Parents' attributions about childhood cancer: implications for relationships with medical staff

Abstract

Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However, the aggressiveness of therapy and uncertainty about prognosis are associated with many adverse effects, psychological as well as physical, for both the child and family. This study investigates family coping with treatment in relation to attributions about cause and responsibility for onset of the disease. We interviewed parents of 30 children with cancer (28 mothers and 23 fathers) about their attributions of causality, and perceptions of responsibility for the diagnosis and care of the child. Coping strategies which were found to be helpful were assessed using the Coping Health Inventory for Parents (CHIP). Fathers were more likely than mothers to accept that there was no known cause for the child's illness. Fathers who blamed doctors for failing to diagnose the condition found medical staff less helpful up to 2 years later. The theoretical importance of blaming others more than oneself is discussed, along with practical implications for services in paediatric oncology.

Adjustment and coping by parents of children with cancer: a review of the literature

“…Bearison et al [7] found that internal types of attribution, and especially self-blame were reported most often. Eiser et al [18] also found self-blame to be a common attribution for mothers. Fathers were more likely than mothers to accept that there was no reason for the child's illness [18].…”

“…Communication with the medical staff is one of the three scales of the CHIP. Brown et al [10] found that parents often relied on understanding the medical situation through communication with the medical staff, while Eiser et al [18] found the contrary. They found that both mothers and fathers gave much lower ratings to the helpfulness of social support/information compared with the other three strategies measured with the CHIP.…”

How do parents perceive high-dose chemotherapy and autologous stem cell transplantation for their children

“…21 It partly depends on the way children experience the treatment and its physical effects, 22 but also on the way their parents cope with this situation, 4 and on the quality of the staff-parentspatient relation. 23,24 However, the parents' confidence and ability to cope are also linked to their capacity to understand the doctors' explanations, which is also linked to their ambivalence towards them and towards the treatment.…”

Enfrentamento entre cuidadores de pacientes pediátricos em tratamento de leucemia

“…Na literatura internacional sobre estratégias de enfrentamento adotadas por cuidadores em contexto onco-hematológico pediátrico, uma parte dos estudos focaliza a investigação de estratégias por meio do relato dos pais (Beltrão & cols., 2007;Goldbeck, 1998;Greening & Stoppelbein, 2007;Herman, 2007;Holm, Patterson & Gurney, 2003;James & cols., 2002;Munet-Vilaró, 1984;Norberg & cols., 2005;Patistea, 2005;Patistea, Makrodimitri & Pantelli, 2000;Rodrigues, Rosa, Moura & Baptista, 2000), enquanto outros trabalhos focalizam os processos psicológicos indicativos das estratégias de enfrentamento (Clarke-Steffen, 1997;Eiser, Havertnans & Elser, 1995;Elkin & cols., 2007;Enskär, Carlsson, Golsäter, Hamrin & Kreuger, 1997;Felder-Puig, Gallo, Waldenmair, Gadner & Topf, 2004;Hoekstra--Weebers, Jaspers, Kamps & Klip, 1998;Klassen & cols., 2007;Sloper, 2000;Steele, Long, Reddy, Luhr & Phipps, 2003;Tarr & Pickler, 1999;Trask & cols., 2003). Os principais resultados de ambos os tipos de estudo serão descritos a seguir.…”

“…Algumas pesquisas indicam o uso intenso de estratégias de enfrentamento focalizadas no problema ou manejo do estressor, que envolvem busca por informações sobre doença e tratamento, controle da medicação e procedimentos médicos, vigilância sobre o estado de saúde da criança, planejamento de metas, cumprimento de recomendações médicas, redefinição cognitiva do problema (por exemplo, comparar a situações piores), organização da rotina, comunicação com a equipe, reorganização de papéis familiares, explicações à criança sobre o tratamento, conformação com a doença e negociações com a equipe médica (Clarke--Steffen, 1997;Eiser, Havertnans & Elser, 1995;Enskär, Carlsson, Golsäter, Hamrin & Kreuger, 1997;Goldbeck, 1998;Greening & Stoppelbein, 2007;Holm, Patterson & Gurney, 2003;James & cols., 2002;Munet-Vilaró, 1984;Norberg & cols., 2005;Patistea, 2005;Rodrigues, Rosa, Moura & Baptista, 2000;Steele, Long, Reddy, Luhr & Phipps, 2003;Tarr & Pickler, 1999;Trask & cols., 2003).…”