title: Parent Attributions About Child Symptoms Related to Cancer Therapy.
abstract: OBJECTIVE
  Symptom assessment is an emergent area of research in pediatric cancer. Our team previously reported on the development of a questionnaire to be completed by parents to determine symptom prevalence and bother. This exploratory study examined parental nonprobed, free-text comments about their child's treatment-related symptoms reported on the questionnaire.
  
  
  METHODS
  Participants were parents of children aged 4 to 18 years who had been diagnosed with cancer at least 2 months prior to enrolment and had received intravenous chemotherapy within the past month at 1 of 5 pediatric cancer centers. The questionnaire consisted of 69 or 71 items (based on child's age) addressing physical and psychological sequelae. Each symptom query was accompanied by a blank space in which parents could comment on their response. Comments were analyzed guided by content analysis methodology.
  
  
  RESULTS
  Five major themes emerged: parental attributions for the symptoms experienced in their child; coping patterns and communication styles within the family; evidence of anticipatory, procedural, and other anxieties; interruption of daily life; and changes in the child's physical appearance.
  
  
  CONCLUSIONS
  These exploratory findings provide context to parental perception of their child's treatment-related symptoms and may contribute to a better understanding of parental perception of child and the family coping and communicating style. These findings may assist in the development of psychoeducational interventions aimed at promoting open communication styles within the family and reducing child and parent burden during treatment procedures.
authors.affiliation: 1 Community Head Injury Resource Services of Toronto, Toronto, Ontario, Canada.
authors.forename: Ashley
authors.initials: A
authors.lastname: Di Battista
authors.affiliation: 2 University of Toronto, Toronto, Ontario, Canada.|3 Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Lee L
authors.initials: LL
authors.lastname: Dupuis
authors.affiliation: 4 Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Cassidy
authors.affiliation: 5 McMaster University, Hamilton, Ontario, Canada.|6 McMaster Children's Hospital, Hamilton, Ontario, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Portwine
authors.affiliation: 4 Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.|7 University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Donna L
authors.initials: DL
authors.lastname: Johnston
authors.affiliation: 8 Kingston General Hospital, Kingston, Ontario, Canada.|9 Queen's University in Kingston, Ontario, Canada.
authors.forename: Mariana
authors.initials: M
authors.lastname: Pradier Silva
authors.affiliation: 2 University of Toronto, Toronto, Ontario, Canada.|3 Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
authors.affiliation: 2 University of Toronto, Toronto, Ontario, Canada.|3 Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Maru
authors.initials: M
authors.lastname: Barrera
keywords: parental attributions; pediatric oncology; qualitative research; symptoms