Sibling and Parent Bereavement from Childhood Cancer

描述（由申请人提供）：癌症杀死的儿童比任何其他疾病都多，但儿童死亡对家庭的影响尚未得到充分研究。失去亲人的家庭可能面临许多社会心理困难的风险，这些困难可能持续数年。其他人可能会在最初的悲伤期后经历新的能力和个人成长（例如，成熟，同情）；各种风险和阻力因素（例如，年龄，应对技能和社会支持）可能会影响结果，但对于改善困难和促进复原力的因素知之甚少。一个主要的问题是缺乏关于这个主题的精心设计的研究。我们的长期目标是通过对这些家庭的社会心理结果进行有控制的纵向研究，减少受癌症和失去孩子影响的家庭的痛苦和发病率。本应用程序的目的是区分需要帮助的兄弟姐妹和父母的亚组，并确定与调整相关的可修改因素。在我们的四点研究中，我们将招募180个在过去3- 12个月内死于癌症的儿童家庭，以及180个未失去亲人的对照家庭。从每个丧亲家庭中随机抽取一个8-17岁的兄弟姐妹参加，并与一个性别、种族和年龄相同的同学配对作为比较。数据将在失联后的第一年（T1）和一年后的随访家访期间从每个孩子的教室（即同伴、老师、孩子）和家中（即母亲、父亲、孩子）的多个来源收集。这些信息将确定临床试验中特定的因素和丧亲个体的亚组，以加速从悲伤中恢复并防止长期发病。目标1：比较丧亲家庭和比较家庭随时间的社会心理适应（即社会、情感、行为、家庭功能），并检查中介和调节关联。目的2：检查悲伤症状的过程和心理社会适应作为疾病/死亡特征，儿童的发展水平和悲伤工作的功能。

DESCRIPTION (provided by applicant): Cancer kills more children than any other disease, but the impact of a child's death on families is understudied. Bereaved families may be at risk for numerous psychosocial difficulties, which can persist for years. Others may experience new competencies and personal growth (e.g., maturity, compassion) after the initial grieving period; a variety of risk and resistance factors (e.g., age, coping skills, and social support) may affect outcomes, but little is known about what ameliorates difficulties and what promotes resilience. A primary problem has been a lack of well-designed research on the topic. Our long-term goal is to reduce the suffering and morbidity of families affected by cancer and the loss of a child through controlled, longitudinal research on the psychosocial outcomes of these families. The objective of this application is to differentiate subgroups of siblings and parents in need of assistance and to identify modifiable factors associated with adjustment, in our four-site study, we will recruit 180 families of children who died from cancer in the past 3- 12 months, and 180 non-bereaved comparison families. One sibling (aged 8-17 years) from each bereaved family will be randomly selected to participate and matched to a classmate of the same gender, race, and age as a comparison. Data will be collected from multiple sources in each child's classroom (i.e., peer, teacher, child) and home (i.e., mother, father, child) during the first year post-loss (T1) and during a follow-up home visit one year later (T2). This information will identify specific factors and subgroups of bereaved individuals to target in clinical trials to hasten recovery from grief and prevent long-term morbidity. Aim 1: compare the psychosocial adjustment (i.e., social, emotional, behavioral, family functioning) of bereaved and comparison families over time and examine mediating and moderating associations. Aim 2: Examine the course of grief symptoms and psychosocial adjustment as a function of characteristics of the illness/death, the child's developmental level, and grief work.