Children of cancer patients: Prevalence and predictors of emotional and behavioral problems

Abstract

BACKGROUND: Children of patients with cancer are at increased risk for developing emotional and behavioral problems. This study explored the prevalence and predictors of emotional and behavioral problems in children of cancer patients in a multisite research project. METHODS: A cross-sectional sample of N 5 235 families was recruited simultaneously in 5 university medical centers. The participants, including parents (N 5 402) and children (N 5 324; ages 11-21 years) completed standardized questionnaires. Emotional and behavioral problems in children were measured by the Strengths and Difficulties Questionnaire (SDQ). On the basis of previous research and using a mixed-model approach, child-, parent-, family-and cancer-related variables were examined in addition to socioeconomic status as potential predictors. Descriptive statistics and a multiple random coefficient model were used in the analyses. RESULTS: Compared to norms, children of cancer patients show increased mean levels of emotional and behavioral symptoms. The best predictor of emotional and behavioral problems from the perspectives of the child, the healthy parent, and the ill parent was general family dysfunction. Although family dysfunction was identified as the main predictor, the analysis revealed that the main part of variance was related to the individual child's level. CONCLUSIONS: The results indicate that screening for child mental health problems and family dysfunction in oncological and psychosocial treatment units can identify the families most in need of psychosocial support. Psychological services need to be both family-oriented and child-centered and focus on family dysfunction to prevent mental health problems in children.

The well-being of children impacted by a parent with cancer: an integrative review

“…Their distress is likely due to their vulnerability and reliance on positive family functioning [8,9] and concerns about the parent's survival and the family's future [7]. Distress can lead to emotional and psychosocial problems [6], such as problematic internalization (e.g., depressive mood states) or externalization (e.g., aggression, delinquency) of behavior [9,10].…”

When a parent has cancer: How does it impact on children's psychosocial functioning? A systematic review

“…Ill parents also reported significantly higher levels of internalising, externalising and total problems for their male children compared to the general population. Only in Möller and colleagues study (), both healthy and ill parents reported more emotional and behavioural problems in younger children than adolescents, independently from gender.…”

“…Eleven studies have shown that emotional and/or behavioural problems increased in most children and adolescents during their parent's illness (Compas, Worsham, Ey, & Howell, ; Compas et al., ; Costas‐Muñiz, ; Gazendam‐Donofrio et al., ; Grant & Compas, ; Krattenmacher et al., ; Küçükoĝlu & Çelebioĝlu, ; Möller et al., ; Thastum et al., ; Visser et al., ; Watson et al., ; Welch, Wadsworth, & Compas, ), while prevalence of social problems was more or less comparable to normative groups across studies. Percentages of clinically significant emotional and behavioural symptoms ranged from 7% (Möller et al., ) to 20% (Visser et al., ) in children under the age of 11, while in preadolescents and adolescents, the presence of symptoms ranged from 23% (Visser et al., ) to 30% (Edwards et al., ). Assumption of risky behaviours in adolescents ranged from 3% to 23% and was more or less comparable to scores in the normative group (Jantzer et al., ).…”

Kayıp ve Yas Sürecinde Kardeşler

“…36 Sevdikleri insanın ölümünü deneyimleyen kardeşlerde dürüst ve açık bir iletişim onu desteklemede önemlidir. 28,29,37,38,39 Yas sürecinde tüm yaştaki çocuklar, güven ortamı içinde, sü-reçle ilgili soru sorabilme ve paylaşımda bulunmaya gereksinim duyarlar. Ancak, bu gereksinim erişkinlerin çocukları olumsuz haberlerden koruma gerekçesi ile karşılanamamaktadır.…”

“…Literatür ebeveynlerin bu konuda hemşireler tarafından desteklenmeleri gerektiğini belirtirken, 37,38,50,51 çoğu hemşire bu konuda eği-timlerinin yetersiz olması nedeniyle bu rehberliği sağlamada çekinik davranmaktadır. 39,42,43,49,51 Hemşireler ve ebeveynler, yas yaşayan çocukla iletişimde şunlara dikkat etmelidir: 1) Hasta kardeşin hastalığı ile ilgili bilgiler erken dönemde açık ve dürüst bir şekilde açıklanmalı-dır. 2) Kelimelerin yaratacağı etki unutulmamalı, bu nedenle kanser ve ölüm gibi kelimeler seçilirken dikkatli olunmalıdır.…”