title: Parenting changes in adults with cancer.
abstract: BACKGROUND
  Children whose parents have cancer are at risk for psychosocial difficulties; however, the mechanisms are not well understood. This cross-sectional study sought support for a model connecting parental cancer to child distress through its impact on parenting self-efficacy beliefs and parenting behaviors by examining relations among parental illness, quality of life/parent functioning, parenting efficacy beliefs, and concerns about children's emotional distress.
  
  
  METHODS
  One hundred ninety-four adult oncology outpatients with children who were 18 years old or younger completed questionnaires assessing their health-related quality of life (Functional Assessment of Cancer Therapy-General), depression and anxiety symptoms (Hospital Anxiety and Depression Scale), overall distress (Distress Thermometer), and parenting efficacy beliefs and parenting concerns (Parenting Concerns Questionnaire).
  
  
  RESULTS
  Parenting efficacy scores for parents and coparents declined significantly after diagnosis. This decline correlated with more visits to a medical clinic, treatment with intravenous chemotherapy in the past month, poorer health-related quality of life, and more depression and distress. Parents experiencing the most concern about the impact of mood, physical limitations, and changes in routines on their children experienced the biggest declines in their own sense of efficacy as parents and in their belief in their coparent's efficacy. Finally, declines in parenting efficacy beliefs correlated with parental concerns about children's emotional distress about aspects of the parent's illness.
  
  
  CONCLUSIONS
  This study highlights the importance of identifying and addressing parenting concerns to alleviate patient distress, and it may help to guide future intervention efforts.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Cynthia W
authors.initials: CW
authors.lastname: Moore
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Paula K
authors.initials: PK
authors.lastname: Rauch
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Lee
authors.initials: L
authors.lastname: Baer
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: William F
authors.initials: WF
authors.lastname: Pirl
authors.affiliation: Division of Pediatric Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Muriel
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D016487:Parenting / Q000523:psychology*; D011788:Quality of Life
keywords: cancer; depression; family relations; parenting; quality of life; self-efficacy