Individual and Marital Adjustment among Bereaved and Nonbereaved Parents of Children Treated for Cancer.

Studies of parents of children treated for cancer have rarely included adequate samples of fathers or couples. Further, bereaved parents have been over-represented as compared to parents of cancer survivors. This study investigated the personal and interpersonal effects of having a child treated for cancer on 124 parents. Twenty-seven married couples were bereaved and 33 married couples were nonbereaved. Four bereaved parents without spouses were also included. All survivors had been off-treatment for at least 6 months and the average time since diagnosis was 6 years. Effects at the personal level-psychological distress-were assessed by self-report on one global scale and 7 subscales of the Brief Symptom Inventory (BSI). Effects at the interpersonal level-marital satisfaction-were assessed by self-report on the summary scale and 2 factors of the Martial Adjustment Test. Mothers and fathers reported higher levels of psychological distress than nonpatient norms, but lower levels than outpatient psychiatric norms. Fathers reported lower levels of marital satisfaction than nonreferred male norms; mothers did not differ from norms on marital satisfaction. Matched pairs t-tests on 60 couples demonstrated no differences between mothers and fathers in terms of levels of psychological distress and marital satisfaction. Bereaved and nonbereaved mothers did not differ on reported levels of psychological distress after controlling for the effects of time since diagnosis. This time effect appeared to be more salient for mothers, with mothers of more recently diagnosed children reporting higher levels of distress. Bereaved fathers did report higher levels of psychological distress on several BSI subscales than did nonbereaved fathers; no effect of time since diagnosis was observed for fathers. After a median split into high and low on the distress dimension, bereaved mothers reporting higher psychological distress also reported lower satisfaction with their marriages. Fathers reporting higher levels of psychological distress also reported lower marital satisfaction, but this was true of both bereaved and nonbereaved fathers. The results reveal some areas of similarity in outcome for bereaved and nonbereaved parents and for mothers and fathers of children treated for cancer. There are suggestions, however, of differential processes for mothers and fathers in terms of the effects of time since diagnosis, treatment outcome, and personal distress on satisfaction with the marital relationship. The results are suggestive of the complexities of parental coping with childhood cancer and the need for greater specificity and continued study. (Author)