Peace of mind and sense of purpose as core existential issues among parents of children with cancer.

OBJECTIVE

To evaluate issues experienced by parents of children with cancer and factors related to parents' ability to find peace of mind.

DESIGN

Cross-sectional survey.

SETTING

Dana-Farber Cancer Institute and Children's Hospital, Boston, Massachusetts.

PARTICIPANTS

One hundred ninety-four parents of children with cancer (response rate, 70%) in the first year of cancer treatment.

MAIN OUTCOME MEASURE

The Functional Assessment of Chronic Illness Therapy-Spiritual Well-being sense of meaning subscale.

RESULTS

Principal components analysis of Functional Assessment of Chronic Illness Therapy-Spiritual Well-being sense of meaning subscale responses identified 2 distinct constructs, peace of mind (Cronbach alpha = .83) and sense of purpose (Cronbach alpha = .71). Scores ranged from 1 to 5, with 5 representing the strongest sense of peace or purpose. One hundred forty-seven of 181 parents (81%) scored 4 or higher for questions related to sense of purpose (mean [SD] score, 4.4 [0.6]). Only 44 of 185 parents (24%) had scores in the same range for peace of mind (mean [SD] score, 3.2 [0.9]) (P < .001). In a multivariable logistic regression model, parents had higher peace of mind scores when they also reported that they trusted the oncologist's judgment (odds ratio [OR] = 6.65; 95% confidence interval [CI], 1.47-30.02), that the oncologist had disclosed detailed prognostic information (OR = 2.05; 95% CI, 1.14-3.70), and that the oncologist had provided high-quality information about the cancer (OR = 2.54; 95% CI, 1.11-5.79). Peace of mind was not associated with prognosis (OR = 0.74; 95% CI, 0.41-1.32) or time since diagnosis (OR = 1.00; 95% CI, 0.995-1.003).

CONCLUSIONS

Physicians may be able to facilitate formulation of peace of mind by giving parents high-quality medical information, including prognostic information, and facilitating parents' trust.