PURPOSE We conducted a two phase, mixed methods study to develop a Parenting Concerns Questionnaire (PCQ) for adults with cancer. Limited information about this area of psychosocial distress highlights the need for a measurement tool that can identify adult oncology patients with heightened parenting concerns who could benefit from additional intervention. PATIENTS AND METHODS Telephone focus groups were conducted with 16 oncology patients who had children 18 years old and younger. Group interview transcripts were analyzed to generate qualitative themes and candidate items for the PCQ. A 38-item version of the questionnaire was completed by 173 oncology outpatients with children 18 years old and under. Participants also completed the Distress Thermometer, HADS, and FACT-G. Exploratory factor analyses revealed the emergence of 3 subscales of 5 items each, yielding a 15 item questionnaire. Associations between total PCQ scores, standardized measures of distress, depression, anxiety, quality of life, and demographic and illness characteristics were examined. RESULTS The 15 item PCQ demonstrates good internal consistency (Cronbach’s α = .83). PCQ scores were significantly associated (p<.01) with standardized measures of psychosocial distress (Distress Thermometer, HADS, and FACT-G) in the expected directions. Higher PCQ scores were associated with female gender, single parenthood, metastatic or recurrent cancer, subjective understanding of incurable disease, co-morbid chronic health condition, and current mental health treatment. CONCLUSIONS The Parenting Concerns Questionnaire proved a reliable and valid measure of parenting distress among cancer patients meriting further study.

Background Children whose parents have cancer are at-risk for psychosocial difficulties, however, the mechanisms are not well understood. This cross-sectional study sought support for a model connecting parental cancer to child distress through its impact on parent self-efficacy beliefs and parenting behaviors, by examining relationships among parental illness, quality of life/parent functioning, parent and co-parent efficacy beliefs, and concerns about children's emotional distress. Methods 194 adult oncology outpatients, with children 18 years of age and younger completed questionnaires assessing health-related quality of life (FACT-G), depression and anxiety symptoms (HADS), overall distress (Distress Thermometer), and parent and co-parent efficacy beliefs and parenting concerns (PCQ). Results Parent and co-parent efficacy scores declined significantly after diagnosis. This decline correlated with having more visits to a medical clinic, treatment with IV chemotherapy in the past month, poorer health-related quality of life, and more depression and distress. Parents experiencing the most concern about the impact of mood, physical limitations and changes in routines on their children, experienced the biggest declines in their own sense of efficacy as a parent, and in their belief in their co-parent's efficacy. Finally, declines in parenting efficacy beliefs correlated to parent concerns about children's emotional distress about aspects of the parent's illness. Conclusions The study highlights the importance of identifying and addressing parenting concerns to alleviate patient distress, and may help guide future intervention efforts.

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Objective-To compare contact lenses and intraocular lenses (IOLs) for the optical correction of unilateral aphakia during infancy.Methods-In a randomized, multicenter (12 sites) clinical trial, 114 infants with a unilateral congenital cataract were assigned to undergo cataract surgery either with or without IOL implantation. Children randomized to IOL treatment had their residual refractive error corrected with spectacles. Children randomized to no IOL had their aphakia treated with a contact lens Main Outcome Measures-Grating acuity at 12 months of age and HOTV visual acuity at 4.5 years of age Results-Enrollment began in December 2004 and was completed in January 2009. The median age at the time of cataract surgery was 1.8 months. Fifty patients were 4-6 weeks of age at the time of enrollment, 32 patients were between 49 days and 3 months of age and the remaining 32 children were 3 to 7 months of age. Fifty-seven children were randomized to each treatment group with either IOL placement or aphakia. The eyes with cataracts had shorter axial lengths and steeper corneas on average than the fellow eyes.Conclusions-The optimal optical treatment of aphakia in infants is unknown. IATS was designed to provide empirical evidence whether optical treatment with an IOL or a contact lens following unilateral cataract surgery during infancy is associated with a better visual outcome.

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