The impact of parental cancer on children\'s quality of life
Ministry of Science and Technology
University of Taipei
Department of Early Childhood Education
Parental cancer;mental coping style;children;quality of life;psychosocial adjustment
本研究主要在探討罹癌父母的適應如何影響4至16歲兒童的生活品質。第一年是問卷調查，運用認知因應的理論，檢視兒童對疾病的理解是否會發揮中介效果，並影響罹癌父母的因應心態與兒童生活品質的關係。此外，維護家庭生活慣例是否會調節上述中介效果?本研究共有132位罹癌父母參與問卷填寫，刪除兒童年齡超出範圍的12份問卷，共計120位(96位母親、21位父親，平均年齡43.61)罹癌家長參與。罹癌父母完成兩份問卷的填寫，分別為兒童生活品質及兒童對疾病的理解，以及父母適應問卷，包含癌症心理適應簡版(mini-MAC)、親子溝通的開放度、家庭生活慣例的維護等題項。問卷資料以典型相關及多元迴歸等方式進行分析。研究結果顯示罹癌父母的焦慮因應與兒童較差的生活品質有關，其他如戰鬥精神、聽天由命、認知迴避等因應方式與兒童生活品質的關係不明顯。家庭生活慣例的維持與溝通開放度等並未發揮調節作用。第二年的研究，以個別訪談20位4-16歲兒童，企圖從兒童觀點探知父母罹癌後的生活經驗。參與者來源為十六位是來自於父母於問卷調查的同意者，另四位是用滾雪球的方式獲得。訪談資料以內容分析法進行。研究結果產生五個主題: (1)從情緒亂流到接受的旅程，(2)生活如常但我看得出來發生甚麼事，(3)我有長大，但有苦澀的滋味，(4)理解為何發生癌症這種事? (5)我會是下一個嗎?青少年的煩惱。研究結果指出罹癌父母需要多關注他們自身內在想法會帶給孩子的影響，以及所展現出來的焦慮帶給孩子的意涵。
The current two-year study investigated how parental cancer affected their 4-16 year-old children’s quality of life. The first year was a survey study, applying a cognitive model of coping to examine a potential mediating effect of children’s appraisal of parental illness on the relationship between the coping styles of cancer patient parents and their children’s quality of life (QoL). Whether such a mediating effect was moderated by family functioning factors was also examined. A cohort of 120 parents (96 females and 24 males) diagnosed with cancer, age ranging from 31 to 59 (M=43.61), participated in this study. Their children (65 girls and 55 boys) were between ages of 4 and 16 (M=10.21). They completed (1) a set of questionnaires about their children’s QoL and appraisal of illness severity as well as (2) a set of parental adjustment questionnaires that included Mini-mental Adjustment to Cancer, openness in parent-child communication about the illness, and maintenance of family routines items. The methods of canonical correlation analysis and multiple regressions were used to analyze data. The results of survey study showed that pathways of cancer patient parents’ coping style influences on child QoL were variable. Cancer patient parents’ anxious preoccupied coping was related to poorer child QoL. Other coping styles (fighting spirit, fatalism, and cognitive avoidance) associated weakly with child adaptation. Maintenance of family routines and openness in parent-child illness-related communication were not effective moderators. In the second year, there were 20 children (9 boys and 11 girls, M=10.2 years) whose parents participated the survey and signed consent form. Four of 20 children were recruited by snow ball method. A semi-structured interview was conducted with each child. Content analysis was used to discern children’s experiences. Five themes emerged: (1) Going on a journey from emotional turbulence to acceptance; (2) Life is as usual, but I can tell what’s going on; (3) I have grown up, but with complex feelings; (4) Making sense of what gives rise to cancer; and (5) “Would I be the next?”: Preadolescents’ worries about themselves. To conclude, cancer patient parents should be mindful of how their coping styles may impact their parenting and distress signaling to their children.