Parenting stress and neurocognitive late effects in childhood cancer survivors

Abstract

Objective Surveillance of neurocognitive late effects has typically focused on the pediatric survivor alone and rarely has focused on the potential family burden. We investigated the impact of child neurocognitive effects on parenting stress, and hypothesized that parents of childhood cancer survivors with greater executive difficulties experience higher stress relative to parents of children with less adverse impact. Method Parents of 44 children who survived cancer involving CNS-directed treatments and who had documented neurocognitive deficits completed standardized questionnaires assessing their perceived level of stress and perception of their child’s executive functioning abilities in daily life. Data from performance-based cognitive tests were obtained on the children. Multivariate regression models examined socio-demographic, clinical, and child’s executive functioning as predictors of parent stress. Differences in parenting stress based on child’s level of executive functioning were evaluated. Results Parent stress was significantly associated with both performance-based and parent report measures of child executive functioning. Child executive functioning significantly predicted parent stress even after controlling for socio-demographic and clinical factors, and the final model accounted for 42% of variance in parent stress levels. Significant differences in parent stress were found when comparing higher versus lower levels of child executive functioning. The nature of the executive difficulties, however, appears important, as we found increased parenting stress among children with behavioral regulation problems rather than metacognitive difficulties. Conclusions The associations between parenting stress and neurocognitive problems found in this study suggests the need for further research, along with professional monitoring and appropriate intervention.

A longitudinal investigation of parenting stress in caregivers of children with retinoblastoma

“…Such findings are in line with other recent studies suggesting that parenting stress influences child cognitive outcomes 12,13 and also provide support for our prior hypothesis that declines in cognitive functioning observed in children with retinoblastoma are at least partially mediated by parenting stress. 8 Future studies of cognitive or functional outcomes in children with cancer-both those who are expected and those who are not expected to have declines-would benefit from longitudinal designs that include indicators of parenting stress.…”

“…We hypothesized that non‐illness‐related factors—such as parenting stress—may have influenced outcomes, particularly given that the largest declines were observed in those children who received enucleation and no other treatment . Two papers examined the influence of parenting stress on neurocognitive outcomes in children with cancer (leukemia and lymphoma). Both papers demonstrated that parenting stress influenced neurocognitive outcomes, particularly with regard to parent‐reported functioning, with higher parenting stress associated with greater functional impairment in survivors.…”

“…[9][10][11] We hypothesized that non-illnessrelated factors-such as parenting stress-may have influenced outcomes, particularly given that the largest declines were observed in those children who received enucleation and no other treatment. 8 Two papers 12,13 examined the influence of parenting stress on neurocognitive outcomes in children with cancer (leukemia and lymphoma).…”

Cognitive outcomes among Latino survivors of childhood acute lymphoblastic leukemia and lymphoma: A cross‐sectional cohort study using culturally competent, performance‐based assessment

“…By parent report, small but statistically significant differences were identified in working memory and executive functioning. These suggest that subtle deficits can impact daily life for survivors, which may be particularly relevant in a population where higher stress levels, low education levels, and low English fluency hinder parents’ ability to assist with school work. Thus, a truly comprehensive approach for providing academic support to these survivors in the home, community, and school must take account of sociodemographic disparities …”

Stress, Psychosocial Mediators, and Cognitive Mediators in Parents of Child Cancer Patients and Cancer Survivors: Attention and Working Memory Pathway Perspectives

“…Finally, some studies described a relationship between socioeconomic status and future psychosocial consequences for the parent and the survivor child. It appears that low income and a precarious situation can lead to negative psychosocial issues such as depression, anxiety, and burnout (Patel, Wong, Cuevas, & Van Horn, 2013). no computational study (i.e., empirical models using computer simulation) has been proposed in the literature based on cognitive task performances for the participant.…”