Family Adjustment to Childhood Cancer: A Systematic Review

Abstract

This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer, were written in English, and were published between 1996 and 2009. Overall, qualitative findings show that families alter roles, responsibilities, and day-to-day functioning to accommodate the needs of children with cancer. Although some degree of family reorganization is normative, the extent and impact of these changes varies. Quantitative work shows that mean levels of family functioning (e.g., cohesion, flexibility) are similar between families facing cancer and normative or comparison samples. However, families follow different trajectories of improvement, decline, or stability in family closeness and marital quality. Parenting has received limited quantitative research attention, but qualitative work suggests that parents perceive deeper bonds with ill children and may spoil or overprotect them. Conclusions support future work examining the influence of family-level variables on the adjustment of individual family members.

In The Aftermath of Cancer: The Psychological Status of Adolescent Cancer Survivors and its Correlates

“…However, cancer-related distress during the adolescent hospitalization was high for both variables assessed; self-perceived distress (median = 10) and effort to cope with the situation (median = 9). According to existing literature on this topic [23], our findings revealed that parents experience great distress throughout the process and even in survivorship. Therefore, they could benefit from interventions targeted to offer support, counseling, encouragement or even to allow expression of their worries and feelings [23].…”

“…According to existing literature on this topic [23], our findings revealed that parents experience great distress throughout the process and even in survivorship. Therefore, they could benefit from interventions targeted to offer support, counseling, encouragement or even to allow expression of their worries and feelings [23]. Professionals responsible for cancer patients need to assess the impact of cancer diagnosis and treatments on parents' well-being, in order to prevent future complications and enhance positive adaptation.…”

“…Therefore, the use of such strategies could provide a certain sense of mastery and control among adolescents and modulate their self-perceived effort to cope with difficult situations impose by cancer. Additionally, resilience framework could also help to understand such results [7,9,23]. For example, having enough social support at that time could reduce the efforts of the adolescents to cope and ask for additional help (e.g., lower use of coping in relation to others).…”

“…In this sense, a certain amount of distress is normal when an individual or a relative has cancer; however, some people might be affected more than others and could start to experience high levels of distress, which would interfere with daily functioning and responsibilities [21,22]. On the one hand, if parents experience this distress, the support they provide to their child could be compromised in quantity or quality [23]. On the other hand, if the child experiences this distress, his/her coping could also be compromised and he/she could not properly adhere to treatment or other medical guidelines that are essential to the therapeutic approach [24].…”

Caring for a Child with Cancer: Impact on Mother's Health

“…Studies even have indicated the existence of the symptoms of the posttraumatic stress syndrome in mothers following treatment (Stuber et al, 1996;Kazak et al, 1997). Since 1970, many investigations have been carried out on different aspects of childhood cancer, which mostly have focused on the parent-child adaptability process (Khoury, 2013), psychological impacts of diseases on children and families (Long and Marsland, 2011), and the effects of diseases on the family system (Patterson et al, 2004;Woodgate, 2006;Tedford and Price, 2011). In the majority of these studies, psychological aspects of the disease and family-child adaptability (Khoury, 2013) have been examined but less attention has been paid to the effect of daily care of children with cancer on mothers' health.…”