How Family Coping With Child Cancer Affects Child's Quality of Life?
Condition: Pediatric Cancer
Study type: Observational

Summary: 
      Children with newly diagnosed cancer and their parents will be contacted and invited to
      participate. Upon agreement, children will be interviewed, both parents will fill out
      questionnaires and be additionally interviewed. Using a 3-wave longitudinal design, mainly
      self-reported parental we-appraisals and we-disease-appraisals, couple dyadic coping (DC) and
      parent-child DC during a course of 12 months will be examined. Additionally, during brief
      separate interviews, the parents' speech will be coded for we-appraisals and expressed
      emotion regarding the other partner and the child. Findings will provide information on how
      family variables affect child QoL over 12 months.
    

Detailed description: 
      Background

      Researchers and clinicians alike have been calling for family-oriented and longitudinal
      research on child cancer (CC). The reason for this is threefold. First, parents are the most
      influential context on child development. Second, CC can be considered a "we-family disease",
      that is, a stressor that affects the patient, their parents and the interaction within all
      family members and subsystems, since they are an interdependent unit. Third, the higher
      survivals rates and increased chronicity of CC demand an ongoing adaptation from the whole
      family to the illness-related stress. As such, several studies have found associations
      between family and child variables during and after cancer treatment, and few studies suggest
      a causal relationship of family functioning on child adjustment and quality of life (QoL).
      Nevertheless, (1) which family dimensions related with the process of stress, appraisal and
      coping with CC, (2) how changes and (3) divergences within those dimensions predict child QoL
      over time, remain answered. Research on stress and coping in couples has identified two
      crucial dimensions for better relational and health outcomes that have the potential to
      provide those answers. "We-Appraisals", which is the process how individuals tend to evaluate
      what happens to them as a couple, i.e., in a more relational-oriented way ("we" problem) or
      in a more individual way ("I/you" problem); and Dyadic Coping, i.e., the process how couples
      cope together with stress. Therefore, the aim to expand and understand these dimensions in
      the context of families coping with CC.

      Aims

      Using a three-wave longitudinal design, the investigators aim to examine (1) the role that
      parental we-appraisals and we-disease appraisals, couple and parent-child dyadic coping have
      for a child's QoL over time, (2) how these variables change over time and how these changes
      predict changes in a child's QoL, (3) how congruence or discrepancies within we-appraisals
      and we-disease-appraisals, couple and parent-child dyadic coping predict changes in child's
      QoL over time, and (4) how observed parental we-appraisals, partner's and parental ex-pressed
      emotion predict child' QoL.

      Hypothesis

      The investigators expect that higher scores on parents' variables will predict positive
      changes on child QoL during the first 12 months after cancer diagnosis (T2 and T3). The
      investigators expect that changes and discrepancies within parents' variables over time will
      predict changes in child QoL at T2 and T3.

      Methods

      One hundred children with newly diagnosed cancer and their mothers and fathers will be
      recruited from the University Children's Hospitals in Zurich and Berne and assessed three
      times during 12 months. The children will be interviewed at all time points. The parents will
      complete several paper-pencil questionnaires assessing the variables of interest and will be
      interviewed at T2 (6 months) and T3 (1 year). Latent change score models with three factors
      (i.e. mother, father, child) and multilevel analysis will be used to test our hypothesis.

      Relevance

      By providing precursor information about the role that key family dimensions play on
      explaining better child QoL over time, this study will enable health-care professionals to
      know which family resources and members should be targeted during cancer treatment, improve
      interventions and, ultimately, to improve child QoL.
    

Observational model: Family-Based
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Children with newly diagnosed cancer and their parents