Parental depressive symptoms and childhood cancer: the importance of financial difficulties

Abstract

Purpose Research suggests a relationship between caring for a child with cancer and psychological distress in caregivers. Less evident is the role which financial difficulties might play in this relationship. We sought to determine if caring for a child with cancer was related to clinically relevant depressive symptoms among parents, whether or not financial difficulties mediated this relationship, and if financial difficulties were independently associated with symptoms of depression among parents of children with cancer. Methods Data are from 215 parents of children diagnosed with cancer or brain tumors (n=75) and a comparison group of parents of healthy children (n=140). Multiple logistic regression analyses were used to assess the factors associated with reporting clinically relevant depressive symptoms. Results Caring for a child with cancer was associated with increased odds of clinically relevant depressive symptoms in parents (OR: 4.93; 95% CI: 1.97 – 12.30), controlling for covariates. The mediating effect of financial burden on this relationship was not statistically significant. However, among parents of children with cancer, negative financial life events increased the likelihood of reporting symptoms of depression (OR: 4.89; 95% CI: 1.26 – 18.96). Conclusions Caring for a child with cancer was associated with depressive symptoms for parents. Financial difficulties were the strongest correlate of these symptoms among parents of children with cancer. Our results suggest that it may not only be the burden of caring for the child with cancer, but also the associated financial difficulties that contribute to a higher likelihood of depressive symptoms in parents.

Assessment of Financial Burden as a Standard of Care in Pediatric Oncology

“…A handful of studies explored the consequences of family financial burden with uniform findings of negative impact on parental and family well‐being. Financial hardship during a child's cancer care was documented to result in increased emotional distress for families, increased burden on parental relationships, and increased risk of serious psychological distress for parents . These findings support a recommendation for standardized efforts to evaluate family financial needs as part of comprehensive psychosocial care in children with cancer.…”

“…Family financial hardship as a consequence of childhood cancer treatment has been documented over the past three decades, and the economic burden of caring for a child with cancer has been described as a significant source of distress for families . Data suggest that financial hardship during childhood cancer treatment has implications for family economic status, parental emotional and mental health, and potentially child well‐being.…”

Standards of Psychosocial Care for Parents of Children With Cancer

“…Most PCC and families adjust well, and report growth, increased closeness, and good family functioning. Potential resiliency factors include higher socio‐economic status higher levels of social support and higher family cohesion and functioning . Parent attributes such as optimism and use of problem‐solving coping strategies (defined as “sets about solving problems purposefully”, compared to “emotion‐focused coping” and other described coping styles) have also been associated with decreased parental distress.…”

Should Clinicians Intervene If They Suspect That a Caregiver Whose Child Has Cancer Is at Risk of Psychological Harm?

“…Studies have shown that while many caregivers demonstrate impressive resilience in the face of a cancer diagnosis, some are at increased risk for post-traumatic stress, depression, anxiety, and somatic illness [6][7][8]. The additional financial burden of treatment may contribute significantly to caregivers' psychological distress [8].…”