title: Parental stress before, during, and after pediatric stem cell transplantation: a review article.
abstract: OBJECTIVE
  Pediatric stem cell transplantation (SCT) is a stressful treatment for children with relapsed or high-risk malignancies, immune deficiencies and certain blood diseases. Parents of children undergoing SCT can experience ongoing stress related to the SCT period. The aim of this article was to present a literature review of articles on parental distress and adaptation before, during, and after SCT and to identify risk and protective factors.
  
  
  METHODS
  The review was conducted systematically by using PubMed, Web of Science, PsychInfo, and Picarta databases. Eighteen articles met our inclusion criteria: publishing date between January 1, 1990 and January 1, 2009; studies concerning parents of children undergoing SCT; studies examining the psychological adjustment and/or stress reactions of parents as primary outcomes and studies available in English.
  
  
  RESULTS
  Highest levels of parental stress are reported in the period preceding SCT and during the acute phase. Stress levels decrease steadily after discharge in most parents. However, in a subgroup of parents, stress levels still remain elevated post-SCT. Parents most at risk in the longer term display highest levels of stress during the acute phase of the SCT.
  
  
  CONCLUSIONS
  Psychosocial assessment before SCT, during the acute phase and in the longer term, is necessary to identify parents in need for support and follow-up care.
authors: Pediatric Department, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. c.m.j.vrijmoet-wiersma@lumc.nl
authors: C M J
authors: CM
authors: Vrijmoet-Wiersma
authors: R M
authors: RM
authors: Egeler
authors: H M
authors: HM
authors: Koopman
authors: A Lindahl
authors: AL
authors: Norberg
authors: M A
authors: MA
authors: Grootenhuis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents / Q000523:psychology*; D010351:Patient Discharge; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000379:methods / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*; D013997:Time Factors