Illness unpredictability and psychosocial adjustment of adolescent and young adults impacted by parental cancer: the mediating role of unmet needs

Abstract

Purpose Given the large number of adolescents and young adults (AYAs) impacted by parental cancer and the potential for negative psychosocial outcomes in this vulnerable population, this study examined the mediating role of offspring unmet needs with regard to parental cancer and the relation between AYAs psychosocial adjustment and perceived illness unpredictability. Methods A total of 113 AYAs (aged 11–24 years) living with a parent diagnosed with cancer completed a questionnaire assessing illness unpredictability, offspring unmet needs, and psychosocial adjustment (i.e., health-related quality of life and internalizing problems). Results Higher offspring unmet needs were associated with lower health-related quality of life (r = –0.24**) and higher internalizing problems (r = 0.21*). Offspring unmet needs mediated the relation between illness unpredictability and health-related quality of life (standardized indirect effect = –0.100* [–0.183, –0.018]) but not internalizing problems (standardized indirect effect = 0.067 [–0.015, 0.148]). In particular, higher illness unpredictability was related to higher unmet needs (β = 0.351**) which, in turn, predicted lower health-related quality of life (β = –0.286**). Conclusion These findings identify offspring unmet needs and illness unpredictability as implicated in AYAs positive psychosocial adjustment to parental cancer. Given that AYAs are at greater risk of elevated psychosocial difficulties, interventions should target offspring unmet needs and perception of illness unpredictability to mitigate the adverse effects of parental cancer.

Families Affected by Parental Cancer: Quality of Life, Impact on Children and Psychosocial Care Needs

“…Jeppesen and colleagues reported in a sample of adolescents that 42% participants had low quality of life levels ( 39 ). Moreover, adolescents themselves report high levels of unmet needs ( 40 ), which may not be captured by quality of life assessment. Similar to other studies ( 41 ), we found moderate positive correlations between parental and children's quality of life.…”

Young Adult Carers during the Pandemic: The Effects of Parental Illness and Other Ill Family Members on COVID-19-Related and General Mental Health Outcomes

“…A substantial body of published international research provides evidence on the adverse psychosocial impacts on youth caring for a family member, particularly a parent, who has a serious mental or physical health condition [ 1 , 2 , 3 , 4 ]. Most studies in this field have investigated children and adolescents up to the age of 18 years (referred to as young carers), with markedly less research on young adult carers (18–24 years) [ 5 ].…”

“There was help for me at the time, but I didn't feel like I deserved it”: exploring the unmet needs of adolescents experiencing maternal cancer in Ireland

“…Adolescents of mothers who completed treatment reported greater unmet needs in relation to support from their friends (Chan et al, 2019). A recent study identified that higher levels of unmet needs were associated with lower healthrelated quality of life in adolescents (Landi et al, 2021). Illness unpredictability was related with high levels of unmet needs, suggesting the need for interventions mitigating illness unpredictability and adolescents' unmet needs (Landi et al, 2021).…”

“…, 2019). A recent study identified that higher levels of unmet needs were associated with lower health-related quality of life in adolescents (Landi et al. , 2021).…”

“…, 2021). Illness unpredictability was related with high levels of unmet needs, suggesting the need for interventions mitigating illness unpredictability and adolescents' unmet needs (Landi et al. , 2021).…”