Patterns of distress in parents of children undergoing stem cell transplantation

Abstract

Parents (N = 151) of children undergoing bone marrow or stem cell transplantation (BMT) were assessed in a prospective, longitudinal design with repeated measures of distress (mood disturbance, perceived stress, caregiver burden). Parents were assessed weekly from admission for BMT (week-1) through week +6 post-BMT, followed by monthly assessments through month +6. Concurrent measures of child distress (somatic distress, mood disturbance) were also obtained by parent and child report. Parents demonstrate modest, but significant elevations in distress, particularly during the early period from admission through week +3. Elevations in parental distress are transient, and appear to be largely resolved by 4-6 months post-BMT. Parental distress was unrelated to child age, gender, diagnosis, or type of transplant, but was significantly related to parental socioeconomic status (SES). Parents from lower SES backgrounds reported greater levels of distress throughout the BMT process. Moderate correlations were observed between measures of parent and child distress, and level of child distress at the time of admission for BMT was predictive parental distress trajectories across the acute phase of BMT. These findings point to appropriate targets for intervention to reduce transplant-related distress.

Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT

“…13 Time since SCT has been associated with parental distress; the more time elapsed since SCT, the lower the stress levels. 4 The effect of objective medical factors on parental stress levels seems to be small; 5,14,15 the subjective appraisal of these factors seems to be more predictive of parental distress. Comparisons between parents of children with a malignant versus a non-malignant disease have not so far been reported.…”

“…[1][2][3] Previous research has shown that before SCT and during the acute phase of SCT, many parents report heightened anxiety, depressive symptoms, parenting stress and general distress, which subsides in the majority of parents between 3 and 12 months after SCT. [4][5][6][7] Most studies have focused on parental stress and adjustment before SCT, during the acute phase and 12-18 months after SCT. To our knowledge, only one (qualitative) study 8 focused on long-term parental distress.…”

“…4 Furthermore, younger mothers reported higher levels of distress than older mothers. 13 Time since SCT has been associated with parental distress; the more time elapsed since SCT, the lower the stress levels.…”

Differences in mothers’ and fathers’ psychological distress after pediatric SCT: a longitudinal study

“…16 The longitudinal studies addressing parental distress after SCT are mainly for mothers. [17][18][19][20][21] In summary, the current literature is inconclusive regarding parental gender differences and psychological distress, and related factors after pediatric SCT. This may be due to reports based on small samples, different assessment tools and follow-up period.…”

“…13,22 Guided by the multivariable model for the impact of chronic illness in the family we adapted in our previous work [22][23][24] and current empirical evidence with parents facing pediatric cancer and SCT, 3,7,13,22 we also examined the association between parental psychological distress and parental age; disease (diagnosis) and treatment variables (radiation history), and child's age, health status and behavior. Again, based on previous reports on mothers facing childhood cancer, 12,13,18,19,21 we hypothesized that (a) psychological distress will decrease over time for both mothers and fathers; (b) mothers will report more distress than fathers; (c) younger parents will report greater distress, and given that mothers are typically the primary caregiver; (d) child's disease, treatment, health status and behavior will have greater impact on maternal than paternal outcomes.…”