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Parental psychological distress and cancer stage: a comparison of adults with metastatic and non-metastatic cancer

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Abstract

Purpose

Parents with cancer have unique and often under-recognized psychological distress about the impact of their illness on their children. Relatively little is known about how parenting concerns may differ among patients by cancer stage.

Methods

This is a secondary data analysis of 203 adults with cancer who had children < 18 years old from two geographically distinct areas. We used an analysis of covariance to estimate the mean differences in PCQ, depression symptom severity and anxiety symptom severity (Hospital Anxiety and Depression Scale, HADS) scores between participants with metastatic and non-metastatic disease, and Pearson’s correlation coefficients to assess associations between HADS and PCQ scores by cancer stage.

Results

Seventy-two percent of participants (n = 146) had metastatic solid tumor cancer. In adjusted analyses, mean PCQ scores did not significantly differ between parents with metastatic and non-metastatic disease (2.0 vs. 2.2, p = 0.06). Differences in mean PCQ scores were driven by a single question concerning the impact of death on children (2.3 vs. 2.9, p = 0.004). Mean HADS scores did not significantly differ between groups, although PCQ scores explained a greater amount of variance in HADS scores for the metastatic group as compared to the non-metastatic group.

Conclusions

With the exception of concerns about death, intensity of parenting concerns, as measured by the PCQ, was similar between parents with metastatic and non-metastatic cancer. However, parenting concerns may be more strongly linked to overall psychological distress in patients with metastatic disease. Further research is needed to clarify how parenting concerns uniquely relate to advanced stage illness.

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Acknowledgements

The authors wish to gratefully acknowledge the patients who participated in this study and who gave their time to share their experiences.

Funding

The study was supported by the Doris Duke Charitable Foundation through Grant Number 2015213 (Park), the Foundation of Hope (Park), and the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through Grant Award Numbers 1UL1TR001111, 550KR41218, and 1KL2TR001109 (Park) and the NIH through R03 CA126394-01 (Muriel) and 1K07 CA218167-0 (Park).

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Authors and Affiliations

  1. Department of Psychiatry, University of North Carolina, 170 Manning Drive, CB #7305, Chapel Hill, NC, 27599, USA

    Eliza M. Park

  2. Department of Medicine, University of North Carolina, Chapel Hill, NC, USA

    Eliza M. Park

  3. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA

    Eliza M. Park & Allison M. Deal

  4. Department of Psychiatry, Vanderbilt University, Nashville, TN, USA

    Elise M. Stephenson

  5. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Cynthia W. Moore

  6. Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA

    Anna C. Muriel

Authors
  1. Eliza M. Park
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  2. Elise M. Stephenson
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  3. Cynthia W. Moore
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  4. Allison M. Deal
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  5. Anna C. Muriel
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Corresponding author

Correspondence to Eliza M. Park.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Park, E.M., Stephenson, E.M., Moore, C.W. et al. Parental psychological distress and cancer stage: a comparison of adults with metastatic and non-metastatic cancer. Support Care Cancer 27, 2443–2451 (2019). https://doi.org/10.1007/s00520-018-4518-1

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  • DOI: https://doi.org/10.1007/s00520-018-4518-1

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