title: Serious illness in childhood: the different threats of cancer and diabetes from a parent perspective.
abstract: OBJECTIVE
  To compare the incidence of disease-related distress symptoms in parents of children with cancer and diabetes.
  
  
  METHODS
  A total of 675 parents of patients with cancer, patients with diabetes, and control subjects were assessed for 11 distress symptom clusters. Patient and control parent mean differences were tested by 2-tailed t tests; illness groups were compared by means of analysis of variance. Distress variations as a function of time since diagnosis were examined by regression analysis.
  
  
  RESULTS
  The distress levels of patient parents exceeded those of control parents for global distress ( P <.0001) and for most symptom subcategories. Distress levels of parents of patients with cancer (CP) significantly exceeded those of parents of patients with diabetes (DP) in anxiety ( P <.0001), physical and psychologic distress ( P <.0001), depression ( P <.005), and loneliness ( P <.05). Levels in DP matched those of CP in uncertainty, loss of control/the patient, self-esteem, disease-related fear, and sleep disturbances. Distress levels were lower in CP most distant in time from diagnosis, whereas DP showed a reversed trend.
  
  
  CONCLUSIONS
  Parental distress patterns in childhood illness depend on illness type and time passed since diagnosis. Symptom profiles verify the need for psychosocial attention at the initial shock after the cancer diagnosis and indicate long-term consequences for many parents. In pediatric diabetes, the persistence or intensification of distress over time is of specific clinical relevance.
authors.affiliation: Department of Woman and Child Health, Childhood Cancer Research Unit, Karolinska Institutet, S-171 76 Stockholm, Sweden. krister.boman@kbh.ki.se
authors.forename: Krister K
authors.initials: KK
authors.lastname: Boman
authors.forename: Jonas
authors.initials: J
authors.lastname: Viksten
authors.forename: Per
authors.initials: P
authors.lastname: Kogner
authors.forename: Ulf
authors.initials: U
authors.lastname: Samuelsson
mesh_terms: D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms; D010290:Parents / Q000523:psychology*; D011610:Psychosocial Deprivation; D013315:Stress, Psychological / Q000209:etiology*; D013997:Time Factors