Parental cancer: Health‐related quality of life and current psychosocial support needs of cancer survivors and their children

Abstract

The presence of cancer and additional parental responsibilities can increase strain for individual patients as well as for their children. The construct of health‐related quality of life (HRQL) is appropriate to measure a combination of physical, mental and social consequences as a result of disease. However, previous research has merely focused on symptom checklists. This study addresses the following questions: (i) does HRQL in children and their parents with cancer differ compared to the general population? (ii) Are there any variables that are associated with HRQL in children? (iii) What are current psychosocial support needs? A population‐based survey of 976 survivors (<6 years post diagnosis) with minor children between 6 and 18 years (n = 1,449) was conducted with two German cancer registries. HRQL was assessed using SF‐8 (survivors) and Kidscreen (children). The results were compared to normative populations, and predictors associated with HRQL in children were evaluated within a multilevel model. We found that the HRQL in children was better compared to the norm. Only children with support needs had worse HRQL. Older age, having a mother with cancer, having a parent not living together with a partner, and worse parental physical and mental health influenced HRQL in children. Illness characteristics were irrelevant. Even with a mean of 3.5 years after diagnosis, survivors had lower physical and mental health compared to the norm. Our findings reinforce the need for health professionals to pay attention to younger patients and their children. Even years after diagnosis, life might not have returned to normal.

The well-being of children impacted by a parent with cancer: an integrative review

“…Primary school children experienced a higher totality of internalizing and externalizing problems [25,28], and ill parents perceived latency-aged primary school sons as having more emotional and behavioral problems than adolescent sons [24]. For older children, internalizing problems were more prevalent [28], as was a reduced quality of life [59], although one study suggested that older children experienced less problems in response to parental cancer, due to their advanced capabilities and independence [28]. Regardless, it appeared that older children had more responsibilities, including financial [58].…”

“…Parent's mental health influenced children's internalizing problems [28,34,41] and quality of life [59,60], and children were more likely to struggle to adjust to their parent's diagnosis if the parent struggled to adjust [18]. Treatment complications increased the number of problems experienced by offspring [28], while treatment intensity impacted adolescent daughters and relapse impacted sons [24].…”

“…Children were significantly impacted by parental cancer [18, 20-22, 24, 26, 34, 35, 40, 42, 43, 46, 59, 61] and exhibited distress [16,17,22,26,28,31,34,39,40,43,45,51,53,59]. Compared to the norm, offspring experienced more psychosocial problems [41,56], internalizing problems [41,48,53], psychological issues [34,55], and posttraumatic stress disorder (PTSD) symptoms [48].…”

“…The duration and seriousness of the disease mediated psychosocial symptoms [44,56]. Also, parent's physical health impacted children's mental health [31] and quality of life [59]. Conversely, parent's age and education were unrelated to children's wellbeing [28].…”

“…Being a single parent with cancer was a significant predictor of offspring's poor adjustment to the disease [18], internalizing and externalizing problems [28], and a reduced quality of life [59], which has been concluded in a separate review [69]. Parent's mental health influenced children's internalizing problems [28,34,41] and quality of life [59,60], and children were more likely to struggle to adjust to their parent's diagnosis if the parent struggled to adjust [18].…”