Psychological Adjustment of Parents of Children with Different Cancer Prognoses

Wechsler, Amanda Muglia; Bragado-Álvarez, Carmen; Hernández-Lloreda, María José; Lopes, Luiz Fernando; Perina, Elisa Maria

doi:10.1590/1982-4327e3120

Brasil

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Psychology of Health • Paidéia (Ribeirão Preto) 31 • 2021 • https://doi.org/10.1590/1982-4327e3120 linkcopy

Psychological Adjustment of Parents of Children with Different Cancer Prognoses

Ajustamento Psicológico de Pais de Crianças com Diferentes Prognósticos de Câncer

Ajuste Psicológico de Padres de Niños con Distintos Pronósticos de Cáncer

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Little is known about the psychological adjustment of parents of children with cancer relapse or remission. This study investigated differences in the psychological adjustment of caregivers of children with different cancer prognosis, by comparing them with a control group. In total, 183 caregivers participated in this study: those with children in relapse/on treatment (n = 32), remission/off treatment (n = 75), and “healthy” (n = 76). The Beck Depression and Anxiety Inventories, the Symptom Check list-90-R, the Norbeck Social Support Questionnaire-Reviewed and the Family Environment Scale were analyzed with Variance Analysis, Student’s t-test, Chi-square and Pearson correlations. The results showed that parents of children with cancer relapse presented less psychological adjustment. Furthermore, a protective effect of family cohesion and possible risk factors related to sociodemographic variables were observed. Conclusions highlight the convenience of developing specific interventions for parents of children with cancer relapse.

Keywords: emotional adjustment; cancer in children; recurrence

Characteristic	Recurrence (n = 32)		Remission (n = 75)		Non-clinical (n = 76)
Characteristic	n	%	n	%	n	%
Gender
female	29	91	62	83	67	88
male	3	9	13	17	9	12
Marital Status
with partner	23	72	55	74	46	61
no partner	9	28	20	26	30	39
Education
primary	11	37	29	39	37	50
High school/college	19	63	46	61	37	50
Religion
religious	27	85	70	93	69	91
no religion / not reported	5	15	5	7	7	9
Diagnosis of children
leukemias	14	44	22	30	----
brain tumors	5	15	7	9	----
bone tumors	6	19	1	1	----
other tumors	7	22	45	60	----
	M	DP	M	DP	M	DP
Age	36.11	7.45	38.31	8.99	35.43	9.26
Family income	2.31	1.81	5.05	5.64	2.25	1.58
Treatment time children (months)	37.32	28.76	14.38	14.22	----
Time current sit. children (months)	5.58	7.14	62.97	27.53	----

Characteristic	Recurrence		Remission		Non-clinical		F	p	Cohen's d	ɳ²
Characteristic	M	DP	M	DP	M	DP	F	p	Cohen's d	ɳ²
BAI	16.61	11.03	14.08	13.82	13.28	14.24	0.31			0.00
BDI	14.54	10.28	10.47	10.44	13.27	10.72	0.75			0.01
Somatization (SCL)	11.10	9.00	11.61	10.65	11.79	10.08	0.05			0.00
Obs.- comp. (SCL)	14.61	9.16	10.85	8.43	10.16	6.94	3,11*	0.03 ^a	0.50 ^a	0.03
Obs.- comp. (SCL)	14.61	9.16	10.85	8.43	10.16	6.94	3,11*	0.02 ^b	0.43 ^b	0.03
Interp. sens. (SCL)	11.61	8.30	8.69	7.95	9.38	7.98	0.83			0.01
Depression (SCL)	19.19	12.17	12.13	10.70	14.07	11.54	4,18*	0.00 ^a	0.62 ^a	0.05
Anxiety (SCL)	12.39	9.17	9.18	8.02	9.37	8.27	0.73			0.01
Hostility (SCL)	4.68	4.85	4.50	4.31	5.38	5.29	0.65			0.01
Phobic Anx. (SCL)	5.48	5.69	3.96	4.75	4.63	5.18	1.01			0.01
Paran. Idea. (SCL)	7.26	5.66	4.90	4.11	5.61	4.82	2.71			0.03
Psychoticism (SCL)	7.42	6.86	6.07	6.58	7.26	7.62	0.66			0.01
GSI (SCL)	1.13	0.73	0.87	0.70	0.92	0.70	1.50			0.02
PST (SCL)	45.32	21.51	36.51	21.40	38.07	26.05	1.62			0.02
PSDI (SCL)	2.21	0.74	1.85	0.80	1.78	0.73	3,65*	0.03 ^a	0.47 ^a	0.04
PSDI (SCL)	2.21	0.74	1.85	0.80	1.78	0.73	3,65*	0.01 ^b	0.59 ^b	0.04

Characteristic	Group	1	2	3	4	5	6	7	8	9
1.BAI	RG	---
	RMG	---
	NCG	---
2.BDI	RG	.52**	---
	RMG	.70**	---
	NCG	.42**	---
3.GSI	RG	.54**	.82**	---
	RMG	.78**	.74**	---
	NCG	.52**	.80**	---
4.PST	RG	.55**	.78**	.91**	---
	RMG	.25*	.33**	.84**	---
	NCG	−.10	.29*	.89**	---
5.PSDI	RG	.47**	.56**	.77**	.48**	---
	RG	.63**	.50**	.79**	.43**	---
	RMG	.28*	.66**	.80**	.54**	---
6. Cohe. Family	RG	−.20	−.28	−.38*	−.25	−.39*	---
	RMG	−.39**	−.34**	−.43**	−.14	−.37**	---
	NCG	−.38**	−.34**	−.47**	−.13	−.20	---
7.Social support	RG	−.01	.44	−.05	.06	.01	.45*	---
	RMG	−.21	−.26*	−.20	.05	−.11	.06	---
	NCG	−.06	.09	.01	.12	.08	.28*	---
Treat. time	RG	.01	−.15	−.178	.16	−.23	.07	−.30	---
Treat. time	RMG	.01	.01	.103	.19	.02	.05	−.06	---
9. T. current sit	RG	.11	.13	.18	−.14	.22	−.06	−.25	.26	---
9. T. current sit	RMG	.12	.11	.12	.07	.18	−.01	−.05	−.07	---
10. N. rec	RG	.40	.04	.02	.22	−.04	−.09	−.04	.37*	−.07

Characteristics	Group	1	2	3	4	5	6	7	8	9	10
1.BAI
2. BDI
3. GSI
4. PST
5.PSDI
6. Age	GR	−.05	−.04	.03	.10	.10	---
	RMG	.23	.23*	.14	−.02	.21	---
	NCG	.04	-.14	−.22	−.01	−.22	---
7. Marital status	GR	−.08	.04	−.02	.09	.11	-.03	---
	RMG	−.22	−.41**	−.33**	.04	−.16	.06	---
	NCG	−.14	.02	−.05	−.05	−.01	.05	---
8. Education	GR	−.06	.09	.04	−.01	−.25	−.09	−.04	---
	RMG	−.17	−.25*	−.11	−.01	−.02	−.20	−.05	---
	NCG	−.10	.00	.15	.05	.17	−.24*	−.01	---
Family income	GR	−.34	−.20	−.20	.13	−.30	.35	.41*	.33	---
	RMG	−.24*	−.23	−.22	−.15	−.13	.07	.27*	.27*	---
	NCG	.00	−.01	.00	.06	−.02	−.21	.19	.26*	---
10. Religion	GR	.14	−.135	−.25	−.14	−.09	.18	.18	−.09	.18	---
	RMG	.00	.112	.08	.00	.09	.17	.05	−.04	−.03	---
	NCG	−.09	−.17	−.197	.08	−.15	.03	.15	.16	.10	---
11. Child age	GR	−.48**	−.36**	−.46**	.11	−.41**	.29	.03	−.06	.30	.11
	RMG	−.17	.04	.01	.04	.01	.12	−.11	.02	−.03	.03
	NCG	−.09	−.17	−.20	.08	−.15	.21	.16	−.21	.00	.11

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Universidade de São Paulo, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Programa de Pós-Graduação em Psicologia Av.Bandeirantes 3900 - Monte Alegre, 14040-901 Ribeirão Preto, Tel.: (55 16) 3315-3829 - Ribeirão Preto - SP - Brazil
E-mail: paideia@usp.br

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[TFN1] Note. Family income = monthly minimum salaries; Treatment time children = how long children were in cancer treatment; Time current sit Children = how long children have been in relapse or remission status.