Stress and marital adjustment in families of children with cancer

Lavi, Iris; Fladeboe, Kaitlyn; King, Kevin M.; Kawamura, Joy; Friedman, Debra L.; Compas, Bruce E.; Breiger, David; Gurtovenko, Kyrill; Lengua, Liliana J.; Katz, Lynn Fainsilber

doi:10.1002/pon.4661

Cited by 16 publications

(12 citation statements)

References 40 publications

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“…Similar findings have been previously observed in parents of cancer-free children 6 . Higher economic strains have been shown to be related to worse marital adjustment in families of children with cancer 24 . Parents with lower socio-economic position may be more often engaged in less flexible work arrangements 25,26 and burdened by combining childcare and work-related obligations which may strain the parental relationship.…”

Section: Discussionmentioning

confidence: 99%

The impact of childhood cancer on parental separation, divorce, and family planning in Denmark

Mader

Hargreave

Frederiksen

et al. 2020

Cancer

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Background: Childhood cancer is a devastating experience for the family. We aimed to assess the impact of having a child with cancer on parental separation, divorce, and future family planning in Denmark. Methods:We conducted a nationwide cohort study using Danish registry data. Parents of children diagnosed with cancer in 1982-2014 (n=7066 children, n=12418 case parents) were matched with ten comparison parents of cancer-free children (n=69993 children, n=125014 comparison parents). We used discrete-time Cox regression models to compare the risk of separation (end of cohabitation) and divorce between case and comparison parents, and to identify risk factors of separation and divorce among case parents only. Descriptive statistics were used to compare family planning between case and comparison parents.Results: Case parents had a slightly lower risk of separation (HR=0.96, 95%-CI: 0.93-0.99) and divorce (HR=0.92, 95%-CI: 0.87-0.97) than comparison parents. We found that case parents aged <45 years, with short education, and who were unemployed were at increased risk of separation and divorce. Moreover, parents of children diagnosed with cancer at a young age (aged <15 years) were more likely to separate or divorce. We observed no differences in the total number of children and time to next child after the cancer diagnosis between case and comparison parents. Conclusions:Having a child with cancer was not associated with an overall adverse impact on parents' risk of separation or divorce and future family planning. These encouraging findings should be communicated to parents to support them along their child´s cancer trajectory.

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Section: Discussionmentioning

confidence: 99%

The impact of childhood cancer on parental separation, divorce, and family planning in Denmark

Mader

Hargreave

Frederiksen

et al. 2020

Cancer

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“…Children with cancer need more attention from family members and this may have its own inherent difficulties, particularly in families having more than one child. Parents of children with cancer may be going through significant marital stress, the degree of which may be related to the perceived level of threat due to the cancer and the number of negative events during the course of treatment [55]. Research also indicates that siblings of young patients may require psychological support [56].…”

Section: Looking After the Emotional Needs Of Siblings And Parentsmentioning

confidence: 99%

What do you need to learn in paediatric psycho-oncology?

Datta

Saha

Ojha

et al. 2019

ecancer

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Paediatric psycho-oncology is an evolving speciality and is increasingly being recognised as an essential component in children’s cancer care. Modern paediatric oncology services aspire to integrate physical care with psycho-social care and build capacity within clinical teams to address the emotional needs of parents and children side by side with other aspects of medical care. This article discusses the unique challenges of paediatric psycho-oncology and common situations where psychological assessment and management of children and young people with cancer become especially important. The authors propose a tiered structure of training. Providing empathic evidence-based psycho-social care is ‘everyone’s business’ in paediatric oncology and not merely that of mental health professionals. However, there are times when a more specialist intervention by a paediatric liaison psychiatrist and/or a clinical psychologist is needed for optimum outcome. Learning interviewing techniques suitable for children and adolescents should be a core part of the training in paediatric psycho-oncology. Professionals should be encouraged to reflect on their own emotional wellbeing, which in turn will provide a stable foundation of emotionally matured care to children, young people and their families.

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“…In addition to direct relationships between caregiver depression and family interactions involving children, Goodman and Gotlib's model also posits that functioning of the marital dyad, which is frequently compromised with caregiver depression, is a powerful mediator between caregiver depression and child adjustment 8 . While some previous work has examined marital functioning and conflict following a child's cancer diagnosis, 6,15–17 little has investigated downstream effects of marital functioning on children in the context of pediatric cancer. In one notable exception, conflict in the marital dyad was found to spill over into the parent‐child dyad, increasing difficulty in the child's relationship with their PC 18 …”

Section: Introductionmentioning

confidence: 99%

Primary and secondary caregiver depressive symptoms and family functioning following a pediatric cancer diagnosis: an exploration of the buffering hypothesis

et al. 2021

Self Cite

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Objective After diagnosis, caregivers of children with cancer, particularly mothers or primary caregivers (PCs), often show elevated depressive symptoms which may negatively impact family functioning. We tested PC and secondary caregiver (SC) depressive symptoms as predictors of family, co‐parenting, and marital functioning and whether having a non‐depressed SC buffers against potential negative effects of PC depressive symptoms. Methods Families (N = 137) were recruited from two major children's hospitals following a diagnosis of pediatric cancer. Caregivers completed self‐report measures of depressive symptoms (Center for Epidemiological Studies‐Depression Scale; Depression, Anxiety, and Stress Scale) and marital functioning (Dyadic Adjustment Scale) at 1‐month post‐diagnosis. A subset of families (n = 75) completed videotaped interaction tasks at approximately 3‐months post‐diagnosis that were coded for family and co‐parenting interactions. Results Higher PC depressive symptoms at 1‐month post‐diagnosis was associated with higher adaptability and lower conflict in family functioning. PC depressive symptoms were also associated lower dyadic consensus and lower dyadic satisfaction. SC depressive symptoms were not significantly associated with any family/co‐parenting/marital functioning variables. Significant interaction analyses suggested that SC depressive symptoms moderated the effect of PC depressive symptoms on family cohesion, withdrawn parenting, and affective expression in the marriage, such that the relationship between PC depressive symptoms and poorer functioning was attenuated when SC depressive symptoms were at low or average levels. Conclusions Having a nondepressed SC buffered against negative effects of PC depressive symptoms on certain domains of family, coparenting, and marital functioning. SCs may play a protective role for families of children with cancer.

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Stress and marital adjustment in families of children with cancer

Abstract: Implications for identification of at-risk families are discussed, and importance of delivering tailored interventions for this population.

Cited by 16 publications

References 40 publications

The impact of childhood cancer on parental separation, divorce, and family planning in Denmark

The impact of childhood cancer on parental separation, divorce, and family planning in Denmark

What do you need to learn in paediatric psycho-oncology?

Primary and secondary caregiver depressive symptoms and family functioning following a pediatric cancer diagnosis: an exploration of the buffering hypothesis

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