The Benefits of Family-Centered Care for Parental Self-Efficacy and Psychological Well-being in Parents of Children with Cancer

Abstract

Objectives
The purpose of this study was to examine the direct and indirect links between the perception of family-centered care (FCC) and psychological well-being via the perceived self-efficacy of parents of children with cancer. This study also sought to identify the potential moderators of these links (treatment status and patient age).

Methods
This cross-sectional study was conducted at the pediatric oncology wards of two Portuguese public hospitals. The consecutive sample comprised 251 parents (87.6% mothers) of children/adolescents (8−20 years old) diagnosed with cancer. Participants completed self-report questionnaires measuring their perception of family-centered care (family-centered services and providing general information), perceived self-efficacy (regarding healthcare and parenting role) and psychological wellbeing.

Results
Results from the Structural Equation Modeling suggested that parents’ perception of FCC was indirectly, but not directly, linked to psychological well-being via perceived self-efficacy. Multi-group analyses suggested that this mediation model was valid across treatment status (on vs. off-treatment) and patient age groups (children vs. adolescents).

Conclusions
These findings highlighted that, through the implementation of FCC, healthcare professionals may promote parents’ perceived self-efficacy and, consequently, their psychological well-being. Results also suggest that FCC may equally operate on parents’ psychosocial functioning, regardless of treatment status or patient age. Overall, our findings reinforced the benefits of FCC practices in pediatric oncology wards.

Full text

Journal of Child and Family Studies (2019) 28:1926–1936
https://doi.org/10.1007/s10826-019-01418-4
ORIGINAL PAPER
The Benefits of Family-Centered Care for Parental Self-Efficacy and
Psychological Well-being in Parents of Children with Cancer
Ágata Salvador 1●Carla Crespo 1●Luísa Barros 1
Published online: 19 April 2019
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract
Objectives The purpose of this study was to examine the direct and indirect links between the perception of family-centered
care (FCC) and psychological well-being via the perceived self-efficacy of parents of children with cancer. This study also
sought to identify the potential moderators of these links (treatment status and patient age).
Methods This cross-sectional study was conducted at the pediatric oncology wards of two Portuguese public hospitals. The
consecutive sample comprised 251 parents (87.6% mothers) of children/adolescents (8−20 years old) diagnosed with cancer.
Participants completed self-report questionnaires measuring their perception of family-centered care (family-centered ser-
vices and providing general information), perceived self-efficacy (regarding healthcare and parenting role) and psychological
wellbeing.
Results Results from the Structural Equation Modeling suggested that parents’perception of FCC was indirectly, but not
directly, linked to psychological well-being via perceived self-efficacy. Multi-group analyses suggested that this mediation
model was valid across treatment status (on vs. off-treatment) and patient age groups (children vs. adolescents).
Conclusions These findings highlighted that, through the implementation of FCC, healthcare professionals may promote
parents’perceived self-efficacy and, consequently, their psychological well-being. Results also suggest that FCC may
equally operate on parents’psychosocial functioning, regardless of treatment status or patient age. Overall, our findings
reinforced the benefits of FCC practices in pediatric oncology wards.
Keywords Family-centered care ●Parents ●Pediatric cancer ●Psychological well-being ●Self-efficacy
Pediatric cancer is a life-threatening condition requiring
intensive treatments with adverse side effects and long-term
impairments for the child (Long and Marsland 2011; Pat-
terson et al. 2004). Unsurprisingly, cancer poses significant
challenges for the ill child and also for his/her family
(Patterson et al. 2004), especially for parents, who are
responsible for providing ongoing care. Most parents cope
well with this disruptive experience; however, a subset of
them report psychological distress (e.g., anxiety and
depressive symptoms; see Vrijmoet-Wiersma et al. 2008,
for review) and poorer quality of life (Klassen et al. 2012).
The risk for parents’psychological distress arises from
the experience of being simultaneously a parent and a
caregiver of a child with a serious health condition (Raina
et al. 2004). Immediately after the diagnosis, parents must
learn to perform difficult tasks, such as administering
medication, monitoring side effects, and planning medical
appointments (Clarke et al. 2005; Klassen et al. 2012). Due
to the technical and emotional requirements of these new
obligations, parents may have doubts about whether they
can successfully perform their new and unexpected role as a
caregiver. Simultaneously, parents must carry on with the
usual care requirements of their child (Clarke et al. 2005),
adding in the challenges brought on by cancer, such as the
child’s intense emotional reactions (Patterson et al. 2004)
and behavioral changes (Clarke et al. 2005). These changes
in the parenting role may undermine parents’confidence to
successfully handle their child’s problems. In fact, mothers
of children with cancer reported a less positive image of
themselves as mothers compared to the mothers of healthy
children (Caroli and Sagone 2014). Similarly, parents of
children with diabetes reported lower self-efficacy regarding
*Ágata Salvador
agata.m.salvador@gmail.com
1CICPSI, Faculdade de Psicologia, Universidade de Lisboa,
Lisboa, Portugal
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