The interaction of family functioning and disease- and treatment-related factors on quality of life for children after cancer

Abstract

Purpose

Children with cancer experience low quality of life (QOL), yet heterogeneity underscores a need to understand how risk and resilience factors interact. This study evaluated if family functioning relates to QOL differentially depending on diagnosis and treatment intensity.

Methods

Participants included children (ages 8–14) who completed treatment within six months for either brain tumor (BT; n = 42) or non-central nervous system solid tumor (ST; n = 29). Caregivers and children rated QOL and family functioning. Treatment intensity was categorized as low, moderate, or high. Cross-informant moderation models tested hypothesized interactions.

Results

Child-reported family functioning significantly interacted with diagnosis and treatment intensity in models of caregiver-reported QOL. More maladaptive family functioning was associated with reduced QOL for children with BT and moderately-intense treatments.

Conclusions

Children with BT and moderate treatment intensities are sensitive to family functioning, highlighting an at-risk group to target for family-level intervention. Future work should evaluate these associations longitudinally.

Keywords:

• Brain neoplasm
• cancer
• family functioning
• family health
• family relations
• family relations
• oncology
• pediatrics
• quality of life

Acknowledgments

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Author contributions include: Emily L. Moscato conceptualized the secondary data analysis design, assisted with secondary data analysis and interpretation, wrote the preliminary drafts of the manuscript, and integrated co-author comments to finalize the manuscript. May V. Albee conducted some of the secondary data cleaning and analysis, assisted with the literature search, and assisted with editing and formatting the manuscript. Ashley Anil conducted some of the secondary data analysis and assisted with writing and editing the manuscript. Matthew C. Hocking designed and oversaw the larger study including securing funding, oversaw data analysis and interpretation, and wrote/edited the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability

Data can be made available upon reasonable request to the authors.

Additional information

Funding

This research was supported by the National Cancer Institute of the National Institutes of Health (K07CA178100).