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: 4.04). 02/2006; 15(1):1-8. DOI: 10.1002/pon.927
Source: PubMed

ABSTRACT 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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    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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