"It's Hard to Talk When Your Child Has a Life Threatening Illness": A Qualitative Study of Couples Whose Child Is Diagnosed With Cancer.

When parents are confronted with something as fundamental as a cancer diagnosis for their child, it is generally assumed that sharing the emotional impact of it, in the form of talking about it with the partner, is helpful and necessary to cope as an individual and a couple. However, couple communication in the context of childhood oncology is often challenging. In this qualitative research, we aimed for a better understanding of how partners experience their couple communication during treatment of their child. Thematic coding was done on in-depth interviews with 16 parents (7 couples interviewed together and 2 mothers). We found that the circumstances of the treatment period affected couple communication. In the interviews, parents provided three main meanings to their limited talking: (a) because of the hospital and treatment context; (b) for self-care/self-protection related to the value of blocking emotions; and (c) because of each other. These findings invite us to rethink emotional closeness being equated with frequent or intense emotional communication in couples with a child who has cancer. This research, framed in a dialectic approach, emphasizes the value of both talking and not talking in the tense and challenging couple situation of dealing with a child's cancer diagnosis and treatment. Rather than advocating for the general promotion of open communication, our study suggests the value of hesitations to talk at certain points in the process, while also taking into account the degree of marital difficulties in offering interventions aimed at improving couple communication.

Family Members Dealing With Childhood Cancer: A Study on the Role of Family Functioning and Cancer Appraisal.

OBJECTIVES: Childhood cancer is a life-threatening disease that poses significant challenges to the life of the diagnosed child and his/her family members. Based on the ABCX-model, the aim of the current study was to explore the association between family functioning, cancer appraisal and the individual adjustment of patients, parents and siblings. METHODS: Participants were 60 children with leukemia or non-Hodgkin lymphoma, 172 parents and 78 siblings (115 families). Time since diagnosis varied from zero to 33 months. Patients, parents and siblings completed the Family Environment Scale (FES), Perceived Stress Scale, Situation-Specific Emotional Reactions Questionnaire and Pediatric Quality of Life Inventory/Maudsley Marital Questionnaire. RESULTS: Family functioning and the appraisal of the cancer diagnosis proved to be related to patients', parents' and siblings' cancer-related emotions and quality of life post-diagnosis. In addition, family members differed in their perception of some family functioning domains, the appraisal of the cancer diagnosis, positive feelings and quality of life. DISCUSSION: Our findings led to the conclusion that family functioning and the appraisal of the cancer diagnosis are important for the individual adjustment of patients, parents and siblings when facing a diagnosis of cancer in the child. Differences across members within one family and differences between families speak to the need of screening all family members and intervening at the level of individual as well as the family unit.

A Mindfulness-Based Intervention for Adolescents and Young Adults After Cancer Treatment: Effects on Quality of Life, Emotional Distress, and Cognitive Vulnerability.

PURPOSE: Adolescent and young adult cancer (AYAC) survivors show an elevated risk of distress. Targeted psychosocial interventions for this distinct population are needed. This study examined the potential efficacy of a mindfulness-based intervention (MBI) to alleviate emotional distress and improve quality of life (QoL) in AYAC survivors. METHODS: Participants were 16 AYAC survivors, aged 14-24, who had completed acute medical treatment. A two-baseline (8 and 1 week before the intervention), post- (1 week after the intervention) and 3 months follow-up within-subjects design was used. Each participant completed two baseline assessments, followed by an 8-week MBI. The primary outcome variables were emotional distress and QoL. Secondary outcomes were cognitive vulnerability factors and mindfulness skills. RESULTS: Multilevel modeling showed (1) a significant reduction in emotional distress and improvement in QoL at 3 months of follow-up, (2) a significant reduction in negative attitudes toward self (i.e., a cognitive vulnerability factor), and (3) a significant improvement in mindfulness skills. CONCLUSION: MBI is a promising approach that is used to treat emotional distress and to improve QoL in AYAC survivors. Further research using randomized controlled trials is needed to generalize these findings. Trial registration information: www.trialregister.nl ; NTR4358.