Hailey Claire E, Yopp Justin M, Deal Allison M, Mayer Deborah K, Hanson Laura C, Grunfeld Gili, Rosenstein Donald L, Park Eliza M
School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Comer Children's Hospital, University of Chicago Medicine, 5721 S. Maryland Avenue, MC 8000, Chicago, IL, 60637, USA.
Support Care Cancer. 2018 Jan;26(1):287-295. doi: 10.1007/s00520-017-3847-9. Epub 2017 Aug 7.
Parents with advanced cancer are faced with difficult decision-making about communication about their illness with their children. The objectives of this study were to describe how parents communicated with their children about advanced cancer and to explore associations between communication and parental depression and anxiety.
This was a cross-sectional, mixed-methods study of 42 patients with stage IV solid tumor malignancies who had at least one child less than 18 years of age. Participants completed a semi-structured interview and the Hospital Anxiety and Depression Scale (HADS). We used multiple linear regression to evaluate the association between extent of communication and HADS Anxiety and Depression scores. Interview data were analyzed using standard qualitative content and thematic techniques and triangulated with survey data.
Higher HADS Anxiety scores, but not HADS Depression scores, were cross-sectionally associated with greater extent of parental communication (p = 0.003), even when controlling for performance status and children's ages. In qualitative analyses, parents who acknowledged the terminal nature of their illness or experienced higher symptom burden were more likely to report that they also communicated more extensively with children. A third of parents (n = 14, 33%) described difficulty with illness-related communication with their children.
In this pilot study, parents with advanced cancer who reported more illness-related communication with their children also reported more symptoms of general anxiety. Future interventions should address psychological distress relevant to parenting and further assess how parental communication may be linked to parental mood symptoms.
患有晚期癌症的父母在决定是否与子女交流自己的病情时面临艰难抉择。本研究的目的是描述父母如何与子女交流晚期癌症病情，并探讨这种交流与父母抑郁和焦虑之间的关联。
这是一项横断面混合方法研究，研究对象为42例IV期实体瘤恶性肿瘤患者，他们至少有一个18岁以下的子女。参与者完成了一次半结构化访谈以及医院焦虑抑郁量表（HADS）。我们使用多元线性回归来评估交流程度与HADS焦虑和抑郁得分之间的关联。访谈数据采用标准的定性内容和主题技术进行分析，并与调查数据进行三角验证。
即使在控制了身体状况和子女年龄后，横断面分析显示，HADS焦虑得分较高（而非HADS抑郁得分）与父母更大程度的交流相关（p = 0.003）。在定性分析中，承认自己病情终末期性质或症状负担较重的父母更有可能报告他们与子女的交流也更广泛。三分之一的父母（n = 14，3%)表示在与子女进行与疾病相关的交流时存在困难。
在这项初步研究中，报告与子女进行更多与疾病相关交流的晚期癌症父母也报告了更多的一般焦虑症状。未来的干预措施应解决与为人父母相关的心理困扰，并进一步评估父母的交流方式可能如何与父母的情绪症状相关联。
