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- Hjelmstedt, Sofia
(author)
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A balancing act : work life and childcare among parents of children with cancer
- 2021
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Doctoral thesis (other academic/artistic)abstract
- Aim: The overall aim of this thesis was to investigate the socioeconomic consequences for parents of children with cancer in Sweden. The specific aims were to increase the knowledge of (I) risk of sick leave, (II) division of childcare leave, (III) balancing work and family roles, and (IV) facilitators and barriers to return to work and meet financial needs. Methods: The thesis comprises four studies. The first two studies were based on quantitative methods. The data were derived from a sample of 3,626 parents of 1,899 children who were diagnosed with cancer during 2004-2009, and a matched reference cohort of 34,874 parents from the general population. National registry data were utilized to analyze sick leave and childcare leave longitudinally. Logistic, negative binomial, beta, and linear regression analyses were conducted. The final two studies were based on qualitative methods. Nine focus group interviews with 22 mothers and 11 fathers of children with cancer were conducted. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using inductive content analysis in study III, and deductive content analysis in study IV. Results: In studies I and II, we found that parents of children with cancer were on sick leave and childcare leave for statistically significantly more days than reference parents from the year of the child’s diagnosis and up to six years after diagnosis. Bereaved parents were at particularly high risk of sick leave. Mothers were overall on sick leave and childcare leave for more days than fathers. The division of childcare leave within a parental couple (i.e. fathers’ share of the couple’s total childcare leave days) was not substantially associated with the division of income within the couple (i.e. fathers’ share of the couple’s total income). Moreover, parents’ income development was not affected by extent of childcare leave. In study III, we found that parents experienced changed perspectives and priorities after a child’s cancer diagnosis. Their ability to balance work and parent roles were affected by context and conditions regarding work, economy and gender roles. Furthermore, parents described a long-term unbalance of roles. In study IV, we found that facilitators for return to work were flexibility and understanding from employers and social services, while barriers were pressures to return without consideration of the consequences. Facilitators to meet financial needs were available public, private and employer support, while barriers were a lack of organized and efficient support from employers and social services. Conclusions: Parents experience considerable work disruptions for several years after a child’s cancer diagnosis, due to both the child’s increased care demands, as well as their own ill health. Parents ability to balance work and family was affected for a long time, while the understanding and support from employers and social services declined over time. For parents to be able to meet financial needs and return to work, more coordinated and efficient support is needed from healthcare and social services, as well as flexibility from employers.
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- Hjelmstedt, Sofia, et al.
(author)
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A Balancing Act: Working and Caring for a Child with Cancer
- 2021
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In: Journal of Child and Family Studies. - : Springer. - 1062-1024 .- 1573-2843. ; 30:8, s. 1881-1894
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Journal article (peer-reviewed)abstract
- Parenting a child with cancer creates numerous additional care demands that may lead to increased difficulties in balancing work and family responsibilities. Still, there is limited knowledge of how parents cope with both parenthood and paid work after a child’s cancer diagnosis. The aim of the study was to explore mothers’ and fathers’ experiences of balancing the dual roles of work and parenthood following a child’s cancer diagnosis. Nine focus groups with in total 32 parents of children with cancer in Sweden were conducted. The data was analysed using qualitative content analysis. Three categories were identified: Shifts in the importance of the parent role and the work role, Influence of context and conditions on the balance of roles, and Long-term unbalance of roles. Parents expressed an increased appreciation of time spent with family, but also emphasized the importance of work to counterbalance the sometimes overwhelming parenting demands. The pre-existing financial situation, work situation, and employer behaviour were important factors influencing the parents’ ability to balance work and family. Traditional gender roles influenced how couples divided responsibilities and reflected on their experiences. Mothers and fathers were also met with different expectations, which highlights the need for the healthcare to consider their communication with caregivers. Importantly, the parents expressed how the child’s illness affected their ability to balance work and family for a long time, while the understanding and support from others had steadily declined. Enabling parents to care for their ill child without sacrificing their own career is of utmost importance, and future research should focus on identifying which factors facilitate for parents to achieve a sustainable work-life balance.
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- Hjelmstedt, Sofia, et al.
(author)
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Division of Childcare Leave among Parents of Children with a Serious Illness
- 2021
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In: Journal of Family Issues. - : Sage Publications. - 0192-513X .- 1552-5481. ; 42:6, s. 1308-1332
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Journal article (peer-reviewed)abstract
- Balancing work and family may be particularly challenging for parents of seriously ill children. This Swedish registry-based study, including 2,788 parents of children with cancer and a matched reference cohort of 27,110 parents, used regression models to analyze the division of childcare, measured as use of temporary parental leave (TPL), and how it relates to income division within couples and change in income over time. The results show that the number of days on TPL increased significantly following a child's cancer diagnosis, particularly among mothers. Fathers' share of the couple's total income was not found to be a strong predictor of the division of TPL, and no association was found between TPL and income development. The study highlights the considerable time needed to care for a seriously ill child, unevenly distributed between mothers and fathers, and suggests that factors other than economic resources may influence the division of childcare responsibility.
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- Hjelmstedt, Sofia, et al.
(author)
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Facilitators and barriers to return to work and meet financial needs in parents of children with cancer
- 2021
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In: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 68:10
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Journal article (peer-reviewed)abstract
- BACKGROUND: The aim of this study was to explore what facilitators and barriers parents of children with cancer identify for their ability to return to work and meet financial needs.PROCEDURE: Nine focus groups (21 mothers; 11 fathers) were performed across Sweden in 2015 and 2019. A deductive content analysis approach was used. A preconstructed matrix consisting of 12 codes based on previous literature was used to organize the data. The codes were grouped into subcategories, which were abstracted to four generic categories.RESULTS: Facilitators for a return to work were covered in the category "Flexibility and understanding from employers and social services," and barriers in the category "Pressure to return without consideration of the consequences." Facilitators to meeting financial needs were covered in the category "Available public, private, and employer support," and barriers in the category "Lack of organized and efficient support from employers and social services."CONCLUSIONS: The identified barriers suggest that there is room for improvement in the provision of psychosocial support, which relates to a perceived lack of organized support regarding practical, financial, and occupational matters. The results show a need for a coordinated support system that includes major stakeholders, such as the health care, welfare agencies, and employers. Moreover, employers should consider how to implement more workplace flexibility and involvement of occupational health services. Importantly, to be able to return to work and achieve a sustainable financial situation, it is necessary for all stakeholders to recognize the long-term impact of parenting a child with cancer.
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- Hjelmstedt, Sofia, et al.
(author)
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Sick leave among parents of children with cancer : a national cohort study
- 2017
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In: Acta Oncologica. - : Taylor & Francis Group. - 0284-186X .- 1651-226X. ; 56:5, s. 692-697
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Journal article (peer-reviewed)abstract
- Background: Due to psychological distress and an increased care burden, parents of children diagnosed with cancer may face a higher risk of sickness absence from work. The objective of this study was to examine the association of childhood cancer with parents' sick leave.Material and methods: The sample comprised 3626 parents of 1899 children diagnosed with cancer in Sweden during 2004-2009, and a matched control group of parents (n=34 874). Sick leave was measured as number of days with sickness benefit, retrieved from national registries. Logistic and negative binomial regression models were used to compare outcomes with parents from the control cohort.Results: The risk of sick leave was statistically significantly higher up to six years following a child's cancer diagnosis. The increase in number of days with sickness benefit was most pronounced the year after diagnosis. Although mothers' sick leave prevalence was higher, the increase in risk relative to control parents was similar for mothers and fathers. Bereavement was associated with a heightened risk of sick leave, especially on the year of the child's death.Conclusions: Findings confirm that mothers and fathers of children diagnosed with cancer are at higher risk of sickness absence from work, with particularly pronounced risk among bereaved parents. Acquisition of further knowledge is warranted regarding possibilities and constraints of parents trying to combine their work life with caring for both their child and themselves.
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