Patterns of psychological responses in parents of children that underwent stem cell transplantation.
OBJECTIVE
Hematopoietic stem cell transplantation (HSCT) is curative in several life-threatening pediatric diseases but may affect children and their families inducing depression, anxiety, burnout symptoms, and post-traumatic stress symptoms, as well as post-traumatic growth (PTG). The aim of this study was to investigate the co-occurrence of different aspects of such responses in parents of children that had undergone HSCT.


METHODS
Questionnaires were completed by 260 parents (146 mothers and 114 fathers) 11-198 months after HSCT: the Hospital Anxiety and Depression Scale, the Shirom-Melamed Burnout Questionnaire, the post-traumatic stress disorders checklist, civilian version, and the PTG inventory. Additional variables were also investigated: perceived support, time elapsed since HSCT, job stress, partner-relationship satisfaction, trauma appraisal, and the child's health problems. A hierarchical cluster analysis and a k-means cluster analysis were used to identify patterns of psychological responses.


RESULTS
Four clusters of parents with different psychological responses were identified. One cluster (n = 40) significantly differed from the other groups and reported levels of depression, anxiety, burnout symptoms, and post-traumatic stress symptoms above the cut-off. In contrast, another cluster (n = 66) reported higher levels of PTG than the other groups did.


CONCLUSIONS
This study shows a subgroup of parents maintaining high levels of several aspects of distress years after HSCT. Differences between clusters might be explained by differences in perceived support, the child's health problems, job stress, and partner-relationship satisfaction.
Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden.
Roberto
R
Riva
Ulla
U
Forinder
Johan
J
Arvidson
Karin
K
Mellgren
Jacek
J
Toporski
Jacek
J
Winiarski
Annika Lindahl
AL
Norberg
D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000523:psychology*; D004651:Employment / Q000523:psychology; D005260:Female; D006402:Hematologic Diseases / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D007223:Infant; D008297:Male; D008393:Marriage / Q000523:psychology; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010290:Parents / Q000523:psychology*; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D013997:Time Factors
cancer; hematopoietic stem cell transplantation; oncology; parents; post-traumatic growth; psychological distress