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Quality of Life Research

, Volume 19, Issue 9, pp 1373–1380 | Cite as

The relationship between parental overprotection and health-related quality of life in pediatric cancer: the mediating role of perceived child vulnerability

  • Stephanie E. HullmannEmail author
  • Cortney Wolfe-Christensen
  • William H. Meyer
  • Rene Y. McNall-Knapp
  • Larry L. Mullins
Article

Abstract

Purpose

The current study sought to examine the relation of parental overprotection and perceived child vulnerability to parent-reported health-related quality of life in parents of children with cancer.

Methods

Parents (N = 89) of children who had been diagnosed with cancer completed measures of parental overprotection, perceived child vulnerability, and parent-proxy report of health-related quality of life.

Results

After controlling for theoretically relevant covariates, parental overprotection and perceived child vulnerability were both found to be significantly related to child health-related quality of life. Additional analyses revealed that perceived child vulnerability mediated the relationship between overprotective parenting behaviors and the child’s health-related quality of life.

Conclusion

The findings highlight the need to assess for these discrete parenting variables in parents of children with cancer and to develop interventions to target parental perceptions of vulnerability.

Keywords

Cancer Child Quality of life Overprotection Vulnerability 

Abbreviations

ALL

Acute lymphoblastic leukemia

CVS

Child vulnerability scale

HIPAA

Health insurance portability and accountability act

HRQOL

Health-related quality of life

IRB

Institutional review board

PedsQL

Pediatric quality of life inventory 3.0 cancer module

PPS

Parent protection scale

References

  1. 1.
    Levi, R. B. (2006). Quality of life in childhood cancer: Meaning, methods, and missing pieces. In R. T. Brown (Ed.), Comprehensive handbook of childhood cancer and sickle cell disease: A biospsychosocial approach (pp. 170–188). New York: Oxford University Press.Google Scholar
  2. 2.
    Drotar, D. (1998). Preface. In D. Drotar (Ed.), Measuring health-related quality of life in children and adolescents: Implications for research and practice (pp. 3–24). Mahwah, NJ: Erlbaum.Google Scholar
  3. 3.
    Kazak, A. E., & Barakat, L. P. (1997). Brief report: Parenting stress and quality of life during treatment for childhood leukemia predicts child and parent adjustment after treatment ends. Journal of Pediatric Psychology, 22, 749–758.CrossRefPubMedGoogle Scholar
  4. 4.
    Cote, M. R., Mullins, L. L., Hartman, V. L., Hoff, A., Balderson, B. H. K., Chaney, J. M., et al. (2003). Psychosocial correlates of health care utilization for children and adolescents with Type I diabetes. Children’s Health Care, 32, 1–16.CrossRefGoogle Scholar
  5. 5.
    Holmbeck, G. N., Johnson, S. Z., Wills, K. E., McKernon, W., Rose, B., Erklin, S., et al. (2002). Observed and perceived parental overprotection in relation to psychosocial adjustment in preadolescents with a physical disability: The mediational role of behavioral autonomy. Journal of Consulting and Clinical Psychology, 70, 96–110.CrossRefPubMedGoogle Scholar
  6. 6.
    Colletti, C. J. M., Wolfe-Christensen, C., Carpentier, M. Y., Page, M. C., McNall-Knapp, R. Y., Meyer, W. H., et al. (2008). The relationship of parental overprotection, perceived vulnerability, and parenting stress to behavioral, emotional, and social adjustment in children with cancer. Pediatric Blood & Cancer, 51, 269–274.CrossRefGoogle Scholar
  7. 7.
    Lopez, W. L., Mullins, L. L., Wolfe-Christensen, C., & Bourdeau, T. (2008). The relation between parental psychological distress and adolescent anxiety in youths with chronic illnesses: The mediating effect of perceived child vulnerability. Children’s Health Care, 37, 171–182.CrossRefGoogle Scholar
  8. 8.
    Powers, T. G., Dahlquist, L. M., Thompson, S. M., & Warren, R. (2003). Interactions between children with juvenile rheumatoid arthritis and their mothers. Journal of Pediatric Psychology, 28, 213–221.CrossRefGoogle Scholar
  9. 9.
    Thompson, R. J., & Gustafson, K. E. (1996). Adaptation to chronic childhood illness. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  10. 10.
    Thomasgard, M., & Metz, W. P. (1997). Parental overprotection and its relation to perceived child vulnerability. American Journal of Orthopsychiatry, 67, 330–335.CrossRefPubMedGoogle Scholar
  11. 11.
    Levy, D. (1931). Maternal overprotection and rejection. Archives of Neurology and Psychiatry, 25, 886–889.Google Scholar
  12. 12.
    Parker, G. (1981). Parental representations of patients with anxiety neurosis. Acta Psychiatrica Scandinavica, 63, 33–36.CrossRefPubMedGoogle Scholar
  13. 13.
    Parker, G. (1983). Parental overprotection: A risk factor in psychosocial development. New York, NY: Grune & Stratton, Inc.Google Scholar
  14. 14.
    Anthony, K. K., Gil, K. M., & Schanberg, L. E. (2003). Brief report: Parental perceptions of child vulnerability in children with chronic illness. Journal of Pediatric Psychology, 28, 185–190.CrossRefPubMedGoogle Scholar
  15. 15.
    Forsyth, B., Horwitz, S., Leventhal, J., Burger, J., & Leaf, P. (1996). The child vulnerability scale: An instrument to measure parental perceptions of child vulnerability. Journal of Pediatric Psychology, 21, 89–101.CrossRefPubMedGoogle Scholar
  16. 16.
    Thomasgard, M., & Metz, W. (1993). Parental overprotection revisited. Child Psychiatry and Human Development, 24, 67–79.CrossRefPubMedGoogle Scholar
  17. 17.
    Mullins, L. L., Wolfe-Christensen, C., Pai, A. L., Carpentier, M. Y., Gillaspy, S., Cheek, J., et al. (2007). The relationship of parental overprotection, perceived child vulnerability, and parenting stress to uncertainty in youth with chronic illness. Journal of Pediatric Psychology, 32, 973–982.CrossRefPubMedGoogle Scholar
  18. 18.
    Vance, Y. H., Morse, R. C., Jenney, M. E., & Eiser, C. (2001). Issues in measuring quality of life in childhood cancer: Measures, proxies, and parental mental health. Journal of Child Psychology and Psychiatry and Allied Disciplines, 42, 661–667.CrossRefGoogle Scholar
  19. 19.
    Varni, J. W., Burwinkle, T. M., Katz, E. R., Meeske, K., & Dickinson, P. (2002). The PedsQL in pediatric cancer: Reliability and validity of the pediatric quality of life inventory generic core scales, multidimensional fatigue scale, and cancer module. Cancer, 94, 2090–2106.CrossRefPubMedGoogle Scholar
  20. 20.
    Thomasgard, M., Metz, W. P., Edelbrock, C., & Shonkoff, J. P. (1995). Parent–child relationship disorders. Part I. Parental overprotection and the development of the Parent Protection Scale. Journal of Developmental and Behavioral Pediatrics, 16, 244–250.PubMedGoogle Scholar
  21. 21.
    Thomasgard, M., Shonkoff, J. P., Metz, W. P., & Edelbrock, C. (1995). Parent–child relationship disorders. Part II. The vulnerable child syndrome and its relation to parental overprotection. Journal of Developmental and Behavioral Pediatrics, 16, 251–256.PubMedGoogle Scholar
  22. 22.
    Varni, J. W., Limbers, C., & Burwinkle, T. M. (2007). Literature review: Health-related quality of life measurement in pediatric oncology: Hearing the voices of the children. Journal of Pediatric Psychology, 32, 1151–1163.CrossRefPubMedGoogle Scholar
  23. 23.
    Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.CrossRefPubMedGoogle Scholar
  24. 24.
    Holmbeck, G. N. (2002). Post-hoc probing of significant moderational and mediational effects in studies of pediatric populations. Journal of Pediatric Psychology, 27, 87–96.CrossRefPubMedGoogle Scholar
  25. 25.
    Spurrier, N. J., Sawyer, M. G., Staugas, R., Martin, A. J., Kennedy, D., & Streiner, D. L. (2000). Association between parental perception of children’s vulnerability to illness and management of children’s asthma. Pediatric Pulmonology, 29, 88–93.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Stephanie E. Hullmann
    • 1
    Email author
  • Cortney Wolfe-Christensen
    • 2
  • William H. Meyer
    • 3
  • Rene Y. McNall-Knapp
    • 3
  • Larry L. Mullins
    • 1
  1. 1.Department of PsychologyOklahoma State UniversityStillwaterUSA
  2. 2.Department of Pediatrics/NeurologyChildren’s Hospital of MichiganDetroitUSA
  3. 3.Department of PediatricsOklahoma University Health Sciences CenterOklahoma CityUSA

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