Relationship Between Caregiver Uncertainty, Problem-Solving, and Psychological Adjustment in Pediatric Cancer

Abstract

Objective The current study examined the roles of constructive and dysfunctional problem-solving strategies in the relationships between illness uncertainty and adjustment outcomes (i.e., anxious, depressive, and posttraumatic stress symptoms) in caregivers of children newly diagnosed with cancer. Methods Two hundred thirty-eight caregivers of children (0–19 years of age) newly diagnosed with cancer (2–14 weeks since diagnosis) completed measures of illness uncertainty, problem-solving strategies, and symptoms of anxiety, depression, and posttraumatic stress. Results A mediation model path analysis assessed constructive and dysfunctional problem-solving strategies as mediators between illness uncertainty and caregiver anxious, depressive, and posttraumatic stress symptoms. Dysfunctional problem-solving scores partially mediated the relationships between illness uncertainty and anxious, depressive, and posttraumatic stress symptoms. Constructive problem-solving scores did not mediate these relationships. Conclusions The current findings suggest that illness uncertainty and dysfunctional problem-solving strategies, but not constructive problem-solving strategies, may play a key role in the adjustment of caregivers of children newly diagnosed with cancer. Interventions aimed at managing illness uncertainty and mitigating the impact of dysfunctional problem-solving strategies may promote psychological adjustment.

Designing and validating novel communication measures for pediatric, adolescent, and young adult oncology care and research: The PedCOM measures

“…Parents and children can experience worsened mental health during and after cancer treatment. 37,38 Furthermore, parents have to navigate their child's multiple healthcare needs, care for other family members, maintain employment, and meet financial challenges of cancer care. 39,40 Furthermore, long-term worries can negatively affect peace of mind long after completion of cancer therapy.…”

“…These negative correlations are especially interesting, because they suggest that better communication could ease caregiver burden and decrease anxiety for patients and parents. Parents and children can experience worsened mental health during and after cancer treatment 37,38 . Furthermore, parents have to navigate their child's multiple healthcare needs, care for other family members, maintain employment, and meet financial challenges of cancer care 39,40 .…”

A qualitative examination of the benefits and challenges of a psychosocial screening intervention in pediatric oncology: “Support comes to us”

“…old male] as a potential solution may have allowed caregivers to take back some of their power and their sense of control over what had seemed uncontrollable. 19,20 EPSI was perceived as valuable and convenient, as well as personally helpful gaining a sense of control, which is often lost during childhood cancer treatment as families face numerous uncontrollable stressors. 21 Feeling cared for and listened to give caregivers and youth a sense of self-worth that comes from feeling valued by others.…”

“…Feeling empowered by receiving information on psychosocial resources and services in the hospital and community was an additional benefit, even when they often admitted that they had not used the recommended resources. The simple act of learning about resources and having them in their “back pocket” [mother of 17‐year‐old male] as a potential solution may have allowed caregivers to take back some of their power and their sense of control over what had seemed uncontrollable 19,20 …”

Development and Theoretical Underpinnings of the PRIORITY Intervention: A Parenting Intervention to Prevent Disordered Eating in Children and Young People With Type 1 Diabetes

“…The skills and techniques that the intervention uses to prevent T1DE drew on cognitive behavioural techniques such as cognitive restructuring and problem solving. Conflict resolution and managing family identity alongside T1D, identified through systemic literature and the co-design approach were also included ( 5 , 51 , 52 ). These are embedded alongside character scenarios which ask parents to consider key questions to reflect on the character/their own experiences.…”