title: Parental distress during pediatric leukemia and posttraumatic stress symptoms (PTSS) after treatment ends.
abstract: OBJECTIVE
  To evaluate prospectively the association between parental anxiety during treatment for childhood leukemia and posttraumatic stress symptoms (PTSS) after treatment ends. A secondary goal is to explore concurrent variables associated with parental avoidance after treatment ends.
  
  
  METHODS
  This is a longitudinal follow-up study of 113 parents of children treated for leukemia who previously participated in a study of procedural distress during treatment. Data included parental self-report questionnaires completed during treatment and after treatment.
  
  
  RESULTS
  Using hierarchical multiple regression, we found anxiety during treatment to be a significant predictor of later PTSS for mothers, but not fathers. Anxiety, self-efficacy, posttraumatic growth and length of time since treatment ended were associated with parental avoidance.
  
  
  CONCLUSIONS
  Highly anxious parents are at risk for PTSS and may benefit from approaches that decrease anxiety during treatment and afterward. Enhancing self-efficacy related to follow-up care and identifying positive aspects of the traumatic experiences are suggested as treatment approaches for families after cancer treatment.
authors.affiliation: The Children's Hospital of Philadelphia, Pennsylvania 19104-4399, USA.
authors.forename: M
authors.initials: M
authors.lastname: Best
authors.forename: R
authors.initials: R
authors.lastname: Streisand
authors.forename: L
authors.initials: L
authors.lastname: Catania
authors.forename: A E
authors.initials: AE
authors.lastname: Kazak
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology*; D001294:Attitude to Health; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007938:Leukemia / Q000523:psychology* / Q000628:therapy; D008297:Male; D010290:Parents / Q000523:psychology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D020377:Self Efficacy; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors