title: How children cope when a parent has advanced cancer.
abstract: OBJECTIVE
  When parents are diagnosed with cancer, children experience significant distress. There is little information regarding the nature of this distress and how children cope, particularly when a parent is diagnosed with advanced cancer. This study aimed to explore how children cope, and to identify areas where there may be barriers to children accessing support to enable them to cope.
  
  
  METHODS
  Semi-structured interviews were conducted with ill parents with advanced cancer and well parents and/or any children above the age of 7. Interviews were recorded and transcribed fully, and analysed using a constructionist grounded theory approach.
  
  
  RESULTS
  Twenty-eight family participants were interviewed. Four major themes emerged from the data including response to diagnosis, mechanisms of coping, life changes, and positive aspects. Children described being distressed by their parents diagnosis and having concerns related to their parents and their own health. Distraction and maintaining normality were described as the dominant strategies of coping for children, and increased responsibilities and decreased social activity were considered to be the most noticeable of life changes. Parents did not recognise the impact on children to the same degree as described by children and focused on limiting the impact by maintaining normality. Positive aspects described by children and parents included strengthening of relationships and learning to value family members and the important things in life.
  
  
  CONCLUSIONS
  Open communication within the family may lead to more effective coping and a positive experience for children whose parents have been diagnosed with advanced cancer.
authors.affiliation: Academic Palliative and Supportive Care Studies Group, School of Population, University of Liverpool, Liverpool L69 3GB, UK.
authors.forename: Vida L
authors.initials: VL
authors.lastname: Kennedy
authors.forename: Mari
authors.initials: M
authors.lastname: Lloyd-Williams
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001293:Attitude to Death; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D003142:Communication; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010287:Parent-Child Relations; D011340:Problem Solving; D011379:Prognosis; D012737:Sex Factors; D012941:Social Responsibility