Featured Article: The Relationship Between Parent and Child Distress in Pediatric Cancer: A Meta-Analysis

Abstract

Objective Parents and children affected by pediatric cancer are at risk for psychological distress, including depression, anxiety, and post-traumatic stress. A link is believed to exist between parent and child distress; however, no systematic analysis of this relationship has occurred. A meta-analysis was conducted to assess the relationship between parent and child distress among families affected by pediatric cancer. Methods A systematic review and meta-analysis was conducted using EBSCO (searching PsycINFO, MEDLINE, Academic search Premiere, and Health Source: Nursing/Academic Edition) and PubMed. The initial search yielded a total of 29,118 articles. Inclusion criteria were that studies assessed the relation between parent and child distress in the context of pediatric cancer, were written in English, and were published in peer-reviewed journals. 28 articles met inclusion criteria. Results A statistically significant association was found between overall parent and child distress (r = .32, p < .001), such that increased parent-reported distress was associated with increased distress in their children. Significant relationships were also present among each type of parental distress (i.e., depression, anxiety, post-traumatic stress, and global distress; rs = .31–.51, ps < .001) and overall child distress. Moderation analyses via meta-regression indicated that parent proxy-report of child symptoms was associated with a stronger relationship between parent and child distress than child self-report of their own distress. Conclusions Aligned with the social–ecological framework, familial factors appear to be highly relevant in understanding distress following pediatric cancer diagnosis. Indeed, greater parent distress was associated with greater child distress.

Longitudinal predictors of caregiver resilience outcomes at the end of childhood cancer treatment

“…In addition to highlighting the importance of screening for family psychosocial risks and resources and integrating broad assessment of caregiver resilience throughout treatment, implications for family intervention are raised. Because the literature strongly suggests that caregiver functioning relates to child functioning through parenting roles, emotional availability, illness uncertainty, and so forth, interventions aimed at supporting caregiver adaptation should be tested not only during active treatment (e.g., Bright IDEAS, PRISM‐P, and SCCIP‐ND) but after treatment ends 10 12 , 34 An individually delivered, on treatment, caregiver resilience intervention has been pilot tested with demonstrated acceptability, feasibility, and efficacy compared to usual care 35 .…”

“…, 2 While caregivers endorse distress, anxiety, and intrusive thoughts about cancer, 3 , 4 we also know that many caregivers traverse childhood cancer with resilience 2 5–7 Caregiver adaptation sets the stage for how the family functions across cancer diagnosis and treatment, 8 , 9 and child and parent adaptation to a pediatric cancer diagnosis are closely linked 10 11 The experiences of caregivers of children with cancer during active treatment are well documented; however, the ways in which on‐treatment experiences impact adaptation (and resilience outcomes) over time, particularly in the context of the needs of families at the end of the treatment, have only recently been explored 12 …”

Psychological adjustment outcomes among pediatric brain tumor survivors: A meta‐analysis

“…Specific search terms were utilized to capture psychological distress, child, and brain tumor concepts (Supporting Information) 30 . Search terms utilized were based upon previous systematic review research in pediatric cancer populations examining psychological adjustment 27,28 . Searches across all databases resulted in 2833 total articles, with 2310 remaining upon removal of duplicate articles via EndNote (Figure 1).…”

“…30 Search terms utilized were based upon previous systematic review research in pediatric cancer populations examining psychological adjustment. 27,28 Searches across all databases resulted in 2833 total articles, with 2310 remaining upon removal of duplicate articles via EndNote (Figure 1). 29 Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were adhered to throughout the review process (Table S1).…”

Barriers to care in pediatric cancer: The role of illness uncertainty in relation to parent psychological distress

“…Extant literature has highlighted the potentially traumatic nature of pediatric cancer, demonstrating that the burden of treatments, existence of family stressors, and lack of financial or social resources may heighten levels of depressive and anxious symptoms, posttraumatic stress (PTSS), and general distress experienced by parents following a pediatric cancer diagnosis . In turn, parent distress has the potential to negatively impact their child's adjustment in light of the transactional relationship between parent and child psychosocial functioning …”