Parenting Stress in Childhood Leukaemia
Parenting Stress in Childhood Leukaemia
Vol. 7 No. 2 : 2012 (73-83)
Abstract
Parenting stress is the stress level experienced within the role of a parent (Hoekstra-Weebers et al. 1998). The source of stressors is variable and dependent on the phase of disease and chemotherapy (Sawyer et al. 2000). Failure to cope with these stressors may in turn affect the child’s emotional and social adjustment towards the diagnosis of cancer in addition to poor medical treatment adherence behaviour (Sawyer et al. 1993). The objectives of this study are to determine the level of parenting stress, the risk factors contributing to high parenting stress, and the coping mechanisms used to handle the stress. This single centred, cross-sectional study was done amongst 117 parents at the Paediatric Haematology and Oncology Unit, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) over two years duration. Self-administered questionnaires comprising the Parenting Stress Index/Short Form (PSI/SF) and Coping Inventory for Stressful Situation (CISS) were distributed to parents of children who were 12 years old and below. The mean total parenting stress score amongst parents of children diagnosed with acute leukaemia was 91.5±21.1(95% CI). A total of 27.3% of parents experienced a high total parenting stress score (defined as total PSI score ≥ 75th centile, ie ≥ 103). Task-oriented coping mechanism was used by the majority of parents. Emotion-oriented coping mechanism was the only identifiable risk factor for high parenting stress score following multiple logistic regression analysis. A parent who used emotion-oriented coping mechanism was 7.1 times (95% Confidence Interval 1.2 to 41.4) more likely to have a high parenting stress score compared to a parent who used other coping mechanisms. By identifying these at-risk parents, appropriate counselling and psychological support may be offered early to alleviate the stress as well as assist in the coping and adjustment mechanisms of these parents.
Keywords :
childhood leukaemia,
parenting stress,
Correspondance Address
Prof. Dr. Zarina Abdul Latiff, Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +603-91457888 Fax:+603-91737827 Email: zarinaal@ppukm.ukm.edu.my
References
Abidin, R.R. 1995. Parenting Stress Index (PSI) Manual. 3rd edn. Charlottesville VA: Pediatric Psychology Press.
Endler, N.S., Parker, J.D.A. 1990. Coping Inventory for Stressful Situations (CISS): Manual. Toronto: Multi-Health Systems.
Farah Inaz, S.A. 2004. Parenting stress in mothers of children with epilepsy. A dissertation for the Masters of Medicine (Pediatrics), Faculty of Medicine Universiti Kebangsaan Malaysia.
Folkman, S., Lazarus, R.S. 1998. The relationship between coping and emotion: Implications for theory and research. Soc Sci Med 26(3): 309-17.
Greaves, M. 2002. Childhood leukaemia. BMJ 324(7332): 283-287.
Hoekstra-Weebers, J.E., Jaspers, J.P., Kamps, W.A., Klip, E.D. 1998. Gender differences in psychological adaptation and coping in parents of pediatric cancer patients. Psychooncology 7(1): 26–36.
Hoekstra-Weebers, J.E., Jaspers, J.P., Kamps, W.A., Klip, E.C. 2001. Psychological adaptation and social support of parents of pediatric cancer patients: A prospective longitudinal study. J Pediatr Psychol 26(4): 225–235.
Kazak, A.E., Boyer, B.A., Brophy, P., Johnson, K., Scher, C.D., Covelman, K., Scott, S. 1995. Parental perceptions of procedure-related distress and family adaptation in childhood leukemia. Child Health Care 24(3): 143–158.
Kazak, A.E., Barakat, L.P., Meeske, K., Gallagher, P., Cnaan, A, Stuber, M. 2001. Posttraumatic stress in survivors of childhood cancer and
83
Parenting Stress in Childhood Leukaemia Med & Health 2012; 7(2): 73-83
their mothers: development and validation of the Impact of Traumatic Stressors Interview Schedule (ITSIS). Journal of Clinical Psychology in Medical Settings 8(4):307–323.
Kazak, A.E., Cant, M.C., Jensen, M.M., McSherry, M., Rourke, M.T., Hwang, W.T., Alderfer, M.A., Beele, D., Simms, S., Lange, B.J. 2003. Identifying psychosocial risk indicative of subsequent resource use in families of newly diagnosed pediatric oncology patients. J Clin Oncol 21(17): 3220–3225.
Kazak, A.E., Alderfer, M., Rourke, M.T., Simms, S., Streisand, R., Grossman, J.R. 2004. Posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in families of adolescent childhood cancer survivors. J Pediatr Psychol 29(3): 211-219.
Lazarus, R.S., Folkman, S. 1984. Stress, appraisal and coping. New York: Springer Publishing Company 328-333.
Lim, G.C.C., Halimah, Y. 2003. The Second Report of the National Cancer Registry - Cancer Incidence in Malaysia. National Cancer Registry
Manne, S.L., Du Hamel, K., Gallelli, K., Sorgen, K., Redd, W.H. 1998. Posttraumatic stress disorder among mothers of pediatric cancer survivors: diagnosis, comorbidity, and utility of the PTSD checklist as a screening instrument. J Pediatr Psychol 23(6): 357–366.
Ministry of Health Malaysia. Health Indicator, 2000.
Norshireen Nazli, A.R. 2005. Parental stress in Malaysian mothers of children with spina bifida. Dissertation for the Masters of Medicine (Paediatrics), Faculty of Medicine Universiti Kebangsaan Malaysia.
Pearlin, L.I., Schooler, C. 1978. The structure of coping. J Health Soc Behav 19(1): 2-21.
Pui, C.H. 2000. Acute lymphoblastic leukemia in children. Curr Opin Oncol 12(1): 3-12.
Ray, C., Lindop, J., Gibson, S. 1982. The concept of coping. Psychol Med 12(2): 385-395.
Salwina, W.W.I. 2001. Coping styles, self-concept and stress level among the psychiatry nursing staff and the casualty nursing staff. A dissertation for the Masters of Medicine (Psychiatry), Faculty of Medicine, Universiti Kebangsaan Malaysia.
Sawyer, M.G., Antoniou, G., Toogood, I., Rice, M., Baghurst, P.A. 1993. A prospective study of the psychological adjustment of parents and families of children with cancer. J Paediatr Child Health 29(5): 352– 356.
Sawyer, M., Antoniou, G., Toogood, I., Rice, M., Baghurst, P. 2000. Childhood cancer: a 4-year prospective study of the psychological adjustment of children and parents. J Pediatr Hematol Oncol 22(3): 214–220.
Streisand, R., Braniecki, S., Tercyak, K.P., Kazak, A.E. 2001. Childhood illness related parenting stress: The pediatric inventory for parents. J Pediatr Psychol 26(3): 155–162.
Yeh, C.H. 2002. Gender differences of parental distress in children with cancer. J Adv Nurs 38(6): 598-606.
Young, B., Dixon-Woods, M., Findlay, M., Heney, D. 2002. Parenting in a crisis: conceptualising mothers of children with cancer. Soc Sci Med 55(10): 1835–1847.
