title: Psychological distress in parents of children with advanced cancer.
abstract: OBJECTIVE
  Parent psychological distress can impact the well-being of childhood cancer patients and other children in the home. Recognizing and alleviating factors of parent distress may improve overall family survivorship experiences following childhood cancer.
  
  
  OBJECTIVE
  To describe the prevalence and factors of psychological distress (PD) among parents of children with advanced cancer.
  
  
  METHODS
  Cohort study embedded within a randomized clinical trial (Pediatric Quality of Life and Evaluation of Symptoms Technology [PediQUEST] study).
  
  
  METHODS
  Multicenter study conducted at 3 children's hospitals (Boston Children's Hospital, Children's Hospital of Philadelphia, and Seattle Children's Hospital).
  
  
  METHODS
  Parents of children with advanced (progressive, recurrent, or refractory) cancer.
  
  
  METHODS
  Parental PD, as measured by the Kessler-6 Psychological Distress Scale.
  
  
  RESULTS
  Eighty-six of 104 parents completed the Survey About Caring for Children With Cancer (83% participation); 81 parents had complete Kessler-6 Psychological Distress Scale data. More than 50% of parents reported high PD and 16% met criteria for serious PD (compared with US prevalence of 2%-3%). Parent perceptions of prognosis, goals of therapy, child symptoms/suffering, and financial hardship were associated with PD. In multivariate analyses, average parent Kessler-6 Psychological Distress Scale scores were higher among parents who believed their child was suffering highly and who reported great economic hardship. Conversely, PD was significantly lower among parents whose prognostic understanding was aligned with concrete goals of care.
  
  
  CONCLUSIONS
  Parenting a child with advanced cancer is strongly associated with high to severe levels of PD. Interventions aimed at aligning prognostic understanding with concrete care goals and easing child suffering and financial hardship may mitigate parental PD.
authors.affiliation: Division of Pediatric Hematology and Oncology, Seattle Children's Hospital, WA, USA.
authors.forename: Abby R
authors.initials: AR
authors.lastname: Rosenberg
authors.forename: Veronica
authors.initials: V
authors.lastname: Dussel
authors.forename: Tammy
authors.initials: T
authors.lastname: Kang
authors.forename: J Russel
authors.initials: JR
authors.lastname: Geyer
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Gerhardt
authors.forename: Chris
authors.initials: C
authors.lastname: Feudtner
authors.forename: Joanne
authors.initials: J
authors.lastname: Wolfe
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009369:Neoplasms / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D015995:Prevalence; D011581:Psychological Tests; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*
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