Psychological resilience and long-term distress in Swedish and Icelandic parents’ adjustment to childhood cancer

Abstract

Aim. Studies of parental reactions to a child's cancer have traditionally been carried out within the framework of psychiatry and psychopathology. We studied the significance of individual resource factors strengthening parents’ resilience to long-term cancer-related distress, a focus that has rarely been used. Participants and methods. The two-nation Nordic sample included 398 parents; 190 of whom had experienced a child's cancer, and 208 reference parents. We studied the sense of coherence (SOC) using the SOC-13 questionnaire. For assessing distress reactions we used a primarily illness-specific 11-dimensional Parental Psychosocial Distress in Cancer (PPD-C) self-report questionnaire developed for use with parents of childhood cancer patients, and the General Health Questionnaire (GHQ). Resilience was defined as absence of/less severe distress. Results. Low SOC was significantly associated with more severe distress in all dimensions of the PPD-C and GHQ. The protective effect of SOC was indicated by it being most negatively related to general psychiatric symptoms, physical and psychological stress symptoms, anxiety and depression. The influence of SOC varied with parents’ gender, showing a stronger modifying influence among mothers. Mothers and fathers also differed in their utilisation of professional psychosocial support when confronted with the child's cancer. Conclusion. Parental resilience to cancer-related distress varies with identifiable strength factors. A strengths-oriented approach helps in understanding parental adjustment to childhood cancer. In order to counteract psychological vulnerability, addressing resilience instead of pathology helps to identify parents at risk and in need of professional support when faced with a child's cancer.

Acknowledgements

This study was supported by grants from The Swedish Childhood Cancer Foundation, Swedish Cancer and Traffic Injury Fund, and the Iceland Kristin Fund. We thank Jeremy H. Becker for helpful comments during preparation of the manuscript. Among those who contributed to make this study possible, our greatest appreciation also goes to all mothers and fathers who participated. The authors declare no conflict of interest.