Pediatric Cancer, Family Conflict and Child Adjustment

小儿癌症、家庭冲突和儿童适应

• 批准号: 7781776
• 负责人: LYNN Fainsilber KATZ
• 金额: $ 39.31万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-02-05 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7781776
• 关键词: Accounting; Acute Lymphocytic Leukemia; Address; Adverse effects; Affect; Attention; Behavioral; Buffers; Cancer Family; Cancer Patient; Cancer Survivor; Caregivers; Central Nervous System Neoplasms; Child; Child Development; Childhood; Conflict (Psychology); Diagnosis; Disease; Event; Family; Family Research; Family Study; Family member; Goals; Healthcare; Intervention; Lead; Life; Life Expectancy; Longitudinal Studies; Malignant Childhood Neoplasm; Malignant Neoplasms; Mediating; Mediator of activation protein; Mental Depression; Methods; Modeling; Nature; Nephroblastoma; Neuroblastoma; Outcome; Parents; Patient Self-Report; Physiological; Preventive Intervention; Problem behavior; Process; Quality of life; Relative (related person); Research; Risk; Role; Siblings; Staging; Stress; Supportive care; Testing; Time; Treatment-Related Cancer; cancer diagnosis; cancer therapy; coping; design; emotion regulation; experience; improved; indexing; prospective; psychological distress; public health relevance; resilience; stressor

DESCRIPTION (provided by applicant): With the improved life expectancy of most children with cancer, attention has been turned to improving the quality of life of cancer survivors and their family members. It is well-known that family conflict is one of the best familial predictors of childhood behavior problems. There is also recent evidence that children with cancer have higher levels of conflict with their parents than healthy controls, and that family conflict is associated with higher psychological distress in young cancer patients and their caregivers. Yet, little is known about the nature and course of family conflict post-cancer diagnosis and through the treatment process. To develop interventions to reduce the adverse effects of cancer diagnosis and treatment and improve outcomes for cancer patients, their families and their caregivers, it is important to identify the nature and course of conflict within the family and determine whether family conflict is associated with maladjustment in children with cancer and their caregivers. Building on recent conceptual and methodological advances in the field of family research, the proposed research will use a multi-method approach to test a conceptual model of how the stresses inherent in cancer diagnosis and treatment affect family conflict and child and caregiver adjustment. In a short-term prospective longitudinal study, self-report, observational and physiological methods will be used to study families of young children diagnosed with the most common forms of young childhood cancer: acute lymphoblastic leukemia, central nervous system tumors, Wilms tumor and neuroblastoma. The primary aims of the proposed research will be: (1) to describe the course of family conflict across the disease process; (2) to test whether stress occurring during cancer treatment is associated with family conflict across the disease process and whether family conflict increases with increases in stress; (3) to test whether family conflict at the early stages of the disease process predicts the manner in which families deal with the treatment process itself; and (4) to test whether family conflict mediates relations between stress during cancer treatment and adjustment in children with cancer and their caregivers. Competing meditational models relating to parental depression and parental overprotection will also be tested. Positive qualities of the relationship between the child with cancer and their primary caregiver, as well as children's emotion regulation abilities, will be explored as potential resilience factors that buffer children from the negative outcomes. Promising findings can provide direction for prevention and intervention efforts that can have significant impact on the long-term development of children with cancer and their caregivers. PUBLIC HEALTH RELEVANCE: The proposed research will examine how the stresses inherent in the diagnosis and treatment of pediatric cancer affect family conflict and child adjustment. Our goals are to describe the course of family conflict across the disease process, identify which stressors occurring during cancer treatment are associated with family conflict across the treatment process, determine whether the degree of family conflict at the early stages of the disease process predicts the manner in which families deal with the treatment process itself, and test a model of how stresses associated with cancer affect family conflict and child and caregiver adjustment.

描述（由申请人提供）：随着大多数癌症儿童的预期寿命提高，人们的注意力已转向改善癌症幸存者及其家人的生活质量。众所周知，家庭冲突是儿童行为问题的最佳家庭预测指标之一。最近还有证据表明，患有癌症的儿童与父母的冲突水平高于健康对照，并且家庭冲突与年轻癌症患者及其护理人员的心理困扰有关。然而，对家庭冲突后癌后诊断和通过治疗过程的性质和进程知之甚少。为了制定干预措施，以减少癌症诊断和治疗的不良影响并改善癌症患者，其家人和护理人员的结果，重要的是要确定家庭内部冲突的性质和冲突的性质和过程，并确定家庭冲突是否与癌症儿童及其护理人员的不良疾病有关。在家庭研究领域的最新概念和方法学进步的基础上，拟议的研究将使用多方法方法来测试概念模型，该模型是癌症诊断和治疗中固有的压力如何影响家庭冲突，儿童和照料者的调整。在一项短期前瞻性纵向研究中，自我报告，观察性和生理方法将用于研究诊断出患有最常见幼儿癌症形式的幼儿家庭：急性淋巴细胞白血病，中枢神经系统肿瘤，Wilms肿瘤和神经母细胞瘤。拟议研究的主要目的是：（1）描述整个疾病过程中家庭冲突的过程； （2）测试癌症治疗期间的压力是否与整个疾病过程中的家庭冲突有关，以及家庭冲突是否随着压力的增加而增加； （3）测试疾病过程早期的家庭冲突是否预测家庭处理治疗过程本身的方式； （4）测试家庭冲突在癌症治疗期间的压力与癌症儿童及其护理人员的调整之间的关系是否介导。还将测试与父母抑郁和父母过度保护有关的竞争冥想模型。癌症儿童与其主要护理人员以及儿童的情绪调节能力之间关系的积极品质将被探讨，这是缓解儿童从负面结果中缓解儿童的潜在弹性因素。有希望的发现可以为预防和干预工作提供指导，这可能会对癌症及其护理人员的长期发展产生重大影响。 公共卫生相关性： 拟议的研究将研究小儿癌诊断和治疗中固有的压力如何影响家庭冲突和儿童调整。我们的目标是描述整个疾病过程中家庭冲突的过程，确定在癌症治疗过程中发生的压力源与整个治疗过程中的家庭冲突有关，确定疾病过程早期的家庭冲突程度是否预测家庭与治疗过程本身的方式，并测试与癌症和儿童冲突和儿童和护理人员和护理人员的压力如何相关的模型。