title: Coming to terms: parents' response to a first cancer recurrence in their child.
abstract: The purpose of this study was to explore, using grounded theory, the process experienced by parents who are dealing with the first recurrence of cancer in their child. The sample of 33 guardians (27 mothers, 1 grandmother, and 5 fathers) was drawn from three pediatric oncology settings. Data were collected through interviews, observations, and medical record review. Thirteen parents were interviewed to validate first the evolving and, later, the complete study findings. Four interactive components emerged: regulating shock, situation monitoring, alternating realizations, and eyeing care-limiting decisions. The overall organizing construct induced from these components was labeled "coming to terms." This construct represents the parents' efforts to overcome shock and despair to make wise decisions about treatment while accepting that the outcome if beyond their control, and to help their child have the optimal chance for cure while preparing for the child's possible death.
authors.affiliation: St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Hinds
authors.forename: L K
authors.initials: LK
authors.lastname: Birenbaum
authors.forename: L
authors.initials: L
authors.lastname: Clarke-Steffen
authors.forename: A
authors.initials: A
authors.lastname: Quargnenti
authors.forename: S
authors.initials: S
authors.lastname: Kreissman
authors.forename: A
authors.initials: A
authors.lastname: Kazak
authors.forename: W
authors.initials: W
authors.lastname: Meyer
authors.forename: R
authors.initials: R
authors.lastname: Mulhern
authors.forename: C
authors.initials: C
authors.lastname: Pratt
authors.forename: J
authors.initials: J
authors.lastname: Wilimas
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D003657:Decision Making; D003674:Defense Mechanisms; D005260:Female; D006117:Grief; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D015404:Nursing Methodology Research; D010290:Parents / Q000523:psychology*; D011795:Surveys and Questionnaires