Child and Adolescent Social Work Journal

, Volume 30, Issue 4, pp 293–310 | Cite as

Financial and Social Effects on Children and Adolescents when a Parent is Diagnosed with Cancer

  • Steffen Torp
  • Lisbeth Thoresen
  • Arne Backer Grønningsæter
  • Ellen Karine Grov
  • Karin Gustavsen


The aim of this study was to investigate the financial effects of cancer on families in which a parent has cancer and lives with his/her children, to identify financial hardship risk factors, and to describe the children’s experiences regarding the impact of cancer on their socioeconomic situation. A mixed-methods research approach was applied. Norwegian cancer patients living with their children (≤18 years) completed a questionnaire (n = 386). Ten children (≤18 years) of cancer patients were given in-depth interviews regarding their experiences associated with the family’s socioeconomic situation. Eight percent of the cancer patients reported a poor financial situation. Fourteen percent of the patients had to minimize their expenditures on goods and activities for their children because of costs attributed to cancer. Risk factors for cancer-related financial hardships affecting children were single parenthood, not working, metastasis, chemotherapy and additional health impairments. Qualitative descriptions suggest that parents shield their children from financial hardships. The children were generally not concerned with their family’s financial issues, but certain older children took responsibility for the household financial situation by obtaining employment and declining expensive gifts and activities. The children were more preoccupied with caring for the sick parent and coping with their own emotions. Despite some families being at greater risk for financial hardships when a parent is diagnosed with cancer, most Norwegian families with children are not seriously affected by the parents’ cancer status. These children should be regarded as significant informal caregivers. The family’s financial situation should be included in a holistic assessment during the cancer follow-up period.


Cancer survivors Informal caregivers Economy Children Adolescents Health promotion 


  1. American Cancer Society. (2007). Cancer facts & figures 2007. Atlanta: American Cancer Society.Google Scholar
  2. Bradley, S. E., Sherwood, P. R., Kuo, J., Kammerer, C. M., Gettig, E. A., Ren, D., et al. (2009). Perceptions of economic hardship and emotional health in a pilot sample of family caregivers. Journal of Neuro-oncology, 93, 333–342.PubMedCrossRefGoogle Scholar
  3. Brannen, J. (1995). Mixing methods: Qualitative and quantitative research. Brookfield: Ashgate.Google Scholar
  4. Bugge, K. E., Helseth, S., & Darbyshire, P. (2008). Children’s experiences of participation in a family support program when their parent has incurable cancer. Cancer Nursing, 31(6), 426–434.PubMedCrossRefGoogle Scholar
  5. Bugge, K. E., Helseth, S., & Darbyshire, P. (2009). Parents’ experiences of a family support program when a parent has incurable cancer. Journal of Clinical Nursing, 18(24), 3480–3488. doi:10.1111/j.1365-2702.2009.02871.x.PubMedCrossRefGoogle Scholar
  6. Cancer Registry of Norway. (2009). Cancer in Norway 2008: Cancer incidence, mortality, survival and prevalence in Norway. Oslo: Cancer Registry of Norway.Google Scholar
  7. Chalmers, K. I., Kristjanson, L. J., Woodgate, R., Taylor-Brown, J., Nelson, F., Ramserran, S., et al. (2000). Perceptions of the role of the school in providing information and support to adolescent children of women with breast cancer. Journal of Advanced Nursing, 31(6), 1430–1438.PubMedCrossRefGoogle Scholar
  8. Christ, G. H., Siegel, K., Freund, B., Langosch, D., Hendersen, S., Sperber, D., et al. (1993). Impact of parental terminal cancer on latency-age children. American Journal of Orthopsychiatry, 63(3), 417–425.PubMedCrossRefGoogle Scholar
  9. Christ, G. H., Siegel, K., & Sperber, D. (1994). Impact of parental terminal cancer on adolescents. American Journal of Orthopsychiatry, 64(4), 604–613.PubMedCrossRefGoogle Scholar
  10. Dyregrov, K., & Dyregrov, A. (2011). Barn og unge som pårørende ved kreft. Hvordan kan barns situasjon og foreldres omsorgskapasitet styrkes i et rehabiliteringsperspektiv? [Children and adolescents as informal carers related to cancer. How can children’s situation and parents’ caring capasity be strengthened in a rehabiltation perspective?]. Bergen: Senter for Krisepsykologi [Centre for Crisis Psychology].Google Scholar
  11. Fitch, M. I., & Abramson, T. (2007). Information needs of adolescents when a mother is diagnosed with breast cancer. Canadian Oncology Nursing Journal, 17(1), 16–25.PubMedCrossRefGoogle Scholar
  12. Fitch, M. I., Bunston, T., & Elliot, M. (1999). When mom’s sick: Changes in a mother’s role and in the family after her diagnosis of cancer. Cancer Nursing, 22(1), 58–63.PubMedCrossRefGoogle Scholar
  13. Fløtten, T., Torp, S., Kavli, H., Nielsen, R., Syse, J., Grønningsæter, A., & Gustavsen, K. (2008). Kreftrammedes levekår. Om arbeid, økonomi, rehabilitering og sosial støtte [Living conditions of cancer survivors: Work, finances, rehabilitation and social support]. Oslo: Fafo. Report 2008, p. 47.Google Scholar
  14. Gates, M. F., & Lackey, N. R. (1998). Youngsters caring for adults with cancer. Journal of Nursing Scholarship, 30(1), 11–15.CrossRefGoogle Scholar
  15. Grov, E. K. (2005). Anxiety, depression and quality of life in caregivers of patients with cancer in late palliative phase. Annals of Oncology, 16, 1185–1191.PubMedCrossRefGoogle Scholar
  16. Grov, E. K., Fossa, S. D., Sorebo, O., & Dahl, A. A. (2006a). Primary caregivers of cancer patients in the palliative phase: A path analysis of variables influencing their burden. Social Science and Medicine, 63(9), 2429–2439. doi:10.1016/j.socscimed.2006.06.008.PubMedCrossRefGoogle Scholar
  17. Grov, E. K., Fossa, S. D., Tonnessen, A., & Dahl, A. A. (2006b). The caregiver reaction assessment: Psychometrics, and temporal stability in primary caregivers of Norwegian cancer patients in late palliative phase. Psycho-oncology, 15(6), 517–527. doi:10.1002/pon.987.PubMedCrossRefGoogle Scholar
  18. Grunfeld, E., Coyle, D., Whelan, T., Clinch, J., Reyno, L., Earle, C. C., et al. (2004). Family caregiver burden: Results of a longitudinal study of breast cancer patients and their principal caregivers. Canadian Medical Association Journal, 170(12), 1795–1801.PubMedCrossRefGoogle Scholar
  19. Gustavsen, K., Grønningsæter, A. B., Fløtten, T., Syse, J., Nielsen, R., & Torp, S. (2008). Barn og unge i kreftrammede familier [Children and adolescents in cancer families]. Oslo: Fafo. Report 2008, p. 38.Google Scholar
  20. Hanratty, B., Holland, P., Jacoby, A., & Whitehead, M. (2007). Financial stress and strain associated with terminal cancer: A review of the evidence. Palliative Medicine, 21(7), 595–607.PubMedCrossRefGoogle Scholar
  21. Heath, J., Lintuuran, R., Rigguto, G., Tikotlian, N., & McCarthy, M. (2006). Childhood cancer: Its impact and financial costs for Australian families. Pediatric Hematology and Oncology, 23(5), 439–448. doi:10.1080/08880010600692526.PubMedCrossRefGoogle Scholar
  22. Hilton, B. A., & Elfert, H. (1996). Children’s experiences with mothers’ early breast cancer. Cancer Practice, 4(2), 96–104.PubMedGoogle Scholar
  23. Kvale, S. (1996). Interviews: An introduction to qualitative research interviewing. Newbury Park: Sage.Google Scholar
  24. Lewis, F. M., & Darby, E. L. (2003). Adolescent adjustment and maternal breast cancer: A test of the “faucet hypothesis”. Journal of Psychosocial Oncology, 21(4), 81–104. doi:10.1300/J077v21n04_05.CrossRefGoogle Scholar
  25. Lewis, F. M., Fletcher, K. A., Cochrane, B. B., & Fann, J. R. (2008). Predictors of depressed mood in spouses of women with breast cancer. Journal of Clinical Oncology, 26, 1289–1295.PubMedCrossRefGoogle Scholar
  26. Lewis, F. M., Zahlis, E. H., Shands, M. E., Sinsheimer, J. A., & Hammond, M. A. (1996). The functioning of single women with breast cancer and their school-aged children. Cancer Practice, 4(1), 15–24.PubMedGoogle Scholar
  27. Longo, C., Fitch, M., Deber, R., & Williams, A. (2006). Financial and family burden associated with cancer treatment in Ontario, Canada. Supportive Care in Cancer, 14, 1077–1085.PubMedCrossRefGoogle Scholar
  28. Marshall, C., & Rossmann, G. B. (1989). Designing qualitative research. London: Sage.Google Scholar
  29. Mehnert, A. (2011). Employment and work-related issues in cancer survivors. Critical Reviews in Oncology/Hematology, 77, 109–130. doi:10.1016/j.critrevonc.2010.01.004.PubMedCrossRefGoogle Scholar
  30. Nadim, M., & Nielsen, R. A. (2009). Barnefattigdom i Norge. Omfang, utvikling og georgrafisk variasjon [Child poverty in Norway. Extent, development and geographical variation]. Oslo: Fafo. Report 2009, p. 38.Google Scholar
  31. Northouse, L. L., Mood, D., Templin, T., & George, T. (2000). Couples’ patterns of adjustment to colon cancer. Social Science and Medicine, 50, 271–284.PubMedCrossRefGoogle Scholar
  32. Norwegian National Insurance (NAV). (2011). Sickness benefit for EEA citizens. Retrieved May 30, 2012, from
  33. Osborn, T. (2007). The psychosocial impact of parental cancer on children and adolescents: A systematic review. Psycho-oncology, 16(2), 101–126.PubMedCrossRefGoogle Scholar
  34. Patton, M. Q. (1990). Qualitative evaluation and research methods (2nd ed.). Newbury Park: Sage.Google Scholar
  35. Regional Committee for Medical and Health Research Ethics. (2012). Retrieved November 21, 2012, from
  36. Ridge, T. (2007). It’s a family affair: Low-income children’s perspectives on maternal work. Journal of Social Policy, 36, 399–416. doi:10.1017/S0047279407001109.CrossRefGoogle Scholar
  37. Sandbæk, M. (2008). Barns levekår [Living conditions among children]. Oslo: NOVA. Report no 07/08.Google Scholar
  38. Sjövall, K., Attner, B., Lithman, T., Noreen, D., Gunnars, B., Thome, B., et al. (2010). Sick leave of spouses to cancer patients before and after diagnosis. Acta Oncologica, 49, 467–473.PubMedCrossRefGoogle Scholar
  39. SPSS Inc. (2010). PASW Statistics 19. Chicago: SPSS Inc.Google Scholar
  40. Östlund, U., Wennmann-larsen, A., Persson, C., Gustavson, P., & Wengström, Y. (2010). Mental health in significant others of patients dying from lung cancer. Psycho-oncology, 19, 29–37.PubMedCrossRefGoogle Scholar
  41. Søgaard, A., Selmer, R., Bjertnes, E., & Thelle, D. (2004). The Oslo Health Study: The impact of self-selection in a large, population-based survey. International Journal for Equity in Health, 3(1), 3. doi:10.1186/1475-9276-3-3.PubMedCrossRefGoogle Scholar
  42. Syse, A., Aas, G. B., & Loge, J. H. (2012). Children and young adults with parents with cancer: A population-based study. Clinical Epidemiology, 4, 41–52. doi:10.2147/clep.s28984.PubMedCrossRefGoogle Scholar
  43. Syse, A., & Tonnessen, M. (2011). Cancer’s unequal impact on incomes in Norway. Acta Oncologica,. doi:10.3109/0284186x.2011.640710.PubMedGoogle Scholar
  44. Tilden, V. P., Tolle, S. W., Drach, L. L., & Perrin, N. A. (2004). Out-of-hospital death: Advance care planning, decedent symptoms, and caregiver burden. Journal of the American Geriatrics Society, 52(4), 532–539. doi:10.1111/j.1532-5415.2004.52158.x.PubMedCrossRefGoogle Scholar
  45. Torp, S., Gudbergsson, S. B., Dahl, A. A., Fossa, S. D., & Flotten, T. (2011). Social support at work and work changes among cancer survivors in Norway. Scandinavian Journal of Public Health, 39(6), 33–42. doi:10.1177/1403494810395827.PubMedCrossRefGoogle Scholar
  46. Underlid, K. (2005). Poverty and experiences of social devaluation: A qualitative interview study of 25 long-standing recipients of social security payments. Scandinavian Journal of Psychology, 46(3), 273–283. doi:10.1111/j.1467-9450.2005.00457.x.PubMedCrossRefGoogle Scholar
  47. Visser, A., Huizinga, G. A., van der Graaf, W. T. A., Hoekstra, H. J., & Hoekstra-Weebers, J. E. H. M. (2004). The impact of parental cancer on children and the family: A review of the literature. Cancer Treatment Reviews, 30(8), 683–694. doi:10.1016/j.ctrv.2004.06.001.PubMedCrossRefGoogle Scholar
  48. Yabroff, K. R., & Kim, Y. (2009). Time costs associated with informal caregiving for cancer survivors. Cancer, 115, 4362–4373.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Steffen Torp
    • 1
  • Lisbeth Thoresen
    • 1
  • Arne Backer Grønningsæter
    • 2
  • Ellen Karine Grov
    • 3
  • Karin Gustavsen
    • 1
    • 4
  1. 1.Department of Health PromotionVestfold University CollegeTønsbergNorway
  2. 2.Fafo Institute for Labor and Social ResearchOsloNorway
  3. 3.Department of Nursing ScienceUniversity of OsloOsloNorway
  4. 4.Telemark Research InstituteBø i TelemarkNorway

Personalised recommendations