title: Objective and subjective factors as predictors of post-traumatic stress symptoms in parents of children with cancer--a longitudinal study.
abstract: BACKGROUND
  Parents of children with cancer report post-traumatic stress symptoms (PTSS) years after the child's successful treatment is completed. The aim of the present study was to analyze a number of objective and subjective childhood cancer-related factors as predictors of parental PTSS.
  
  
  METHODS
  Data were collected from 224 parents during and after their child's cancer treatment. Data sources include self-report questionnaires and medical records.
  
  
  RESULTS
  In a multivariate hierarchical model death of the child, parent's perception of child psychological distress and total symptom burden predicted higher levels of PTSS. In addition, immigrants and unemployed parents reported higher levels of PTSS. The following factors did not predict PTSS: parent gender, family income, previous trauma, child's prognosis, treatment intensity, non-fatal relapse, and parent's satisfaction with the child's care.
  
  
  CONCLUSIONS
  Although medical complications can be temporarily stressful, a parent's perception of the child's distress is a more powerful predictor of parental PTSS. The vulnerability of unemployed parents and immigrants should be acknowledged. In addition, findings highlight that the death of a child is as traumatic as could be expected.
authors.affiliation: Psychosocial Oncology and Supportive Care, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. Annika.Lindahl.Norberg@pubcare.uu.se
authors.forename: Annika
authors.initials: A
authors.lastname: Lindahl Norberg
authors.forename: Ulrika
authors.initials: U
authors.lastname: Pöder
authors.forename: Gustaf
authors.initials: G
authors.lastname: Ljungman
authors.forename: Louise
authors.initials: L
authors.lastname: von Essen
mesh_terms: D000328:Adult; D054242:Emigrants and Immigrants / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms; D010290:Parents / Q000523:psychology*; D010465:Perception / Q000502:physiology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000523:psychology