Child and parental adaptation to pediatric oncology Vrijmoet-Wiersma, J.

Citation

Vrijmoet-Wiersma, J. (2010, January 14). Child and parental adaptation to pediatric oncology. Retrieved from https://hdl.handle.net/1887/14561

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Review article Stress reactions of parents of pediatric cancer patients Chapter 2 Cross sectional study PIP: Psychometric qualities, parents of children with cancer Chapter 3 Review article Stress reactions of parents of SCT patients Chapter 4 Longitudinal study Stress of parents and HRQoL of children pre- post-SCT Chapter 5 Cross sectional study Stress reactions of parents 5/10 years post-SCT Chapter 6 Cross sectional study Sequelae in children with LCH Chapter 7 Participants/ Number of articlesn = 67 articlesn = 100 mothers, n = 74 fathers

n = 18 articlesn = 19 mothers n = 12 fathers n = 21 children n = 38 mothers n = 35 fathers

n = 24 children Characteristics of the childrenChildren with cancerChildren diagnosed with cancer 1-18 moths ago (80% on treatment), mean age 9.6

Children who underwent SCT Children who underwent SCT with heterogeneous diagnoses. Mean age at fi rst assessment 11.0 Children who underwent SCT 5 or 10 years ago with miscellaneous diagnoses. Mean ages 13.4 and 16.6 v

Children with LCH. 21% CNS involvement, 30 % Diabetes Mellitus, 67% chemotherapy. Mean age 11.9 Assessment instrumentsn.a.PIP, STAI, PSI-SF, GHQn.a.DUX 25 (child and parent form), PSIPIP-SF, GHQ, CVSDUX 25, LCH-DUX, WISC III subtests, CBCL/TRF/YSR OutcomeMost emotional stress reactions were reported around diagnosis, i.e. anxiety, depressive symptoms, PTSS and uncertainty. Most parents seem resilient. A subset of parents reports continuing stress.

The Dutch PIP has adequate (test-retest) reliability and validity. Evidence was found for the four-factor model and the one-factor model.

Highest levels of parental stress are reported in the period preceding SCT and during the acute phase of SCT. Stress subsides in the majority of parents 3-6 months post-SCT.

Diminished HRQoL with regards to home functioning, not on other domains. Higher levels of parenting stress, on average 10 months post- SCT. Parents felt less competent as a parent, post-SCT.

40% mothers 5 years post- SCT reported elevated stress levels. High levels of perceived vulnerability: 94% after 5 years, 76% after 10 years for both mothers and fathers.

Lower physical HRQoL More internalizing problems Miscellaneous cognitive problems. Visual short term memory was affected in many children. Special education: 25% Risk factors- High levels of stress at diagnosis - Lower SES - Trait anxiety - Child behavior problems - Less perceived social support - Traumatic life events

- Parents of children on treatment - Less time since diagnosis - Higher paternal age - Lower child age

- High levels of stress during SCT - Avoidant coping - Lack of support - Pre-existing stress - Younger maternal age - Lower SES - ICU transfers - Child mood disturbance - Older children (lower HRQoL) - High perceived child demandingness (higher parenting stress)

- Parents of children with a malignant disease - Higher paternal age - Being non-Dutch - Higher perceived vulnerability - Older age - Children with Diabetes Insipidus, other CNS involvement and children who have had chemotherapy

Table 1. Overview of studies presented in this thesis

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