Losing a parent to cancer as a teenager: Family cohesion in childhood, teenage, and young adulthood as perceived by bereaved and non‐bereaved youths

Abstract

Objective The aim of this study was to investigate levels of perceived family cohesion during childhood, teenage years, and young adulthood in cancer‐bereaved youths compared with non‐bereaved peers. Methods In this nationwide, population‐based study, 622 (73%) young adults (aged 18‐26) who had lost a parent to cancer 6 to 9 years previously, when they were teenagers (aged 13–16), and 330 (78%) non‐bereaved peers from a matched random sample answered a study‐specific questionnaire. Associations were assessed using multivariable logistic regression. Results Compared with non‐bereaved youths, the cancer‐bereaved participants were more likely to report poor family cohesion during teenage years (odds ratio [OR] 1.6, 95% CI, 1.0‐2.4, and 2.3, 95% CI, 1.5‐3.5, for paternally and maternally bereaved youths, respectively). This was also seen in young adulthood among maternally bereaved participants (OR 2.5; 95% CI, 1.6‐4.1), while there was no difference between paternally bereaved and non‐bereaved youths. After controlling for a number of covariates (eg, year of birth, number of siblings, and depression), the adjusted ORs for poor family cohesion remained statistically significant. In a further analysis stratified for gender, this difference in perceived poor family cohesion was only noted in females. Conclusion Teenage loss of a parent to cancer was associated with perceived poor family cohesion during teenage years. This was also noted in young adulthood among the maternally bereaved. Females were more likely to report poor family cohesion. Our results indicate a need for increased awareness of family cohesion in bereaved‐to‐be families with teenage offspring, with special attention to gender roles.

Much is left unspoken: Self‐reports from families in pediatric oncology

“…Although there is a shortage of studies following siblings over time, research indicates that child functioning is closely associated with—and often dependent on—parent and family functioning 8,9 . For example, poor cohesiveness or having difficulty expressing feelings and emotions in the family unit can predict posttraumatic stress reactions in children 10 …”

“…8,9 For example, poor cohesiveness or having difficulty expressing feelings and emotions in the family unit can predict posttraumatic stress reactions in children. 10 Parents play a significant role in providing support throughout a child's development-whether the child is ill or healthy-but parents of children with cancer are at risk of own marked or prolonged distress or psychopathology. 11 Parents experience multiple stressors throughout the illness trajectory, including managing treatment and side effects, financial strain, a sense of being dependent on the care provided, and balancing care of healthy siblings.…”

Acute and long-term grief reactions and experiences in parentally cancer-bereaved teenagers

“…Bereavement in children and adolescents has been shown to be associated with increased risk of suicide attempts [ 8 , 9 ] and increased mortality [ 10 , 11 ], and previous research based on the same study sample as the current study showed almost a doubled risk of self-injury in the first 6–9 years following teenage bereavement [ 12 , 13 ]. While not all bereaved children and adolescents will face these negative outcomes of bereavement [ 14 , 15 ], risk factors such as sudden, unexpected or traumatic [ 5 ] loss, parental depression [ 16 ] and poor family cohesion [ 17 , 18 ] have been identified. Complicated or prolonged grief is another factor that has been shown to be associated with those negative health-related outcomes in bereaved children and adolescents [ 19 , 20 ].…”

Impact of the Family Environment on the Emotional State of Medical Staff During the COVID-19 Outbreak: The Mediating Effect of Self-Efficacy

“…In contrast, low family cohesion and conflict between parents increased the risk of depression and anxiety in family members ( Park et al, 2018 ; Cano et al, 2020 ). In families with a high degree of cohesion, individuals can get more psychological help and emotional support within the family ( Birgisdóttir et al, 2019 ), so that the psychological pressure can be appropriately relieved. Positive emotional expression within the family can prevent suppression of inner feelings and buffer internal conflicts, especially in the face of stressful events.…”