title: Coping and its effect on psychological distress of parents of pediatric cancer patients: a longitudinal prospective study.
abstract: OBJECTIVE
  This prospective 5-year longitudinal study examined the use of coping styles of fathers and mothers of pediatric cancer patients over time and the prospective effects of coping on distress.
  
  
  METHODS
  Psychological distress (General Health Questionnaire) and the use of seven coping styles (Utrecht Coping List: active problem focussing, palliative and passive reaction patterns, avoidance, social support seeking, expression of emotions, and comforting cognition) were assessed in 115 parents shortly after diagnosis, 6 and 12 months, and 5 years later.
  
  
  RESULTS
  At diagnosis, parents' use of coping styles did not differ from the norm population except more frequent use of support seeking. No significant change over time was found in a palliative reaction pattern. Support seeking declined and emotional expression increased linearly, whereas use of the remaining coping styles decreased, followed by an increase. At 5 years, parents' use differed from the norm population only in less use of expression of emotions and comforting cognitions. Initial coping use significantly predicted fathers' future distress at 6 and 12 months but not at 5 years. This was not found for mothers. Changes in coping were significantly associated with both parents' changes in distress only during the first year. Increased passive reaction pattern and social support seeking were the risk factors for mothers. Increased avoidance, a passive reaction pattern, expression of emotions, and decreased active problem focussing formed the risk factors for fathers.
  
  
  CONCLUSIONS
  Findings illustrate that coping seems to be a situation-specific process and that coping predictors vary as a function of parents' gender.
authors: Wenckebach Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Comprehensive Cancer Center North East Netherlands, Groningen, The Netherlands.
authors: Josette E H M
authors: JE
authors: Hoekstra-Weebers
authors: Barbara J
authors: BJ
authors: Wijnberg-Williams
authors: Jan P C
authors: JP
authors: Jaspers
authors: Willem A
authors: WA
authors: Kamps
authors: Harry B M
authors: HB
authors: van de Wiel