Parents Of Pediatric Cancer Patients Research Articles

Psychological adaptation and social support of parents of pediatric cancer patients: a prospective longitudinal study.

To investigate levels of support and the concurrent and prospective effects of support on the psychological functioning of parents of children with cancer in a prospective longitudinal study. Parents' (n = 128) self-perceived level of psychological distress, quantity of support, and dissatisfaction with support were assessed, at diagnosis, at 6, and at 12 months. Parents received most support at diagnosis. Self-perceived quantity decreased with time, but parents indicated they remained equally satisfied. Support significantly predicted concurrent and prospective distress of fathers, but not of mothers. Dissatisfaction with support and negative interactions were consistent risk factors for fathers. Mothers who adjusted well psychologically received more support and were less dissatisfied than mothers who remained clinically distressed. Nevertheless, no persisting effect of support was found. Findings illustrate that social support varies with the stress situation and with gender. Identification of vulnerable parents at diagnosis on the basis of their perception of received quantity of and dissatisfaction with support seems difficult. Intervention efforts aimed at mobilization of needed support may be efficacious.

USE OF ALTERNATIVE THERAPY AMONG PEDIATRIC ONCOLOGY PATIENTS IN TAIWAN

Both alternative medicine and western medicine have been commonly used to treat pediatric cancer patients in Taiwan. Each has its own intrinsic strengths and weaknesses and they can be complementary. Little is known about medical help-seeking behaviors of parents of pediatric cancer patients, especially those related to alternative therapies. This study investigated the extent and parental expectations on use of alternative therapies. All primary caregivers of 63 eligible patients were interviewed. Use of alternative therapies, regardless of education level or social status of their families, is prevalent (n = 46, 73%) in Taiwan. Commonly used alternative therapies included, in order of popularity, formulated functional food (n = 22, 48%), temple worship/shamanism (n = 19, 40%), traditional Chinese medicine (n = 9, 20%), secret recipes/herbs (n = 13, 28%), and diet supplements (n = 9, 19%). Such practices generally occur without medical guidance from oncologists, largely because of poor interactions between parents and oncologists. Future efforts should be made to encourage both parents and oncologists to discuss this issue. Nurses may serve as mediators by developing mutual trust and a sharing relationship between these groups.

Risk Factors for Psychological Maladjustment of Parents of Children With Cancer

To examine risk variables for future, more immediate, and persistent psychological distress of parents of pediatric cancer patients. Parents (n = 128) completed questionnaires at the time of diagnosis (T1) and 12 months later (T2). Multiple regression analyses were performed using the following as predictors: demographics, illness-related variables, other life events, personality, coping styles, and social support. Trait anxiety was the strongest predictor of both fathers' and mothers' future distress. Changes in trait anxiety during the year also accompanied changes in both parents' levels of distress. Additional prospective predictors for fathers were the coping style "social support-seeking" and dissatisfaction with support. Dissatisfaction with support also had short-term effects for fathers. An additional prospective predictor for mothers was the number of pleasant events they had experienced prior to diagnosis, while a short-term effect was found for performance in assertiveness. No predictors for the persistence of distress were found. These results underscore the importance of personality anxiety in predicting parents' risk for adjustment difficulties associated with the experience of cancer in one's child. An additional risk factor for fathers was social support. For mothers, previously experienced life events and the frequency of assertive behavior were additional risk factors.

Marital Dissatisfaction, Psychological Distress, and the Coping of Parents of Pediatric Cancer Patients

This study examines the marital satisfaction of 124 parents of pediatric cancer patients in relation to their psychological distress and coping preferences over a year. Results show that there was a significant increase in marital dissatisfaction for the group as a whole. Marital dissatisfaction was significantly and positively associated with psychological distress at 6 and 12 months, but not at diagnosis. Fathers appeared to be more self-oriented when they judged the quality of their marriage. Their marital distress was related to their own coping behavior, not to that of their partners. Mothers were more other oriented. Their marital distress was related to their partners' coping preferences, rather than to their own. Discrepancies in coping within couples were associated with marital distress in both partners.

Gender differences in psychological adaptation and coping in parents of pediatric cancer patients.

This study investigated differences in psychological distress and coping styles between fathers and mothers of pediatric cancer patients, over a 1-year time period. Also examined were (dis)similarities in couples in distress and coping, and the relationship between (dis)similarities in coping and psychological functioning of both members of a couple. Parents (n = 124, 62 couples) were assessed at diagnosis, at 6 and 12 months. Fathers and mothers experienced higher levels of psychiatric symptomatology and psychological distress at diagnosis than men and women of a normgroup. Distress declined significantly with time. Although parents did not report more symptoms than the normgroup 12 months post-diagnosis, they still were psychologically out of balance. Contrary to findings in the general population, no differences were found between fathers and mothers in psychiatric symptoms or psychological distress on any of the measurements. Only a few gender differences in coping were found. Fathers used more active-problem focusing at diagnosis and a less palliative reaction pattern at 12 months than did mothers. Mothers used more social-support seeking on all measurements. A tendency for similarity in the use of the coping styles within couples was found. Discrepancies in coping in couples were positively related to distress in fathers at diagnosis. However, 12 months later, the more discrepant the couples were in their coping preferences the more distress the mothers indicated.

Parental bereavement: spiritual connections with deceased children.

Of a sample of 43 bereaved parents of pediatric cancer patients, 38 reported experiencing feelings of continued connection with their deceased child. Analysis of the data revealed several consistent themes in the experiences and in their impact on the parental bereavement process. Implications for research and clinical practice are discussed.

Brief report: the assessment of posttraumatic stress disorder in pediatric cancer patients and survivors.

Investigated the incidence and severity of Posttraumatic Stress Disorder (PTSD) in childhood cancer using informant methodology. The parents of pediatric cancer patients (n = 30) and off-treatment survivors (n = 42) completed a modified version of the Posttraumatic Stress Disorder Symptom Scale (PSS) on their children (M age = 8.8: SD = 4.0), in addition to the Child Behavior Checklist (CBCL) and the Personality Inventory for Children (PIC). Medical treatment and demographic data were also collected for each child. The only variables that significantly identified the presence of symptoms of PTSD were being on treatment at the time of the evaluation or in the preparatory phase prior to bone marrow transplantation and not having received cranial irradiation. Results indicate that a full constellation of PTSD symptoms can occur in children over the course of cancer treatment. Within the off-treatment pediatric cancer survivors, however, the incidence of PTSD was no greater than epidemiological estimates from the general population. The concurrent validity of the PSS received support, and the results, while preliminary, suggest that extended periods of medical trauma during which emotional support is present may not excessively predispose children to PTSD.

281 Differences in coping in parents of pediatric cancer patients and the relation with psychological distress

Introduction How parents cope with cancer in their child may influence psychological functioning with time. Differences in coping in couples may impact psychological distress negatively. Method In a longitudinal controlled study parents of pediatrie cancer patients completed the Goldberg General Health Questionnaire (measuring psychological distress), and the Utrecht Coping List (a Dutch standardised coping list, measuring active problem focusing, palliative reaction pattern, avoidance, social support seeking, depressive reaction pattern, expression of emotions and comforting cognitions) shortly after diagnosis (Tl) and 12 months (T2) later. Results On T1 differences in couples in their use of palliative reaction pattern and expression of emotions correlate for fathers with psychological distress (P < 0.005 and P < 0.05 resp.). For mothers no correlations were found. On T2 no correlations were found for fathers. However, for mothers differences in couples in their use of active problem focusing, avoidance, depressive reaction pattern and expression of emotions were found to correlate with psychological distress (P < 0.05, P < 0.01, P < 0.001, P < 0.05 respectively). Conclusion Differences in the use of coping in couples results for fathers in more psychological distress shortly after diagnosis and for mothers one year later. How parents cope with cancer in their child may influence psychological functioning with time. Differences in coping in couples may impact psychological distress negatively. In a longitudinal controlled study parents of pediatrie cancer patients completed the Goldberg General Health Questionnaire (measuring psychological distress), and the Utrecht Coping List (a Dutch standardised coping list, measuring active problem focusing, palliative reaction pattern, avoidance, social support seeking, depressive reaction pattern, expression of emotions and comforting cognitions) shortly after diagnosis (Tl) and 12 months (T2) later. On T1 differences in couples in their use of palliative reaction pattern and expression of emotions correlate for fathers with psychological distress (P < 0.005 and P < 0.05 resp.). For mothers no correlations were found. On T2 no correlations were found for fathers. However, for mothers differences in couples in their use of active problem focusing, avoidance, depressive reaction pattern and expression of emotions were found to correlate with psychological distress (P < 0.05, P < 0.01, P < 0.001, P < 0.05 respectively). Differences in the use of coping in couples results for fathers in more psychological distress shortly after diagnosis and for mothers one year later.