Assessment of Parental Psychological Stress in Pediatric Cancer: A Review

Abstract

The authors recommend clear definitions of parental stress, fixed points in time to assess parental stress, and an approach that highlights both parental strengths and weaknesses. Improved assessment can contribute to tailoring psychological care to those parents most in need.

Impacto psicossocial do câncer pediátrico para pais: revisão da literatura

“…The parents may respond to the diagnosis with behavior indicative of depression, such as persistent sadness, pessimism, hopelessness, guilt, helplessness, decreased energy, difficulty concentrating or making decisions, fatigue, insomnia or sleepiness, which may last for several months, especially with initial levels of moderate or severe depression (Bayat, Erdem, & Kuzucu, 2008;Vrijmoet-Wiersma et al, 2008;Ward-Smith, Kirk, Hetherington, & Hubble, 2005). Studies addressing anxiety indicate that manifestations frequently occur at the time when a diagnosis is disclosed and usually decline to normal levels, though remain higher than levels experienced by parents of healthy children (Bayat et al, 2008;Gerhardt et al, 2007;Lähteenmäki, Sjöblom, Korhonen, & Salmi, 2004;Piersol, Johnson, Wetsel, Holtzer, & Walker, 2008;Sawyer, Antoniou, Toogood, Rice, & Baghurst, 2000;Vrijmoet-Wiersma et al, 2008).…”

“…Studies addressing anxiety indicate that manifestations frequently occur at the time when a diagnosis is disclosed and usually decline to normal levels, though remain higher than levels experienced by parents of healthy children (Bayat et al, 2008;Gerhardt et al, 2007;Lähteenmäki, Sjöblom, Korhonen, & Salmi, 2004;Piersol, Johnson, Wetsel, Holtzer, & Walker, 2008;Sawyer, Antoniou, Toogood, Rice, & Baghurst, 2000;Vrijmoet-Wiersma et al, 2008).…”

“…Mothers tend to report higher levels of anxiety than fathers, whether at the time the diagnosis is disclosed or in other stages of the disease, though these manifestations can be a result of how gender roles are constructed or the way parental caregivers split responsibilities; the primary caregiver role is usually attributed to mothers (Beck & Lopes, 2007a;Dahlquist, Czyzewski, & Jones, 1996;Santos & Gonçalves, 2008;Vrijmoet-Wiersma et al, 2008). Parents reporting high levels of anxiety at the diagnosis usually continue to experience significant manifestations even after the treatment ends (Vrijmoet-Wiersma et al).…”

“…About half of parents report moderate to intense levels of posttraumatic stress, including intrusive thoughts, treatment avoidance, physiological responses, flashbacks and psychological agitation (Kazak, Boeving, Alderfer, Hwang, & Reilly, 2005;Santacroce, 2002;Vrijmoet-Wiersma et al, 2008). On the other hand, the work of Jurbergs, Long, Ticona e Phipps (2009) does not report significant differences in posttraumatic stress symptoms between parents of children undergoing treatment and symptoms in parents of healthy children.…”

“…Factors that need to be addressed in detail in studies involve access to the healthcare system, satisfaction with the health service, promoting healthful aspects, and the repertoire of self-care behavior. Such elements are essential to understanding how circumstantial differences may influence the impact of psychological disturbances or protect against them (Boman et al, 2003;Holmbeck et al, 2006;Vrijmoet-Wiersma et al, 2008).…”