Background: When a child has a tumour, parents enter a world where the ground is unfamiliar and their basic child-rearing tasks are challenged. Adherence to pediatric cancer treatment can be difficult for families, especially when the child is very young. Parents’ child-rearing attitudes and practices may affect the child’s reactions to treatments and her/his general adjustment in several ways, i.e. helping the child during medical procedures and increasing her/his general compliance with treatments. Aims: This chapter has two aims: the first is to explore what happens to parenting behavior during childhood; the second is to develop and test a model of how family processes influence the psycho-social development of children with leukemia. Method: Patients were 118 leukemic children and their families recruited at the Haematology-Oncologic Clinic of the Department of Pediatrics, University of Padua. All parents were Caucasian with a mean age of 37.39 years (SD = 6.03). Most parents had 13 years of school (50.8%); 32.2% had 8 years; 5.9% had college education; 9.3% had degree or diploma and 1.7% had 5 years of school. The parents who participated were mostly mothers (N = 101) and only a few were fathers (N = 17) because the mothers were more proximal to the child during hospitalization while fathers stayed with other siblings or continued to work to maintain the family. Children’s mean age was 5.89 years (SD = 4.21, range = 1 year-17 years). Mostly children had Acute Lymphoblastic Leukemia (ALL) (N = 98), while 20 had Acute Myeloid Leukemia (AML). The families were contacted by a clinical psychologist during the first hospitalization of their children (T1). Project aims were explained and informed consent was asked for. The parents were interviewed in a separate room of the Clinic using the Ecocultural Family Interview-Cancer (Tremolada et al., 2011) from which we derived 8 family Psycho-Social Factors (including Parenting) and 3 child’s Factors (including Child’s coping with medical procedures). One year later (T2, N= 78), the clinical psychologist interviewed again parents using the VABS scales (Sparrow et al., 1984; Italian edition by Balboni & Pedrabissi, 2003) to assess child’s adaptation during the maintenance therapy phase. Results: The analyses revealed the presence of a significant difference in parenting by child’s age: Infants required an higher and more intensive parenting compared to preschoolers and older children. Child’s coping to medical procedures at the second week after the diagnosis (T1), controlled for parenting effect, impacted upon child’s adaptation one year post diagnosis (T2). In this model parenting was identified as a mediator that increases the effect of child’s coping on her/his adaptive behavior. Discussion: These findings confirm the difficult role of parents in caring their children especially when they are infants. Specific intervention programmes will be discussed in order to help children more at risk just after the diagnosis for developmental delays.
Parenting a Child with Leukemia: A Key Role in the Global Adjustment of Child
TREMOLADA, MARTA;BONICHINI, SABRINA;
2012
Abstract
Background: When a child has a tumour, parents enter a world where the ground is unfamiliar and their basic child-rearing tasks are challenged. Adherence to pediatric cancer treatment can be difficult for families, especially when the child is very young. Parents’ child-rearing attitudes and practices may affect the child’s reactions to treatments and her/his general adjustment in several ways, i.e. helping the child during medical procedures and increasing her/his general compliance with treatments. Aims: This chapter has two aims: the first is to explore what happens to parenting behavior during childhood; the second is to develop and test a model of how family processes influence the psycho-social development of children with leukemia. Method: Patients were 118 leukemic children and their families recruited at the Haematology-Oncologic Clinic of the Department of Pediatrics, University of Padua. All parents were Caucasian with a mean age of 37.39 years (SD = 6.03). Most parents had 13 years of school (50.8%); 32.2% had 8 years; 5.9% had college education; 9.3% had degree or diploma and 1.7% had 5 years of school. The parents who participated were mostly mothers (N = 101) and only a few were fathers (N = 17) because the mothers were more proximal to the child during hospitalization while fathers stayed with other siblings or continued to work to maintain the family. Children’s mean age was 5.89 years (SD = 4.21, range = 1 year-17 years). Mostly children had Acute Lymphoblastic Leukemia (ALL) (N = 98), while 20 had Acute Myeloid Leukemia (AML). The families were contacted by a clinical psychologist during the first hospitalization of their children (T1). Project aims were explained and informed consent was asked for. The parents were interviewed in a separate room of the Clinic using the Ecocultural Family Interview-Cancer (Tremolada et al., 2011) from which we derived 8 family Psycho-Social Factors (including Parenting) and 3 child’s Factors (including Child’s coping with medical procedures). One year later (T2, N= 78), the clinical psychologist interviewed again parents using the VABS scales (Sparrow et al., 1984; Italian edition by Balboni & Pedrabissi, 2003) to assess child’s adaptation during the maintenance therapy phase. Results: The analyses revealed the presence of a significant difference in parenting by child’s age: Infants required an higher and more intensive parenting compared to preschoolers and older children. Child’s coping to medical procedures at the second week after the diagnosis (T1), controlled for parenting effect, impacted upon child’s adaptation one year post diagnosis (T2). In this model parenting was identified as a mediator that increases the effect of child’s coping on her/his adaptive behavior. Discussion: These findings confirm the difficult role of parents in caring their children especially when they are infants. Specific intervention programmes will be discussed in order to help children more at risk just after the diagnosis for developmental delays.Pubblicazioni consigliate
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