title: Peace of mind and sense of purpose as core existential issues among parents of children with cancer.
abstract: OBJECTIVE
  To evaluate issues experienced by parents of children with cancer and factors related to parents' ability to find peace of mind.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Dana-Farber Cancer Institute and Children's Hospital, Boston, Massachusetts.
  
  
  METHODS
  One hundred ninety-four parents of children with cancer (response rate, 70%) in the first year of cancer treatment.
  
  
  METHODS
  The Functional Assessment of Chronic Illness Therapy-Spiritual Well-being sense of meaning subscale.
  
  
  RESULTS
  Principal components analysis of Functional Assessment of Chronic Illness Therapy-Spiritual Well-being sense of meaning subscale responses identified 2 distinct constructs, peace of mind (Cronbach alpha = .83) and sense of purpose (Cronbach alpha = .71). Scores ranged from 1 to 5, with 5 representing the strongest sense of peace or purpose. One hundred forty-seven of 181 parents (81%) scored 4 or higher for questions related to sense of purpose (mean [SD] score, 4.4 [0.6]). Only 44 of 185 parents (24%) had scores in the same range for peace of mind (mean [SD] score, 3.2 [0.9]) (P < .001). In a multivariable logistic regression model, parents had higher peace of mind scores when they also reported that they trusted the oncologist's judgment (odds ratio [OR] = 6.65; 95% confidence interval [CI], 1.47-30.02), that the oncologist had disclosed detailed prognostic information (OR = 2.05; 95% CI, 1.14-3.70), and that the oncologist had provided high-quality information about the cancer (OR = 2.54; 95% CI, 1.11-5.79). Peace of mind was not associated with prognosis (OR = 0.74; 95% CI, 0.41-1.32) or time since diagnosis (OR = 1.00; 95% CI, 0.995-1.003).
  
  
  CONCLUSIONS
  Physicians may be able to facilitate formulation of peace of mind by giving parents high-quality medical information, including prognostic information, and facilitating parents' trust.
authors.affiliation: Department of Medicine, Children's Hospital, Boston, Massachusetts, USA. jennifer_mack@dfci.harvard.edu
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Mack
authors.forename: Joanne
authors.initials: J
authors.lastname: Wolfe
authors.forename: E Francis
authors.initials: EF
authors.lastname: Cook
authors.forename: Holcombe E
authors.initials: HE
authors.lastname: Grier
authors.forename: Paul D
authors.initials: PD
authors.lastname: Cleary
authors.forename: Jane C
authors.initials: JC
authors.lastname: Weeks
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001900:Boston; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003430:Cross-Sectional Studies; D003469:Culture; D003625:Data Collection; D005086:Existentialism; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D009042:Motivation; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010290:Parents / Q000193:education / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011368:Professional-Family Relations; D011379:Prognosis; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D029181:Spirituality; D035502:Trust