Surviving Childhood Cancer: Quality of Life and Parental Regulatory Focus

Abstract

Applying Regulatory Focus Theory (RFT), the authors predicted that among survivors of childhood cancer, quality of life (QOL) may be compromised by prevention-focused parenting characterized by an overly protective concern with possible mishaps and illness recurrence rather than promotion-focused parenting encouraging expectations of recovery and a normal life. Interviews with parents of 64 survivors (M age = 13.83 years) of acute lymphoblastic leukemia (ALL) or central nervous system (CNS) tumors were coded for reports of promotion or prevention-oriented parenting and positive and negative expectancies. Overall, parents expressed more promotion than prevention focus, especially in relation to general rather than illness-related contexts. Greater use by parents of prevention focus in general contexts predicted lower QOL for survivors (as rated both by parents and survivors themselves) and less satisfactory parental well-being. These effects were independent of a main effect for type of cancer, with survivors of ALL having higher QOL.

Unfair treatment and self-regulatory focus

“…Initial and indirect evidence suggests that prevention strategies coupled with an unfair situation undermines psychological wellbeing: Eiser, Eiser, and Greco (2004) showed that parental use of prevention-focused strategies in coping with a cancer-survivor child predicted dampened wellbeing for both parent and child. Ayduk, May, Downey, and Higgins (2003) showed that prevention-focused and rejection sensitive individuals were prone to use covert strategies to cope with rejection.…”

Identifying determinants of quality of life of children with cancer and childhood cancer survivors: a systematic review

“…The most consistent finding was that central nervous system (CNS) or brain tumor patients on treatment and survivors had poorer QOL compared with patients with either leukemia or lymphoma [12,23,25,26,38,39,59,65]. One publication showed poorer overall QOL, as well as more emotional distress and treatment discomfort on the Pediatric Oncology Quality of Life Scale (POQOLS), in a sample of solid tumor patients (including brain tumor patients) when compared with a group of patients with leukemia or lymphoma [17].…”

“…The most frequently studied variable was type of cancer, which was found to be related to child QOL in 15 [12,13,15,17,23,25,26,32,38,39,46,52,59,64,65] of 30 publications where it was assessed. The most consistent finding was that central nervous system (CNS) or brain tumor patients on treatment and survivors had poorer QOL compared with patients with either leukemia or lymphoma [12,23,25,26,38,39,59,65].…”

“…Parental health and well-being, measured with a range of validated instruments, represents the most commonly studied family subtheme studied in relation to child"s QOL [23,24,32,36,37,42,54,56,62]. Symptoms of anxiety [42], depression [23,42,56] and psychological distress [36,37], and parental QOL [23,24] were related to poorer child QOL.…”

“…Symptoms of anxiety [42], depression [23,42,56] and psychological distress [36,37], and parental QOL [23,24] were related to poorer child QOL. One study found that parents with a [15-17, 29, 38, 47-49, 54, 56-61, 66] 0 0 1 5 1 5 1 6 Type of treatment [12, 15, 26, 33, 36, 37, 39-41, 45, 52, 53, 65] 4 2 1 7 13 Time since diagnosis [15,17,22,25,42,47,50,52,64,65] 3 0 3 6 1 0 Treatment intensity [32,36,37,47,[51][52][53]65 [11, 15, 17, 24-26, 29, 31, 32, 36-40, 42, 43, 47, 50-53, 55, 56, 59, 64, 65, 67, 68] Gender [15, 17, 24-26, 30-32, 36-40, 43, 44, 46, 47, 50-53, 56, 59, 61, 64, 65, 68] [23,24,32,36,37,42,54,56,62] 3 3 1 7 9 Socioeconomic status [32,38,40,43,51,52,68] …”