Direct and indirect factors of influence on adjustment of parents of children with solid tumor in active treatment

Our cross-sectional study intended firstly to investigate whether childhood cancer impact on parents’ adult attachment, perceived social support, marital adjustment, anxiety and depressive symptoms. Second aim was to extend our understanding of the adjustment of parents whose children have cancer, by developing an integrative model linking attachment orientations (i.e., attachment anxiety and attachment avoidance) to parents’ adjustment (i.e., anxiety and depression), taking into account the mediating role of dyadic adjustment with the partner, perceived social support, and coping style. 30 parents (20 mothers, 10 fathers; age: 30 – 54 years) of children in active treatment for solid tumor and 30 matched control parents of healthy children participated in the study. Participants completed: Experiences in Close Relationships–Revised questionnaire (ECR-R), Dyadic Adjustment Scale 4-item version (DAS-4), Multidimensional Scale of Perceived Social Support (MSPSS), State-Trait Anxiety Inventory form Y (STAI-Y) and Beck Depression Inventory (BDI), and – only parents of the experimental group – Mini Mental Adjustment to Cancer Scale (Mini-MAC). The study group had significant higher scores of attachment avoidance (t = 3.33, p = .002), state anxiety (t = 3.44, p = .001), and depression (t = 3.26, p = .002) and lower levels of dyadic adjustment (t = -2.72, p = .009) than the matched controls. Path analyses showed that attachment orientations, dyadic adjustment, social support have significant indirect influences on two coping styles of adjustment to cancer (i.e., helplessness/hopelessness, anxious preoccupation) which, in turns, affect parents’ psychological adjustment. Results suggest the importance to consider, during pediatric treatment for cancer, parents’ well-being and adjustment including not only biomedical but also psychosocial and relational factors, to improved familybased intervention in pediatric care.