Parenting in the Face of Cancer: Non-Ill Sibling and Parent Relationships

 描述（由申请人提供）：在美国，每年约有18，000名儿童和青少年被诊断患有癌症[21]。儿童癌症是一种影响整个家庭的危机，包括未患病的兄弟姐妹，他们报告感到悲伤，孤独，焦虑; 对自己生病的兄弟姐妹的癌症感到内疚;嫉妒对兄弟姐妹的关注。他们觉得 流离失所，孤立，被剥夺，并对父母对他们缺乏关注感到愤怒[1，3-5]。早期治疗（诊断后2至6个月）是一个重要的时期，因为癌症治疗期间为未来的育儿行为和沟通奠定了基础，持续一年和三年。父母的可用性和开放的沟通是在学龄期间建立和维持高质量的父母和孩子关系的关键因素[15]，特别是当存在兄弟姐妹癌症等威胁时。这项试点研究的具体目的是审查：1）父母表达其可用性的方式（即，身体可及性、沟通的开放性、对求助的响应性）; 2）父母与非患病儿童就其患病兄弟姐妹的癌症诊断和治疗进行沟通的内容和方式; 3）非患病儿童对其父母的可用性的自我报告（即，身体可及性、沟通的开放性和对求助电话的反应）; 4）未患病儿童如何解释他们父母关于患病兄弟姐妹癌症诊断和治疗的沟通;以及5）描述和分析未患病儿童在早期治疗期间的育儿挑战。将在早期癌症治疗期间（诊断后2至6个月）从太平洋西北部的综合癌症中心招募90名参与者（30名学龄儿童，60名父母）。半结构化面试将分别通过电话和面对面的方式为家长和儿童进行。访谈资料将以内容分析法结合归纳与演绎编码进行分析。一个标准化的问卷将被用来衡量非患病儿童的自我报告，每个家长的可用性。研究结果将为基于证据的干预设计提供信息，以帮助父母和未患病的兄弟姐妹应对兄弟姐妹癌症的挑战，并改善未患病的兄弟姐妹和父母关系的质量。帮助父母养育他们的非患病子女的策略可以对非患病兄弟姐妹的调整和长期的养育关系产生持久的影响。

 DESCRIPTION (provided by applicant): Approximately 18,000 children and adolescents are diagnosed with cancer each year in the United States [21]. Childhood cancer is a crisis that impacts the entire family, including the non-ill siblings, who report feeling sad, lonely, anxious; guilty about their ill sibling's cancer; and jealous of the attention toward the sibling. They feel displaced, isolated, deprived, and angry about their parents' lack of attention toward them [1, 3-5]. Early treatment (2 to 6 months after diagnosis), is an important period because the stage is being set for future parenting behavior and communication during cancer treatment, which lasts one and three years. Parental availability and open communication are key elements for building and maintaining quality parent and child relationships during school age years [15], especially when a threat such as a sibling's cancer exists. The specific aims of this pilot study are to examine: 1) Ways in which parents express their availability (i.e., physical accessibility, openness to communication, responsiveness to calls for help) to non-ill children during early cancer treatment; 2) Content and ways in which parents communicate with non-ill children about their ill sibling's cancer diagnosis and treatment; 3) Non-ill children's self-reports of their parnts' availability (i.e., physical accessibility, openness to communication, and responsiveness to calls for help); 4) How non-ill children interpret their parents' communications about the ill sibling's cancer diagnosis and treatment; and to 5) Describe and analyze the parenting challenges for non-ill children during early treatment. Ninety participants (30 school age children, 60 parents) will be recruited from a Comprehensive Cancer Center in the Pacific Northwest during early cancer treatment (2 to 6 months after diagnosis). Semi-structured interviews will be conducted separately by telephone for parents and in-person for children. Content analysis with inductive and deductive coding will be used to analyze the interview data. A standardized questionnaire will be used to measure non-ill children's self-reports of each parent's availability. Study findins will inform the design of an evidence-based intervention to assist parents and non-ill siblings manage the challenges of a sibling's cancer and improve the quality of non-ill sibling and parent relationships. Strategies that assist parents in parenting their non-ill children can have a lastin impact on the non-ill sibling's adjustment and long-term parenting relationship.