Background: Despite advances in cancer prognosis and increased survival rates for childhood cancer, having a child diagnosed with cancer can be considered one of the most stressful life events in a parent’s life. The adverse psychological impact of childhood cancer on parents has been found to be higher than in any other childhood chronic illness. Parents can find it difficult to adjust and use effective coping strategies to deal with the illness-related demands. Dispositional optimism (i.e. positive outcome expectancies for the future) has become a key theoretical component in positive and health psychological research, aiming to explain adjustment and coping in distressing life situations. However, optimism in the context of caregiving for a child with chronic illness and especially cancer has received little research attention, but may be important as optimistic people tend to show greater psychological adjustment and effective coping. Aims: To identify the characteristics of optimistic parents of children with cancer. To examine the relationship between optimism, anxiety, depression, life satisfaction, coping and subjective health perception in parents of children with cancer and parents of healthy children. Also, to provide a more in-depth understanding of the needs and experiences of parents in relation to their level of optimism/pessimism. Methods: A mixed methodological approach (quantitative and qualitative methods) was adopted to study optimism as well as the impact and the experiences of parents caring for their child with cancer. The mixed method design comprised two phases of data collection and analysis. In Phase I, quantitative methods were used. 100 parents of children with cancer were recruited during attendance at Oncology Out-patients Clinics at a UK regional Cancer Centre. A comparison group of 117 parents of healthy children were also recruited. All parents completed a questionnaire, providing demographic and medical information relating to their child, dispositional optimism, psychological distress, life satisfaction, coping and subjective health perception. Descriptive statistics, unrelated t-tests and x2 tests were used where appropriate to examine differences on optimism, psychological distress, life satisfaction and coping variables between the SG and CG. Bivariate Pearson correlations were used to identify any possible differences between the two groups. In Phase II, qualitative data were collected and analysed using Interpretative Phenomenological Analysis (IPA). 10 semi-structured interviews were conducted with 5 high optimistic and 5 high pessimistic parents of children with cancer given their optimism score in the quantitative study. Results: In the Phase I of the study, findings showed that the parents of children with cancer had higher levels of anxiety, depression, lower levels of optimism, satisfaction with life and subjective health perception than the comparison group. Optimism was significantly correlated with satisfaction with life, subjective health perception, anxiety and depression in both groups. The interviews in Phase II of the study explained better the role of optimism and pessimism in parental experience of adjusting to and coping with childhood cancer. Interviewees described the way that their child’s diagnosis of cancer had affected their lives and their journey from shock to acceptance and adjustment for the optimistic parents or despair and feelings of helplessness and inability to cope for the pessimistic parents. Regardless of level optimism/pessimism, interviews underlined the importance and parents’ need for social support, ongoing communication with health professionals and contact with other parents of children with cancer. Conclusion: The findings highlight the importance of optimism and pessimism in relationship to psychological distress in parents of children with cancer. Interventions targeting parents’ optimism are recommended as a potential source of coping with adversity within this population.
|Date of Award||2007|
|Supervisor||Lesley Powell (Supervisor), Julie Barlow (Supervisor) & Helen Langton (Supervisor)|