Parental palliative cancer: psychosocial adjustment and health-related quality of life in adolescents participating in a German family counselling service

Franziska Kühne,Johanna C Ernst,Wolfgang Herzog,Daniel Führer,Thomas Krattenmacher,Kai V Klitzing,Hans-Henning Flechtner,Corinna Bergelt,Georg Romer,Birgit Möller

doi:10.1186/1472-684x-11-21

Abstract

BackgroundParental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a) to identify differences in psychosocial adjustment and health-related quality of life (HRQoL) among adolescents and young adults with parents suffering from palliative cancer or cancers in other disease stages, b) to relate psychosocial adjustment and health-related quality of life to adolescent coping, and c) to explore significant mediator and predictor variables.MethodsCross-sectional data were derived from a multi-site research study of families before child-centered counselling. N=86 adolescents and young adults were included, their mean age 13.78 years (sd 2.45), 56% being female. Performed analyses included ANCOVA, multiple linear regression, and mediation analysis.ResultsAdolescents with parents suffering from palliative cancers reported significantly less total psychosocial problems, and better overall HRQoL. There were no significant group differences regarding coping frequency and efficacy. Our set of coping items significantly mediated the effect of parental disease stage on psychosocial problems and HRQoL. Further, parental disease status and general family functioning predicted psychosocial problems (R2adj =.390) and HRQoL (R2adj =.239) best.ConclusionThe study indicates distress among adolescents throughout the entire parental disease process. Our analysis suggests that counselling services could offer supportive interventions which focus particularly on adolescent coping as well as family functioning.

Highlights

Parental palliative disease is a family affair, adolescent's well-being and coping are still rarely considered
Since several studies indicate a relation between coping and Health-related quality of life (HRQoL) [22,23,24], but as there is little knowledge regarding coping of children of palliative patients [25], we explored adolescents’ coping in relation to our main outcomes
Psychosocial problems For demographic data of n=86 adolescents nested within N=66 families see Table 1

Summary

Introduction

Parental palliative disease is a family affair, adolescent's well-being and coping are still rarely considered. Considering recent reviews in the field, the following variables seem to be the ones which are theoretically best supported, regarding children's adjustment to parental illness, especially cancer: children's age [4,9,10,11,12], and gender [4,9,11,12,13], gender of the ill parent [9,12,13], and psychological functioning As expected in parental palliative situations, adolescents stated that they were more stressed than adolescents whose parents survived cancer [17]. They expressed their fear, sadness, and anxiety regarding parental palliative disease and death [18], and their adjustment seems to be influenced by disease and treatment burden [19]. Parental palliative disease is regarded as a period of high risk for children's psychological vulnerability [20], there is a knowledge gap concerning quantitative studies on dependent children of palliative cancer patients [21]

Objectives

Methods

Results

Conclusion