Sibling and Parent Bereavement from Childhood Cancer

描述（由申请人提供）：癌症比任何其他疾病都要杀死更多的儿童，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心理社会困难的风险，这些困难可能持续多年。其他人可能会经历新的能力和个人成长（例如，成熟度，同情心）;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，但对什么能改善困难和什么能促进复原力知之甚少。一个主要问题是缺乏关于这一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心理社会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。本申请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，在我们的四个地点的研究中，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个非丧子的对照家庭。从每个丧亲家庭中随机选择一名兄弟姐妹（8-17岁）参与，并与相同性别，种族和年龄的同学进行匹配作为比较。数据将从每个孩子的教室的多个来源收集（即，同伴、老师、孩子）和家庭（即，母亲，父亲，孩子）在失去后的第一年（T1）和一年后的随访家访（T2）。这些信息将确定特定因素和丧亲个体的亚组，以在临床试验中靶向，以加速从悲伤中恢复并防止长期发病。目的1：比较心理社会适应（即，社会，情感，行为，家庭功能）的丧亲和比较家庭随着时间的推移，并检查中介和调节协会。目标二：检查悲伤症状和心理社会调整的过程，作为疾病/死亡，儿童发展水平和悲伤工作特征的函数。

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.