title: Providing care to a child with cancer: a longitudinal study on the course, predictors, and impact of caregiving stress during the first year after diagnosis.
abstract: OBJECTIVE
  This study investigated the course, predictors, and impact of caregiving stress on the functioning of primary caregivers of children with cancer during the first year after a child's cancer diagnosis.
  
  
  METHODS
  Primary caregivers (N = 95, 100% mother, 86% response rate) of consecutive newly diagnosed paediatric cancer patients (0-18 years) completed measures of caregiving stress, depressive symptoms, anxiety, and self-reported health at diagnosis, and 3, 6, and 12 months thereafter.
  
  
  RESULTS
  Results indicated a significant decrease in caregiving stress (especially during the first 3 months after diagnosis). Caregiving stress was predicted by single marital status and the ill child being the mother's only child. Multilevel analyses, controlled for socio-demographic and medical covariates, showed that, over time, the decline in caregiving stress was accompanied by a reduction in depressive symptoms and anxiety. The amount of variance explained by caregiving stress was 53% for depressive symptoms, 47% for anxiety, and 3% for self-reported health.
  
  
  CONCLUSIONS
  The present study suggests that caregiving stress is an important factor in understanding parental adjustment to childhood cancer. This offers possibilities for developing interventions aimed at preventing caregiving stress, and strengthening mothers' confidence in their ability to provide good care.
authors.affiliation: University of Groningen, University Medical Center Groningen, UMCG School of Nursing and Health, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Paediatric Oncology/Haematology Beatrix Children's Hospital, Groningen, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Sulkers
authors.forename: Wim J E
authors.initials: WJ
authors.lastname: Tissing
authors.forename: Aeltsje
authors.initials: A
authors.lastname: Brinksma
authors.forename: Petrie F
authors.initials: PF
authors.lastname: Roodbol
authors.forename: Willem A
authors.initials: WA
authors.lastname: Kamps
authors.forename: Roy E
authors.initials: RE
authors.lastname: Stewart
authors.forename: Robbert
authors.initials: R
authors.lastname: Sanderman
authors.forename: Joke
authors.initials: J
authors.lastname: Fleer
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D009035:Mothers; D009369:Neoplasms / Q000175:diagnosis* / Q000523:psychology; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: cancer; caregiving stress; multilevel modeling; oncology; parental functioning; parents