Psychological Adjustment of Parents of Pediatric Cancer Patients Revisited: Five Years Later

Psychosocial Services, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Psycho-Oncology (Impact Factor: 2.44). 01/2006; 15(1):1-8. DOI: 10.1002/pon.927
Source: PubMed


We investigated the psychological functioning of parents of children suffering from pediatric cancer using a prospective design over a five-year time period. Parents of children diagnosed with cancer participated at diagnosis (T1), six months (T2), twelve months (T3), and five years later (T4, n = 115). Repeated measures ANOVAs were calculated for the three measures of psychological distress (GHQ, SCL-90 and STAI-S) to examine changes over time and gender differences. Independent T-tests were computed to examine differences between the mean scores of the parents at T4 and the norm groups. The effects of health status and earlier levels of distress on T4 functioning were examined using ANOVA and partial correlational analysis. Results showed that levels of reported distress, psychoneurotic symptoms and state anxiety significantly decreased across time to normal levels at T4 except on the GHQ. A significantly higher percentage of parents (27%) than in the norm group (15%) showed clinically elevated scores on the GHQ. Mothers had higher scores than fathers only on state anxiety. Parents of relapsed children reported higher anxiety levels than parents of surviving and deceased children. Psychological functioning at T1 was significantly related to functioning at T4. These results support the conclusion that although parental distress decreases with time, a significant number of parents still suffer from clinical distress after five years. Parents of relapsed children are at risk for long-term psychological problems as are those with higher levels of psychosomatic complaints at diagnosis.

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Available from: Barbara J Wijnberg-Williams,
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    • "Parents of children with brain tumors likewise reported high levels of distress, post-traumatic stress, and a lower quality of life.9,10 They further reported that their elevated stress level continued for 5 years or more post-diagnosis.11 "
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    ABSTRACT: Purpose Our study aimed to examine the relationship between intelligence and health-related quality of life (HRQOL) in children (6-13 years old) diagnosed as having a brain tumor. Materials and Methods We administered a Korean version of the Wechsler Intelligence Scale for Children-III, the Pediatric Quality of Life Inventory, version 4.0 (PedsQL), the Korean version of the Parenting Stress Index-Short Form, and the Korean Version of the Parenting Sense of Competence (K-PSOC) scale before or after initial radiotherapy (T1) and after treatment termination (T2). In total, 13 patients completed both the T1 and T2 interviews. Results Scores significantly declined between T1 and T2 on the full-scale intelligence quotients (FIQ), verbal intelligence quotients (VIQ), performance intelligence quotients (PIQ), similarity and coding tests, as well as the K-PSOC, which measures parental anxiety. FIQ scores at T1 were correlated with the self-reported PedsQL total scores (r=0.739) and the parent proxy-report PedsQL scores for school functioning (r=0.706) at T2. Also, the FIQ scores at T2 were correlated with the self-reported PedsQL total scores (r=0.748) and scores for physical health (r=0.728) at T2. Conclusion The cognitive ability and intelligence level of the patients significantly declined between on and off treatment periods, and higher intelligence functioning at both on and off treatment was correlated with long-term higher HRQOL. Further investigations that monitor intelligence, HRQOL and parenting stress over a longer period, using a greater number of participants, are needed.
    Yonsei medical journal 03/2013; 54(2):306-14. DOI:10.3349/ymj.2013.54.2.306 · 1.29 Impact Factor
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    • "Caregivers of children with brain tumors reported high levels of distress, post-traumatic stress and lower QOL in both the physical and psychological domains.14,15 They reported that stress continued for 5 years or more post-diagnosis.16 "
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    ABSTRACT: To compare health-related quality of life (HRQOL), activities of daily living (ADL), and parenting stress between children with brain tumors and those of normal control (NC). Participants were 31 brain tumor patients who had received chemotherapy, radiotherapy, or peripheral blood stem cell transplantation after surgical resection and 125 NC subjects. We administered the Pediatric Quality of Life Inventory, version 4.0 (PedsQL), to assess HRQOL; the Korean version of the Parenting Stress Index-Short Form (K-PSI-SF), to assess parenting stress; and examined ADL. The mean self-report PedsQL scores for physical health, emotional functioning, social functioning, school functioning, and total scores in the patients were significantly lower than those of the NC group. The mean parent proxy-report PedsQL scores for all scales except emotional functioning in the patient group were significantly lower than those of the NC group. The ADL impairment for the patients was significantly more than that of the NC group. The K-PSI-SF mean scores for stress related to having a difficult child and for stress related to parent-child interaction in the patient group tended to be higher than those of the NC group (p=0.09). The children with brain tumors had lower HRQOL and difficulties in performing ADL. The parents of children with brain tumors tended to experience stress related to having a difficult child and to parent-child interaction. We suggest that long-term monitors for the child's HRQOL and ADL, and parenting stress in children with brain tumors are needed.
    Psychiatry investigation 09/2011; 8(3):250-5. DOI:10.4306/pi.2011.8.3.250 · 1.28 Impact Factor
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    • "There were differences in parental anxiety and quality of life when additional factors are taken into account. For example, anxiety was found to be more prevalent in parents whose children are in active treatment than otherwise [9]. In particular, parents whose children had higher treatment intensity, poorer child health status and shorter time since diagnosis reported poorer quality of life than counterparts [6]. "
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    ABSTRACT: Introduction: Parents of children with cancer experience a challenging situation in coping with the child's diagnosis and changes that the illness puts in the overall family condition. Method: A cross-sectional study on 79 parents was conducted in Hospital Universiti Sains Malaysia. Socio-demographic information was obtained. Participants completed a set questionnaire measuring their level of anxiety and stress, knowledge about cancer, and amount of activities they perform with or for the child to enhance the child's coping abilities. Children's psychological problems were also assessed through parental reports. Results: Parents with higher cancer knowledge reported reduced stress (p<0.01) and anxiety (p<0.05). The higher the income (p<0.05) and education (p<0.01), the higher cancer knowledge. Parental stress was negatively correlated with income (p<0.05) and education (p<0.01), indicating that the better educated and higher the salary, less stress symptoms. Highly educated parents engaged in more activities with their children (p<0.05).Parental anxiety was correlated significantly with children's current treatment including chemotherapy procedure (p<0.01), 'In-patient' Vs 'Outpatient' (p<0.01), and children's condition (p<0.01). Parents of hospitalized children who underwent chemotherapy were significantly more anxious than their counterparts. Parents who perceived their children's current condition as 'very good', reported reduced anxiety, compared to those who reported their child's condition as 'ok'. The more psychological problems the children had, the higher parental anxiety (p<0.05) and stress symptoms (p<0.01). Discussion: Some groups of parents had more psychological difficulties compared to others. Ongoing psychological assessment and intervention may reduce parental stress by increasing coping and reducing children psychological problems.
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