title: Depression and distress in caregivers of children with brain tumors undergoing treatment: psychosocial factors as moderators.
abstract: OBJECTIVE
  This study's objectives were to examine the effects of depression on the distress of caregivers of children with brain tumors and to identify the factors moderating depression and caregiver distress.
  
  
  METHODS
  Participants were 82 caregivers of children with brain tumors undergoing treatment in the National Cancer Center of South Korea. The depression subscale of the Symptom Checklist 90-Revised (SCL-90-R) and the Burden of a Primary Caregiver (BPC) Scale were used to measure participants' depression and caregiver distress, respectively. The Korean version of the Parenting Sense of Competence (K-PSOC) Scale, Family Environmental Scale-Revised (K-FES-R), and the DUKE-UNC Functional Social Support Questionnaire-S (DUKE-UNC-FSSQ) were used to assess parental efficacy, family relationships, and perceived social support, respectively.
  
  
  RESULTS
  Younger patient age, lower family income, and caregivers' greater number of years of education significantly predicted caregiver distress. Caregivers with depression experienced significantly more distress than those without depression. The interaction of depression with parenting efficacy and social support affected caregiver distress. For highly depressed caregivers, parental efficacy, social support, and family relationships played weaker roles as protective factors against caregiver distress. High parental efficacy and social support were protective factors against distress in caregivers without depression.
  
  
  CONCLUSIONS
  A multi-dimensional assessment of the psychosocial factors that may affect caregivers of children with brain tumors should precede interventions for distress management. Interventions tailored to individuals' psychosocial factors are needed.
authors.affiliation: Department of Psychology, Duksung Women's University, Seoul, Republic of Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Choi
authors.affiliation: Department of Psychology, Yonsei University, Seoul, Republic of Korea.
authors.forename: Soo Jin
authors.initials: SJ
authors.lastname: Yoon
authors.affiliation: Mental Health Clinic, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Jong-Heun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Center for Pediatric Cancer, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Hyeon Jin
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Proton Therapy Center, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Mental Health Clinic, National Cancer Center, Goyang, Republic of Korea.|Department of Psychology, Korea University, Seoul, Republic of Korea.
authors.forename: Eun-Seung
authors.initials: ES
authors.lastname: Yu
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001932:Brain Neoplasms / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D016487:Parenting; D010290:Parents / Q000523:psychology*; D056910:Republic of Korea; D060685:Sense of Coherence; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*