Department of Psychiatry, University of North Carolina, 170 Manning Drive, CB #7305, Chapel Hill, NC, 27599, USA.
Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Support Care Cancer. 2019 Jul;27(7):2443-2451. doi: 10.1007/s00520-018-4518-1. Epub 2018 Oct 27.
Parents with cancer have unique and often under-recognized psychological distress about the impact of their illness on their children. Relatively little is known about how parenting concerns may differ among patients by cancer stage.
This is a secondary data analysis of 203 adults with cancer who had children < 18 years old from two geographically distinct areas. We used an analysis of covariance to estimate the mean differences in PCQ, depression symptom severity and anxiety symptom severity (Hospital Anxiety and Depression Scale, HADS) scores between participants with metastatic and non-metastatic disease, and Pearson's correlation coefficients to assess associations between HADS and PCQ scores by cancer stage.
Seventy-two percent of participants (n = 146) had metastatic solid tumor cancer. In adjusted analyses, mean PCQ scores did not significantly differ between parents with metastatic and non-metastatic disease (2.0 vs. 2.2, p = 0.06). Differences in mean PCQ scores were driven by a single question concerning the impact of death on children (2.3 vs. 2.9, p = 0.004). Mean HADS scores did not significantly differ between groups, although PCQ scores explained a greater amount of variance in HADS scores for the metastatic group as compared to the non-metastatic group.
With the exception of concerns about death, intensity of parenting concerns, as measured by the PCQ, was similar between parents with metastatic and non-metastatic cancer. However, parenting concerns may be more strongly linked to overall psychological distress in patients with metastatic disease. Further research is needed to clarify how parenting concerns uniquely relate to advanced stage illness.
患有癌症的父母对自身疾病对子女的影响存在独特且常常未被充分认识的心理困扰。关于父母对子女的担忧在癌症分期不同的患者中可能存在怎样的差异，人们知之甚少。
这是对来自两个地理位置不同地区的 203 名癌症患儿（<18 岁）的父母进行的二次数据分析。我们使用协方差分析来估计转移性和非转移性疾病患者之间在父母关怀问卷（PCQ）、抑郁症状严重程度和焦虑症状严重程度（医院焦虑和抑郁量表，HADS）评分上的平均差异，并使用 Pearson 相关系数来评估 HADS 和 PCQ 评分与癌症分期之间的相关性。
72%的参与者（n=146）患有转移性实体瘤癌症。在调整后的分析中，转移性和非转移性疾病患者的 PCQ 评分均值没有显著差异（2.0 vs. 2.2，p=0.06）。PCQ 评分均值的差异主要由一个关于死亡对子女影响的问题驱动（2.3 vs. 2.9，p=0.004）。两组间的 HADS 评分均值没有显著差异，但与非转移性疾病组相比，PCQ 评分对转移性疾病组 HADS 评分的变异量解释更大。
除了对死亡的担忧之外，父母关怀问卷（PCQ）所测量的父母对子女的担忧强度在转移性和非转移性癌症患者之间相似。然而，在患有转移性疾病的患者中，父母对子女的担忧可能与整体心理困扰更密切相关。需要进一步的研究来阐明父母对子女的担忧如何与晚期疾病独特相关。
