title: Resilience and psychosocial outcomes in parents of children with cancer.
abstract: BACKGROUND
  The psychosocial function of parents of children with cancer can impact the well-being of the entire family. Resilience resources are likely related to psychosocial outcomes and may be amenable to intervention. We hypothesized that parents with lower resources would report worse outcomes.
  
  
  METHODS
  In the "Understanding Resilience in Parents of Children with Cancer" study, comprehensive surveys were mailed to consecutive, English-speaking parents of children with cancer who were treated at Seattle Children's Hospital and completed therapy between January 1, 2009 and December 31, 2010. Resilience resources were measured by the Connor-Davidson Resilience Scale; outcome measures included psychological distress, health-related behaviors, social and family function, and perceived communication with the medical team.
  
  
  RESULTS
  Ninety-six parents (86% of contactable) completed the survey. Compared to population norms, enrolled parents had lower resilience resources, higher psychological distress, and more commonly reported binge drinking. Conversely, they reported higher social support and family adaptability (P < 0.001-0.006). Lower resilience resources were associated with higher distress, lower social support, and lower family function (P < 0.001-0.007). Parents in the lowest quartile of resilience resources had higher odds of frequent sleep difficulties (OR 5.19, 95% CI 1.74,15.45), lower health satisfaction (OR 5.71, 95% CI 2.05,15.92), and decreased ability to express worries to the medical team (OR 4.00, 95% CI 1.43,11.18).
  
  
  CONCLUSIONS
  Parents of children with cancer are at risk for poor psychosocial outcomes and those with low resilience resources may be at greater risk. Interventions directed at promoting resilience resources may provide a novel and complimentary approach toward improving outcomes for families facing pediatric cancer.
authors.affiliation: Seattle Children's Hospital, Seattle, Washington; Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington, Seattle, Washington; Treuman Katz Center for Pediatric Bioethics, Seattle, Washington.
authors.forename: Abby R
authors.initials: AR
authors.lastname: Rosenberg
authors.forename: Joanne
authors.initials: J
authors.lastname: Wolfe
authors.forename: Miranda C
authors.initials: MC
authors.lastname: Bradford
authors.forename: Michele L
authors.initials: ML
authors.lastname: Shaffer
authors.forename: Joyce P
authors.initials: JP
authors.lastname: Yi-Frazier
authors.forename: J Randall
authors.initials: JR
authors.lastname: Curtis
authors.forename: Karen L
authors.initials: KL
authors.lastname: Syrjala
authors.forename: K Scott
authors.initials: KS
authors.lastname: Baker
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D055500:Resilience, Psychological; D012944:Social Support
keywords: parents; pediatric cancer; psychosocial outcomes; resilience; whole patient care