title: Longitudinal study of parent caregiving self-efficacy and parent stress reactions with pediatric cancer treatment procedures.
abstract: BACKGROUND
  Pain/distress during pediatric cancer treatments has substantial psychosocial consequences for children and families. We examined relationships between parents' caregiving self-efficacy, parents' affect in response to their children's cancer-related treatment procedures, and parents' symptoms of post-traumatic stress at follow-up.
  
  
  METHODS
  Participants were 75 pediatric cancer patients and parents. On the day of each of three procedures (i.e., port-start, lumbar puncture, or bone marrow aspiration), parents rated their self-efficacy for six caregiving goals. Parents also self-reported their negative affect (i.e., state anxiety, negative mood, and distress) in response to each procedure. Three months after the last procedure, parents reported their level of post-traumatic stress symptoms (PTSS).
  
  
  RESULTS
  Higher parent self-efficacy about keeping children calm before treatment and/or keeping children calm during the procedure was associated with lower state anxiety. Self-efficacy for keeping the child calm during procedures was significantly correlated with distress in parents at the time of procedures, and self-efficacy for keeping the child calm before procedures was significantly correlated with PTSS. All three negative affect measures significantly mediated the effects of parents' caregiving self-efficacy for both goals on parents' PTSS 3 months later.
  
  
  CONCLUSIONS
  Parents' caregiving self-efficacy influences their immediate and longer-term distress reactions to their children's treatment procedures. These findings provide a more nuanced understanding of how parents' cognitions contribute to their ability to cope with their children's treatment and suggest the benefit of an intervention that targets parents' procedure-specific caregiver self-efficacy.
authors.affiliation: Karmanos Cancer Institute Population Studies and Disparities Research Program, Detroit, MI 48201, USA. harperf@karmanos.org
authors.forename: Felicity W K
authors.initials: FW
authors.lastname: Harper
authors.forename: Amy M
authors.initials: AM
authors.lastname: Peterson
authors.forename: Heatherlun
authors.initials: H
authors.lastname: Uphold
authors.forename: Terrance L
authors.initials: TL
authors.lastname: Albrecht
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Taub
authors.forename: Heather
authors.initials: H
authors.lastname: Orom
authors.forename: Sean
authors.initials: S
authors.lastname: Phipps
authors.forename: Louis A
authors.initials: LA
authors.lastname: Penner
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety; D017028:Caregivers / Q000523:psychology*; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010146:Pain / Q000523:psychology*; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D020377:Self Efficacy; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires