Cancer-related effects on relationships, long-term psychological status and relationship satisfaction in couples whose child was treated for leukemia: A PETALE study

Abstract

ObjectivesFollow-up studies suggest that the psychosocial impact of pediatric cancer on parents often extends beyond the end of their child’s cancer treatments, and parents can continue to experience both individual and relationship effects. In a long-term study of parents of children who were treated for acute lymphoblastic leukemia (ALL), we aimed to: 1) describe parents’ adjustment (psychological distress, relationship satisfaction; 2) describe the perceived impact of cancer on couples’ relationship, and; 3) identify to what extent the perceived impact of cancer on the couple is related to both parents’ long-term adjustment.MethodsParents of childhood ALL survivors (n = 103 couples) were surveyed as part of a cohort recall (PETALE cohort). Both parents completed questionnaires exploring adjustment (Brief Symptom Inventory-18, Dyadic Adjustment Scale) and perceived impact of cancer on the relationship (Impact of Cancer on the Couple). Mothers’ and fathers’ scores were compared using MANOVAs. We also examined the degree to which a parent’s perceived changes in relationship dynamics following their child’s cancer were associated with their own current adjustment (actor effects), and their partner’s current adjustment (partner effects) using the Actor-Partner Interdependence Model (APIM).ResultsFrequencies of current distress were normative in parents (mothers/fathers): general distress (6.8/7.8%), anxiety (5.8/6.8%), depression (2.9/6.8%), somatization (13.6/9.7%), and relationship distress (21.4/20.4%). Mothers and fathers typically agreed on their reported relationship satisfaction, and the perceived nature of relationship changes following the illness. Dyadic analyses indicated that whereas mothers’ adjustment was related to their own perceived relationship changes, fathers’ adjustment was primarily related to their partner’s perceptions.ConclusionIn long-term stable couples, mothers may act as an influential bridge connecting the illness experiences of survivors and fathers. This could explain why mothers’ perceptions of relationship changes were related to their partners’ long-term adjustment, which was not the case for fathers.

Definition and improvement of the concept and tools of a psychosocial intervention program for parents in pediatric oncology: a mixed-methods feasibility study conducted with parents and healthcare professionals

“…Importantly, it has been shown that spousal support on the current emotional and conjugal adjustment of each spouse improves the couples’ functioning in both the short and long term [11]. These findings are in line with the reduction in psychological distress and conjugal conflict, and a greater satisfaction with marital life observed among both fathers and mothers who perceived increased support from their spouse [12].…”

The impact of childhood cancer on parental separation, divorce, and family planning in Denmark

“…Collectively, these findings suggest that the potentially adverse effect of childhood cancer on the parents´ relationship may be outweighed by opposite contributions that may have strengthened parental bonding in many couples. There is indeed evidence suggesting that a child's disease led to a feeling of mutual commitment among some parents, and that this common experience ultimately improved the quality of their relationship 8,[20][21][22] . A child´s cancer diagnosis may also alter parents´ life priorities and conflicts in the parental relationship may be perceived as less important compared to the childhood cancer experience 7 .…”

Parenting a child with cancer: a couple-based approach

“…A small but growing literature suggests the importance of couples' relationship functioning in the context of parenting a child with cancer, and a number of researchers have recommended couple-based interventions to strengthen the couple relationship and enhance their ability to support each other and meet the demands of parenting their child with cancer [19,20,30] To our knowledge, this is the first study to test the feasibility and acceptability of a couple-based intervention to parents of children with cancer. Findings were mixed.…”

“…Given the negative impact of childhood cancer on couples' relationships and the central role of couple functioning in helping the family adjust to a child's cancer, interventions that promote and strengthen parents' relationships may alleviate distress in both members of the couple and perhaps even in their child(ren) [13]. A number of researchers have recommended interventions to support couple's relationships in the context of pediatric cancer [19,20,30], and in one study the majority of couples surveyed reported that they would be interested in couple counseling [19]. However, to date, there have been no studies testing the feasibility or acceptability of a couple-based intervention for these parents.…”