Learning Problems in Childhood Cancer - Impact of Childhood Cancer

Impact of Childhood Cancer

Although a number of investigators have begun to examine the effects of childhood cancer on the family, the relationship between family adjustment and long-term psychosocial outcome is not well understood. The present study explored the relationship betwecn various facets of adaptation to cancer and psychosocial outcome variables asscssed in survivorhood. For 7- four children and their parents were asscssed two years after the children had completed treatment. Parental reactions to the child's illness were related to a variety of psychosocial variables. Most important, parental coping was associated with the long-term adjustment of both parents and child. Also, the amount of emotional distress that parents ex erienced was related to their ability to establish and maintain socially supportive ties with other people.

When a child is diagnosed with cancer, the family experiences great stress and disruption to daily life. As part of a national study in New Zealand, we evaluated the mental health of mothers and fathers of children with cancer, making comparisons to parents of children from the general population.

This was a cross-sectional study. All children diagnosed with cancer at ages 0–14 years in New Zealand during a defined period were ascertained from the national cancer registry and other databases. The population-based comparison children were selected using national birth records. Parents from both groups completed self-administered questionnaires containing the General Health Questionnaire (GHQ-12) and other measures. The analyses included 218 mothers and 179 fathers of children with cancer, and 266 mothers and 224 fathers of children in the comparison group. Multivariate regression was used to adjust for demographic and socioeconomic characteristics, life events, and social support.

Mothers and fathers of children with cancer had poorer GHQ-12 and mood rating scores than those of controls. The adjusted difference in the mean total GHQ-12 score (comparing mothers of children with cancer to mothers of controls) was 2.2 (95% confidence interval 1.3–3.2). The 12 items of the GHQ were each scored 0–3, and the total score was the sum, so 2 points is a small difference. For fathers the difference was 1.5 (95% confidence interval 0.6–2.4). Some subgroups of cancer group parents had poorer emotional health scores than others, including those with poor social support and no paid employment and also those who were bereaved.

We found statistically significant but small differences between the mental health of parents of children with cancer and controls. The small differences suggest that as a group the parents of children with cancer are relatively resilient. Med. Pediatr. Oncol. 35:475–483, 2000. © 2000 Wiley-Liss, Inc.