced by fathers’ experiences throughout a child’s cancer relapse.
Contribution: A better understanding of the particularities of men’s experiences facilitates the development of father-specific interventions. Palliative care can benefit fathers by helping them become aware of finitude and begin a process anticipatory mourning, which contributes to making sense of the experience and coming to terms with possible death.
Keywords:
- cancer,
- culture,
- child,
- fatherhood,
- father,
- masculinities,
- qualitative research
Resumen
Marco de la investigación: La recurrencia del cáncer infantil requiere nuevos significados y nuevas estrategias para que la familia enfrente esta fase. La forma en que los hombres afrontan las situaciones de enfermedad infantil está influida por las normas sociales, las creencias y los valores culturales. Por lo tanto, la antropología médica y las masculinidades fueron elegidas como marcos teóricos de este estudio.
Objetivos: Examinar las experiencias de padres de niños con recaída de cáncer.
Metodología: Investigación narrativa realizada con 13 padres brasileños. Los datos fueron recolectados a través de entrevistas en profundidad, utilizando una guía semiestructurada, y luego procesados a través de análisis temático inductivo.
Resultados: Se elaboró una síntesis narrativa temática: “Días buenos, días malos: oscilando entre la resignación a la muerte y la esperanza de la curación”. La noticia de la recaída, junto con los signos de empeoramiento clínico del niño, llevaron a los padres a los límites del tratamiento y a la finitud de la vida, aunque también tuvieran la esperanza de la curación. Como resultado, los padres oscilaron entre desarrollar estrategias centradas en las emociones y adoptar comportamientos y estrategias para volver a participar en la vida. Además de mantener la esperanza, los padres han mobilizado los siguientes recursos: la religión, la espiritualidad y el apoyo emocional e instrumental.
Conclusión: La cultura, especialmente las masculinidades, influye y es influenciada por las vivencias de los padres durante la recaída del cáncer del niño.
Contribución: Conocer las particularidades de las experiencias masculinas facilita el desarrollo de intervenciones específicas para el padre. Los cuidados paliativos pueden traer beneficios a los padres, ya que les ayudan a tomar conciencia de la finitud y a procesar el duelo anticipado, lo que contribuye a la construcción de sentido y resignación de una posible muerte.
Palabras clave:
- cáncer,
- niño,
- cultura,
- padre,
- paternidad,
- masculinidades,
- investigación cualitativa
Appendices
Bibliographie
- Arruda-Colli, M. N. F., E.M. Perina et M. A. Santos. 2015. « Experiences of Brazilian children and family caregivers facing the recurrence of cancer », European Journal of Oncology Nursing, vol. 19, no 5, p. 458–464.
- Arruda-Colli, M. N. F., R. A. G. Lima, E. M. Perina et M. A. Santos. 2016. « Child cancer recurrence: A study about the mother’s experience », Psicologia USP, vol. 27, no 2, p. 307–314.
- Brandth, B. et E. Kvande. 2018. « Masculinity and fathering alone during parental leave », Men and Masculinities, vol. 21, no 1, p. 72-90.
- Braun, V. et V. Clarke. 2006. « Using thematic analysis in psychology », Qualitative Research in Psychology, vol. 3, no 2, p. 77-101.
- Cherry, K. E. et E. D. Gerstein. 2021. « Fathering and masculine norms: Implications for the socialization of children’s emotion regulation », Journal of Family Theory & Review, vol. 13, no 2, p. 149-163.
- Couternay, W. H. 2000. « Constructions of masculinity and their influence on men’s well-being: a theory of gender and health », Social Science & Medicine, vol. 50, p. 1385-1401.
- Connell, R. 1995. « Masculinities », Berkeley, University of California Press, 295p.
- Connell, R. W. et J. W. Messerschmidt. 2005. « Hegemonic masculinity: Rethinking the Concept », Gender & Society, p. 829-859.
- Costa, G. M. et D. M. Gualda. 2010. « Antropologia, etnografia e narrativa: caminhos que se cruzam na compreensão do processo saúde–doença », História, Ciências, Saúde-Manguinhos, vol. 17, no 4, p. 925-937.
- Creighton, G., M. Brussoni, J. Oliff et L. Olsen. 2015. « Fathers on Child’s Play: Urban and Rural Canadian Perspectives », Men and Masculinities, vol. 18, no 5, p. 559-580.
- Crespi, I. et E. Ruspini. 2015. « Transition to fatherhood: New perspectives in the global context of changing men’s identities », International Review of Sociology, vol. 25, no 3, p. 353-358.
- CASP, Critical Appraisal Skills Programme. 2019. « Making Sense of Evidence. 10 Questions to Help You make Sense of Qualitative Research », Public Health Resource Unit. http://calder.med.miami.edu/portals/ebmfiles/UM%20CASP%20Systematic%20Reviews%20Assessment%20Tool.pdf
- da Silva, R. S., L. L. Miranda, A. C. de Souza, P. M. J. Araujo et R. C. S. Baldo. 2020. « Parental experience in front of childhood cancer diagnosis: an understanding in the light of Betty Neuman », Brazilian Journal of Development, vol. 6, no 12, p. 98446-98463.
- Darlington, A.S.E., D. N. Korones et S. A. Norton. 2018. « Parental coping in the context of having a child who is facing death: a theoretical framework », Palliative & Supportive Care, vol. 16, no 4, p. 432-441.
- Davis, E. S., C. E. Wimberly, L. Towry, E. E. Johnston et K. M. Walsh. 2023. « Financial hardships and psychosocial outcomes among parents of children who die of cancer », Pediatric Blood & Cancer, vol. 70, no 2, p. e30066.
- de Alvarenga, W. A., J. R. Machado, A. C. A. B. Leite, S. Caldeira, M. Vieira, S.S. da Rocha et L.C. Nascimento. 2021. « Spiritual needs of Brazilian children and adolescents with chronic illnesses: A thematic analysis », Journal of Pediatric Nursing, vol. 60, p. 39-45.
- de Graves, S. et S. Aranda. 2008. « Living with hope and fear--the uncertainty of childhood cancer after relapse », Cancer Nursing, vol. 31, no 4, p. 292–301.
- de Montigny, F., C. Verdon, C., J. Lord-Gauthier et C. Gervais. 2017. Décès périnatal : le deuil des pères, Montréal, Éditions du CHU Sainte-Justine, le centre hospitalier universitaire mère-enfant.
- Eche, I. J., T. Aronowitz, L. Shi, M. A. McCabe. 2019. « Parental Uncertainty: Parents’ perceptions of health-related quality of life in newly diagnosed children with cancer » , Clinical Journal of Oncology Nursing , v. 23, no 6 .
- Elliott, K. 2016. « Caring Masculinities: Theorizing an Emerging Concept », Men and Masculinities, vol. 19, no 3, p. 240-259.
- Erdmann, F., L. E., Frederiksen, A. Bonaventure, L. Mader, H. Hasle, L. L. Robison et J. F. Winther. 2021. « Childhood cancer: survival, treatment modalities, late effects and improvements over time », Cancer epidemiology, vol. 71, p. 101733.
- Fisher, V., L. Fraser, J. Taylor . 2021. « Experiences of fathers of children with a life-limiting condition: a systematic review and qualitative synthesis » , BMJ Supportive & Palliative Care , vol. 13, no 1, p. 15- 2 6 .
- Friesen, H., J. Harrison, M. Peters, D. Epp et N. McPherson. 2020. « Death education for children and young people in public schools » , International Journal of Palliative Nursing , v ol . 26, no 7, p. 332-335.
- Gill S. L. 2020. « Qualitative Sampling Methods » . Journal of Human Lactation , v. 36, no. 4, p. 579-581
- Geertz C. 1989. The interpretation of cultures, Rio de Janeiro , Editora Guanabara Koogan, 323 p.
- Hanlon, N. 20 12. « Masculinities, care and equality: identity and nurture in men’s lives » , Basingstoke, Palgrave Macmillan, p. 272 .
- Hennink, M. M., B. N. Kaiser et V. C. Marconi. 2017 . « Code saturation versus meaning saturation: how many interviews are enough? » , Qualitative health research , v ol . 27 , no 4, p. 591-608.
- Hensler, M.A., E. R. Katz, L. Wiener, R. Berkow et A. Madan-Swain. 2013. « Benefit finding in fathers of childhood cancer survivors: a retrospective pilot study » , Journal of Pediatric Oncology Nursing , v ol . 30 , no 3, p. 161-168.
- Hooke M. C. et L. A. Linder. 2019. « Symptoms in Children Receiving Treatment for Cancer—Part I: Fatigue, Sleep Disturbance, and Nausea/Vomiting » , Journal of Pediatric Oncology Nursing , v ol . 36 , no 4 , p. 244-261.
- Hörberg, U., R. Sjögren et K. Dahlberg. 2012. « To be strategically struggling against resignation: the lived experience of being cared for in forensic psychiatric care », Issues in Mental Health Nursing , vol. 33, no. 11, p. 743–51.
- Hydén, L. C. 1997. « Illness and narrative » , Sociology of Health & Illness , v ol . 19, n o 1, p. 48-69 .
- Kaye, E. C., A. Kiefer, L. Blazin, H. Spraker-Perlman, L. Clark et J. N. Baker. 2020. « Bereaved parents, hope, and realism » , Pediatrics, v ol . 145, no 5 , p. e20192771 .
- Kim, M. A., J. Yi, A.Wilford et S. H. Kim. 2020. « Parenting Changes of Mothers of a Child with Cancer » , Journal of Family Issues , v ol . 41 , no 4, p. 460–482 .
- K leinman , A. 1980. Patients and Healers in the Context of Culture: an Exploration of the Borderland between Anthropology , Berkeley, University of California Press.
- K leinman , A. et B. G ood . 1985. Culture and Depression: studies in anthropology and cross-cultural psychiatry of affect and disorder , Berkeley, University of California Press .
- Leite, A.C.A.B., C. García-Vivar, F. de Montigny et L. C. Nascimento. 2021. « Waves of family hope: narratives of families in the context of pediatric chronic illness » , Revista Latino-Americana de Enfermagem , v ol . 29.
- Lewington, L., J. Lee et B. Sebar. 2021 . « “I’m not Just a Babysitter”: Masculinity and Men’s Experiences of First-Time Fatherhood » , Men and Masculinities, v ol . 24 , no 4, p. 571–589.
- Lichtenthal, W.G., R. A. Neimeyer, J. M. Currier, K. Roberts et N. Jordan. 2013. « Cause of Death and the Quest for Meaning After the Loss of a Child », Death Studies , vol. 37, no 4, p. 311–342.
- Linder , L. A. et M. C. Hooke. 2019. « Symptoms in Children Receiving Treatment for Cancer—Part II: Pain, Sadness, and Symptom Clusters » , Journal of Pediatric Oncology Nursing, v ol . 36 , no 4 , p. 262-279.
- Marbut, K. K. 2001. « Clinical Dimensions of Anticipatory Mourning: Theory and Practice in Working with the Dying, Their Loved Ones, and Their Caregivers » , Journal of Pediatric Nursing, v ol . 16, no 3, p. 202–203.
- Maruyama, S. A. T., A. L. C. da Costa, E. A. R. do Espírito Santo, R. Bellato et W. R. Pereira . 2006. « The body and the culture as the locus of cancer » , Cogitare Enfermagem , v ol . 11, no 2, p. 171-175.
- Menezes, R. A. et P. D. C. Barbosa. 2013. « The construction of a "good death" at different stages of life: reflections on the palliative care approach for adults and children » , Ciência & Saúde Coletiva , v ol . 18, no 1 p. 2653-2662.
- Michel, G., T. M. Brinkman, C. E. Wakefield et M. Grootenhuis. 2020. « Psychological outcomes, health-related quality of life, and neurocognitive functioning in survivors of childhood cancer and their parents » , Pediatric Clinics , vol. 67, no 6, p. 1103-1134.
- Moreira, K. S. V., L. C. Diminic, M. L. S. Gonzaga, M. L. B. Falcão et L. A. Buexm . 2022 . « Cancer, Humanization and Childhood Cancer » , Journal of Cancer Research Treatment & Prevention , v ol . 1, no 1, p. 1-8.
- Nierop- van Baalen, C., M. Grypdonck, A. Van Hecke et S. Verhaeghe. 2016. « Hope dies last… A qualitative study into the meaning of hope for people with cancer in the palliative phas e » , European journal of cancer care, v ol . 25, no 4, p. 570-579.
- Olsman, E., C. Leget, W. Duggleby et D. Willems. 2015. « A singing choir: Understanding the dynamics of hope, hopelessness, and despair in palliative care patients. A longitudinal qualitative study » , Palliative and Supportive Care , v ol . 13, no 06, p. 1643–1650.
- Park M., E. E. Suh e S. Y Yu. 2021. « Uncertainty and Nursing Needs of Parents with Pediatric Cancer Patients in Different Treatment Phases: A Cross-Sectional Study » , International Journal of Environmental Research and Public Healt, v ol . 18, no 8, p. 4253.
- Peikert, M. L., L. Inhestern, K. A. Krauth, G. Escherich, S. Rutkowski, D. Kandels et C. Bergelt . 2020. « F ear of progression in parents of childhood cancer survivors: A dyadic data analysis » , Psycho‐Oncology , v ol . 29, no 10, p. 1678-1685.
- Polita, N. B., W. D. A. Alvarenga, A. C. A. B. Leite, J. S. Araújo, L. B. P. A. D. Santos, M. M. F. Zago, F. De Montigny et L. C. Nascimento. 2018. « Care provided by the father to the child with cancer under the influence of masculinities: qualitative meta-synthesis » , Revista brasileira de enfermagem , v ol . 71, no 1, p. 185-194.
- Polita, N.B., F. de Montigny, F., R. R. Neris, W. D. A. Alvarenga, F. M. Silva-Rodrigues, A.C.A.B. Leite et L. C. Nascimento . 2020. « The experiences of bereaved parents after the loss of a child to can cer: a qualitative metasynthesis » , Journal of Pediatric Oncology Nursing , v ol . 37 , no 6, p. 444-457.
- Puchalski, C. M., R. Vitillo, S. K. Hull et N. Reller. 2014. « Improving the spiritual dimension of whole person care: reaching national and international consensus », Journal of Palliative Medicine , vol. 17, no. 6, p. 642-656.
- Schoppe-Sullivan, S.J., K. Shafer, E. L. Olofson et C. M. Kamp Dush. 2021. « Fathers’ parenting and coparenting behavior in dual-earner families: Contributions of traditional masculinity, father nurturing role beliefs, and maternal gate closing » , Psychology of Men & Masculinities, v ol . 22, no 3, p. 538.
- Rodgers C.C, M. C. Hooke, O.A. Taylor, K.M. Koerner, P.A. Mitby, I.M. Moore IM, M.E. Scheurer, M.J. Hockenberry, W. Pan . 2019. « Childhood Cancer Symptom Cluster: Leukemia and Health-Related Quality of Life » . Oncol ogy Nurs ing Forum , v. 46 , no. 2 , p. 228-237.
- Silva, D.G.V et M. Trentini. 2002. « Narrativas como técnica de pesquisa em enfermagem » , Revista latino-americana de enfermagem , v ol . 10, no. 3, p . 423-432.
- Silva, S.G. 2006. « A crise da Masculinidade : Uma Crítica à Identidade de Gênero e à Literatura Masculinista » , Psicologia Ciência e Profissão , v ol . 26, no 1, p. 118-131.
- Squire, C. 2012. « From experience-centred to socioculturally-oriented approaches to narrative » , d ans Doing Narrative Research , sous la dir. de M. Andrews., C. Squire et M. Tamboukou, London, SAGE, p. 47-71.
- de Souza, J. A., J.Y.D.F.A Campos, F. T. dos Santos Neto, M. N. Araújo et M. N. A. de Sousa. 2021. « Childhood cancer and emotional impacts on the family: A review of the literature » , Research, Society and Development , v ol . 10, no 10.
- Uchôa, E. et J. M. Vidal. 1994. « Antropologia Médica: elementos conceituais e metodológicos para uma abordagem da saúde e da doença » , Cadernos de Saúde Pública , v ol . 10, no 4, p. 497-504.
- Van Schoors, M., A. L. de Paepe, K. Norga, V. Cosyns, H. Morren, T. Vercruysse. L. Goubert et L. L. Verhofstadt. 2019 a . « Family members dealing with childhood cancer: A study on the role of family functioning and cancer appraisal » , Frontiers in psychology , v ol . 10, p. 1405.
- Van Schoors, M., J. de Mol, N. Laeremans, L. L. Verhofstadt, L. Goubert et H. Van Parys. 2019 b . « Siblings’ experiences of everyday life in a family where one child is diagnosed with blood cancer: a qualitative study » , Journal of Pediatric Oncology Nursing , v ol . 36, no 2, p. 131-142.
- Walsh, D. et S. Downe. 2006. « Appraising the quality of qualitative research » , Midwifery , v ol . 22, no 2, p. 108-119.
- WHO , World Health Organization . 2 021. « CureAll framework: WHO global initiative for childhood cancer: increasing access, advancing quality, saving lives . https://apps.who.int/iris/handle/10665/347370