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Poster #53 - Effect of Parental Factors on Long-Term Quality of Life among Survivors of Pediatric Cancer

Fri, March 24, 2:30 to 3:15pm, Salt Palace Convention Center, Floor: 1, Hall A-B

Abstract

Background: Adjusting to a pediatric cancer diagnosis can be emotionally taxing for both children and their parents (Sloper, 2000; Sohn et al., 2017). Generally, worse parental mental health and fewer socioeconomic resources can lead to negative parenting behaviors, which are associated with worse child QoL (Steinberg & Silk, 2002; Vreeland et al., 2019). Further, children with cancer experience lower QoL as a result of poorer parental mental health and lower family income (Roddenberry & Renk, 2008; Racine et al., 2018). However, less is known about how parenting behaviors contribute to QoL specifically for children with cancer (Orbuch, Parry, Chesler, Fritz, & Repetto, 2005; Winning et al., 2022), who may be more dependent on their parents. This study aimed to examine direct effects of income and parent depressive symptoms at initial diagnosis, and long-term parenting behaviors, on long-term QoL in childhood cancer survivors.
Methods: Participants (N=98 mothers, N=47 fathers, N=102 children) were from a longitudinal study of families of children diagnosed with new or recurrent cancer. Eligible children were aged 5-17, English-speaking, and lived within 100 miles of the hospital. At enrollment (T1), parents completed surveys on demographic characteristics and depressive symptoms. At the five-year follow-up (T4), parents and children completed surveys on parenting and child QoL. Hierarchical regression models examined direct effects of T1 income, T1 mothers/fathers’ depressive symptoms, and T4 child-reported mother/father parenting (warmth, psychological control, behavioral control) on T4 child self-reported QoL. Two additional models examined direct effects of T1 income, T1 mothers/fathers’ depressive symptoms, and T4 mother/father-reported parenting on T4 mother/father-reported child QoL.
Results: The average age of children was 10.69 (SD=3.96) at T1; 51.8% were males. Most mothers and fathers were White (85.0% and 89.0%, respectively). The average family income was between $50,001-$75,000. Mothers had mild levels of depressive symptoms (M=14.88, SD=10.57; 14-19=mild range) and fathers had minimal levels of depressive symptoms (M=10.96, SD=9.22; 0-13=minimal range) at initial diagnosis. The final child self-reported QoL models were significant (Table 1). Predictors of better QoL included lower levels of mothers’ behavioral control, mothers’ psychological control, and fathers’ behavioral control. The final mother-reported child QoL model was significant (Table 2). Predictors of better QoL included higher income, lower levels of mothers’ depressive symptoms, and less psychological control. The final father-reported model was not significant (Table 2).

Conclusion: Higher levels of child-reported maternal behavioral control, maternal psychological control, and paternal behavioral control at five-year follow-up were predictive of worse child-reported QoL. Lower income, higher levels of depressive symptoms, and more self-reported psychological control among mothers were predictive of worse mother-reported child QoL. Findings indicate that in the context of pediatric cancer survivorship, maternal depressive symptoms at initial diagnosis and more negative parenting behaviors at five-year follow-up may be points of intervention to optimize long-term QoL in survivors. However, more research is needed to understand other predictors of survivor quality of life, particularly with larger samples of fathers. Clinicians should provide parents with mental health resources and parenting tools to optimize child QoL long-term.

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