title: The influence of pediatric cancer diagnosis and illness complication factors on parental distress.
abstract: OBJECTIVE
  We investigated how primary diagnosis and risk for diagnosis-related complication factors influence parental distress after a child's cancer diagnosis.
  
  
  METHODS
  We used a model in which "complicated childhood cancers" were grouped into 1 category, after identifying a set of potentially influential illness complication variables. This category included central nervous system tumors, acute myeloid leukemia, and bone tumors. Parental distress in that category (n=144) was compared with distress after acute lymphoblastic leukemia (n=177) in the child. In addition, comparisons were made between parents of the specific diagnosis groups. A multidimensional questionnaire assessing symptoms of distress was used.
  
  
  RESULTS
  Parents in the complicated cancer category showed significantly heightened disease-related fear, anxiety, depression, loss of control, late effects-related uncertainty, and poorer self-esteem compared with parents of children with acute lymphoblastic leukemia. Significantly heightened parental distress was associated with the child having been treated with cranial irradiation.
  
  
  CONCLUSIONS
  Relatively heightened distress in parents of children with complicated cancer is influenced by diagnosis-related factors like an intricate prediagnostic phase, and uncertainty about late effects. Heightened vulnerability to distress signals exceptional needs for support and information among parents of children treated for central nervous system or bone tumors.
authors.affiliation: Childhood Cancer Research Unit, Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Emma
authors.initials: E
authors.lastname: Hovén
authors.forename: Malin
authors.initials: M
authors.lastname: Anclair
authors.forename: Ulf
authors.initials: U
authors.lastname: Samuelsson
authors.forename: Per
authors.initials: P
authors.lastname: Kogner
authors.forename: Krister K
authors.initials: KK
authors.lastname: Boman
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007389:Internal-External Control; D008297:Male; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013997:Time Factors