Originally published as JCO Early Release 10.1200/JCO.2007.15.2835 on November 24 2008

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Impact of Caring for a Child With Cancer on Parents’ Health-Related Quality of Life

Anne F. Klassen, Robert Klaassen, David Dix, Sheila Pritchard, Rochelle Yanofsky, Maureen O'Donnell, Amie Scott, Lillian Sung

From the Department of Pediatrics, McMaster University, Hamilton; Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa; Department of Pediatrics, University of British Columbia, Vancouver; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg; and the Division of Haematology/Oncology, the Hospital for Sick Children, Toronto, Canada

Corresponding author: Anne F. Klassen, DPhil, Department of Pediatrics, McMaster University, 3A, 1200 Main St W, Hamilton, Ontario, L8N 3Z5, Canada; e-mail: aklass{at}mcmaster.ca

Purpose To compare the health-related quality of life (QOL) of parents of children who are undergoing treatment for cancer with that of Canadian population norms and to identify important parent and child predictors of parental QOL.

Patients and Methods A total of 411 respondents of 513 eligible parents were recruited from five pediatric oncology centers in Canada between November 2004 and February 2007. Parents were asked to complete a questionnaire booklet that included a measure of adult QOL (SF-36), a measure of child health status (functional status IIR), and questions to assess health-promoting self-care actions (eg, sleep, diet, and exercise habits) and characteristics of the child with cancer (eg, relapse status, time since diagnosis, prognosis, treatment intensity).

Results Compared with population norms, parents of children with cancer reported poorer physical and psychosocial QOL in all psychosocial domains (effect sizes range, –0.71 to –1.58) and in most physical health domains (effect sizes range, –0.08 to –0.63). Parent characteristics associated with better parental QOL included better eating, exercise and sleep habits, younger age, and higher income. Child characteristics associated with better parental QOL included better child health status (functional status IIR scores), lower treatment intensity, and longer time since diagnosis.

Conclusion Parents of children with cancer report poorer QOL compared with population norms. Interventions directed at parents should be included as part of the treatment plan for a child with cancer. Modifiable variables associated with poorer parental QOL, such as sleep quality and diet and exercise habits, indicate those parents most likely to experience poor QOL and may be potential areas for intervention.

published online ahead of print at www.jco.org on November 24, 2008

Supported by a grant from the Canadian Cancer Society and by a Career Development Award (L.S.) with the Child Health Clinician Scientist Training Program, a strategic training program of the Canadian Institutes of Health Research. A.K. is a recipient of Canadian Institute of Health Research career award and Michael Smith Scholar Award.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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