Academic journal article Journal of Marriage and Family

Marital Dissatisfaction, Psychological Distress, and the Coping of Parents of Pediatric Cancer Patients

Academic journal article Journal of Marriage and Family

Marital Dissatisfaction, Psychological Distress, and the Coping of Parents of Pediatric Cancer Patients

Article excerpt

This study examines the marital satisfaction of 124 parents of pediatric cancer patients in relation to their psychological distress and coping preferences over a year. Results show that there was a significant increase in marital dissatisfaction for the group as a whole. Marital dissatisfaction was significantly and positively associated with psychological distress at 6 and 12 months, but not at diagnosis. Fathers appeared to be more self-oriented when they judged the quality of their marriage. Their marital distress was related to their own coping behavior, not to that of their partners. Mothers were more other oriented. Their marital distress was related to their partners' coping preferences, rather than to their own. Discrepancies in coping within couples were associated with marital distress in both partners.

Key Words: coping styles, parental marital dissatisfaction, pediatric cancer.

The diagnosis of cancer in a child has a devastating impact on both child and parents. The lifethreatening nature of the illness (40% of children do not survive their illness), invasive treatment, distressing side effects, uncertainty about survival, repeated hospitalizations that disrupt normal family routines, and changes in usual roles and responsibilities have implications not only for each family member, but also for the whole family system (Kazak,1994). Some studies show persistent psychological problems in parents one year after diagnosis, although the incidence of these problems declined significantly in the months following the diagnosis (Hoekstra-Weebers, Heuvel, Boskamp, Kamps, & Klip, 1996; Sawyer, Antoniou, Toogood, Rice, & Baghurst, 1993). Six and 10 years after diagnosis, parents were reported to cope well (Kupst et al., 1995). However, parents frequently complained about feelings of uncertainty and loneliness long after cessation of treatment (DongenMelman et al., 1995), and they continued to be concerned with the physical and mental development of their child and potentially fewer future opportunities (Greenberg & Meadows, 1992).

Cancer in a child affects both parents, and, in coping with this event, parents may need each other for support (Barbarin, Hughes, & Chesler, 1985). Therefore, the quality of the marital relationship is important. Two studies, using interviews and observations found that marital satisfaction remained unchanged-or even increasedand that family cohesion was strengthened by experiences with childhood cancer (Barbarin et al., 1985; Kupst & Schulman, 1988). Other studies, using standardized questionnaires, reported a higher percentage of parents who indicated marital distress shortly after diagnosis than is normal in the general population (Dahlquist et al., 1993; Fife, Norton, & Groom, 1987).

Kupst and Schulman (1988) reported that overall family coping was positively related to the quality of the marital relationship. Coping in their study refers to the psychosocial adaptation of the family to the illness of the child. In the process of adaptation, the actual coping strategies that parents use to manage the stress of the diagnosis and treatment of their child are important, according to Lazarus's theory (1993) of stress and coping. Coping behavior may assume a mediating role between this stressful event and parental psychological functioning. The coping strategies of each parent are likely to affect the marital relationship. Koocher and O'Malley (1981) suggest that marital difficulties arise when partners use different coping styles or when partners use coping styles in a dissynchronic way (Adams-Greenly, 1986). However, there is little information on the association between coping styles and marital discord. We found only two studies that investigated this. One reported a positive association between marital quality and complementarity (one parent using a strategy a great deal; the other, not very much) in problemfocused coping and symmetry in emotion-focused coping (Barbarin et al. …

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