Academic journal article Health and Social Work

Patterns of Change in Marital Relationships among Parents of Children with Cancer

Academic journal article Health and Social Work

Patterns of Change in Marital Relationships among Parents of Children with Cancer

Article excerpt

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Notwithstanding the improved prognosis of the past two decades (Ries et al., 1996), cancer remains a life-threatening illness and typically is characterized by difficult treatment modes and their side effects. The families of cancer patients experience a series of stressful life events, giving rise to a continuous state of uncertainty and anxiety (Best, Streisand, Catania, & Kazak, 2001; Cohen, 1993; Kazak, 2001).

As several reviews show, the majority of research on family responses to childhood cancer (Grootenhuis & Last, 1997a) and children's other acute and chronic illnesses (Faux, 1998; Youngblut, 1998) focuses on individual family members' responses, especially mothers. Despite a growing awareness of the fact that a child's illness is a family phenomenon (Broome, Knafl, Pridham, & Feetham, 1998; Kazak, 1997) and that parents' coping is an interactive process (Barbarin, Hughes, & Chesler, 1985; Dahlquist et al., 1993), relatively little attention has been given to the ways in which the child's illness affects the parents' marital relationship. Some evidence suggests that some relationships are adversely affected by stressful circumstances but that others appear to be relatively unchanged or may even be strengthened by the experience (Gaither, Bingen, & Hopkins, 2000).

This article focuses on changes in marital relationships among parents of children with cancer. For social workers in the health care system and for community and home health care social workers, knowledge about the marital experiences of such parents may enhance the provision of assistance to families in need and facilitate effective collaboration with medical teams (Lesser, 2000).

EFFECT OF CHILDHOOD CANCER ON MARITAL QUALITY

Studies of marital relationships among parents of children with cancer, using both quantitative and qualitative methodologies, have yielded mixed and somewhat conflicting findings. Some researchers found the marriages of parents of children with cancer to be more distressed than established population norms or comparison groups (Cornman, 1993; Fife, Norton, & Groom, 1987), whereas others found no difference in marital adjustment between parents of children with cancer and parents of children with more common illnesses, such as influenza (Wittrock, Larson, & Sandgren, 1994).

Estimates of the percentage of distressed couples with children who have cancer vary greatly. Whereas early reports estimated that 70 percent of such parents suffer serious marital problems (Kaplan, Grobstein, & Smith, 1976), later studies claimed a smaller proportion of distressed relationships. Dahlquist and her colleagues (1993) found marital distress in one-fourth of the parents two months after diagnosis, and a similar percentage was reported by other researchers (Barbarin et al., 1985; Greenberg & Meadows, 1991). In fact, these researchers found that parenting a child who is being treated for cancer may even bring about increased marital cohesion. Barbarin and his colleagues found that most parents in their sample had a more positive attitude toward their spouse. Likewise, 23 percent of the parents in Greenberg and Meadows' study reported that their marital relationship had been strengthened. In a follow-up study 20 months after diagnosis, Dahlquist, Czyzewski, and Jones (1996) found that although the mean level of marital quality had not changed since shortly after diagnosis, considerable changes in the marital relationship had occurred for some respondents in positive and negative directions. No data were provided by these researchers as to the proportion of couples whose relationships had improved or deteriorated over time (Dahlquist et al., 1996).

Studies of marital quality among parents of children with cancer indicate that the marital relationship may be affected in different ways. However, because multiple conceptualizations and methodologies were used, the patterns of change are not well established. …

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