Parenting a Child with Cancer: Perceptions of Adolescents and Parents of Adolescents and Younger Children Following Completion of Childhood Cancer Treatment

By Williams, Lauren K.; McCarthy, Maria C. et al. | Journal of Family Studies, April 2013 | Go to article overview

Parenting a Child with Cancer: Perceptions of Adolescents and Parents of Adolescents and Younger Children Following Completion of Childhood Cancer Treatment


Williams, Lauren K., McCarthy, Maria C., Eyles, Deborah J., Drew, Sarah, Journal of Family Studies


ABSTRACT: Objective: Research examining the impact of childhood cancer on parenting is limited. This qualitative study explored perceptions from adolescents and parents of the impact of childhood cancer on parenting 2-5 years post-end of treatment. Methods: Fifty-seven semi-structured interviews were conducted with: (a) 14 parents of preadolescent children (the 'parents of children' group); and (b) 21 adolescents and 22 parents of adolescents (the "adolescents and their patents' group; N = 43). Inductive thematic analysis was used to identify and interpret themes. Results: Six main themes emerged: (1) Parenting strategies: relaxing discipline, bribing and spoiling children; (2) Regressive parenting; (3) Structured parenting: keeping up a 'normal' routine; (4) Intimacy, closeness and emotional support; (5) Differential parenting; and (6) Parental protectiveness. Some themes were group specific, whilst other themes emerged for both the 'parents of children' and 'adolescents and their parents' groups. Some reports of parenting were associated with initial stages of cancer whereas other aspects of parenting attitudes and behaviours appeared to exist aider the demands of diagnosis and treatment. This suggests that there is some overlap in the parenting strategies used during 'active' stages of the disease and survivorship. Conclusion: Our results highlight the importance of understanding parenting processes that can operate throughout the disease trajectory for families experiencing paediatric cancer. Parenting is an ongoing process and as such, parenting intervention efforts should not be limited to the active treatment phase of a child's diagnosis.

KEYWORDS: paediatric psycho-oncology, parenting, childhood cancer, psychosocial, adolescence, youth, qualitative

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Following a cancer diagnosis in childhood, families experience a multitude of stressors and psychosocial difficulties associated with caring for a child with cancer (Sloper, 1996; Young, Dixon-Woods, Findlay, & Heney, 2002). Parenting in the context of childhood cancer often requires an indefinite adjustment as treatment and the added concerns about late medical and psychosocial effects of disease and treatment often continues several years after diagnosis. Currently however, research exploring parenting strategies in these circumstances is scarce, with the majority of research focussing on children, rather than adolescents, and parenting at early stages of the disease, such as during active treatment (Colletti et al., 2008; Hillman, 1997). Available evidence suggests specific aspects of parenting occur in the context of paediatric cancer diagnosis and differ from parenting behaviours of healthy children (Long & Marsland, 2011). Reported differences included intensification of the parenting role, closer relationships and deeper bonds with the ill child, increased overprotection and indulgence, and decreased discipline of the ill child (Davies, Noll, DeStefano, Bukowski, & Kulkarni, 1991; Long & Marsland, 2011). Further, there is evidence that parenting styles and strategies, including permissive parenting, high criticism and apologetic behaviour, are viewed negatively by the child with cancer (Patterson, Holm, & Gurney, 2004) and are negatively associated with child psychosocial functioning such as coping (Hillman, 1997; Hullmann, Wolfe-Christensen, Meyer, McNall-Knapp, & Mullins, 2010; Vance & Eiser, 2004).

The ill child's age and developmental stage may also play a role in parenting following paediatric cancer diagnosis. For instance, young children may respond well to increased overprotection whereas adolescence is a period of increased autonomy and similar changes to parenting may be perceived as intrusive and a source of tension between the young person and their parents (Pelcovitz et al., 1998). Evidence for differential parenting between the ill child and the ill child's sibling has also been reported. …

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