Coming to Terms: Parents' Response to a First Cancer Recurrence in Their Child

Abstract

The purpose of this study was to explore, using grounded theory, the process experienced by parents who are dealing with the first recurrence of cancer in their child. The sample of 33 guardians (27 mothers, 1 grandmother, and 5 fathers) was drawn from three pediatric oncology settings. Data were collected through interviews, observations, and medical record review. Thirteen parents were interviewed to validate first the evolving and, later, the complete study findings. Four interactive components emerged: regulating shock, situation monitoring, alternating realizations, and eyeing care-limiting decisions. The overall organizing construct induced from these components was labeled "coming to terms." This construct represents the parents' efforts to overcome shock and despair to make wise decisions about treatment while accepting that the outcome if beyond their control, and to help their child have the optimal chance for cure while preparing for the child's possible death.

Adaptational Process of Parents of Pediatric Oncology Patients

“…Parents selectively perceived their child's situation to remain optimistic and to gain strength to face the disease or to compare their situation with others who had it worse. This ® nding is consistent with that of Hinds et al [18] on parents with chronically ill or disabled children [32]. Parents who tended to stay optimistic were more likely to have better medical compliance.…”

“…At the same time, parents have to watch their child suffer. This is similar to the construct of ªcoming to termsº as described by Hinds et al [18], a process by which parents cope with their child's cancer.…”

Anticipatory grieving among parents living with a child with cancer

“…Hinds et al (1996) explored the process experienced by 33 parents with the first recurrence of cancer in their children aged 5-18 years. They described parents' effort to deal with shock and despair and to help their child to have the optimal chance for cure, while preparing for the child's possible death.…”

Health-related quality of life and enrollment in Phase 1 trials in children with incurable cancer

“…Families of children with cancer unresponsive to conventional treatments face difficult decisions Hinds et al, 1996!. The effect of a particular treatment on their child's health-related quality of lifẽ HRQOL!…”