Quality of life in pediatric cancer survivors: contributions of parental distress and psychosocial family risk

Background Pediatric survivors of childhood cancer are at increased risk of poor quality of life and social-emotional outcomes following treatment. The relationship between parent psychological distress and child adjustment in pediatric cancer survivors has been well established. However, limited research has examined the factors that may buffer this association. The current study examined the associations between psychosocial family risk factors, parental psychological distress, and health-related quality of life (HRQL) in pediatric cancer survivors. Methods Fifty-two pediatric cancer survivors (34 males, 18 females, mean age = 11.92) and their parents were recruited from a long-term cancer survivor clinic. Children and their parents who consented to participate completed the Pediatric Quality of Life Inventory 4.0. Parents completed a demographic information form, the Psychosocial Assessment Tool (PAT 2.0) and the Brief Symptom Inventory (BSI). The Intensity of Treatment Rating (ITR-3) was evaluated by the research team. Results Multiple regression analyses revealed that parental psychological distress negatively predicted parent-reported HRQL, while treatment intensity, gender, and psychosocial risk negatively predicted parent and child-reported HRQL. Psychosocial risk moderated the association between parent psychological distress and parent-reported child HRQL (p = 0.03), whereby parents with high psychological distress but low levels of psychosocial risk reported their children to have higher HRQL. Conclusion Low levels of family psychosocial risk buffer the impact of parent psychological distress on child HRQL in pediatric cancer survivors. The findings highlight the importance of identifying parents and families with at-risk psychological distress and psychosocial risk in order to provide targeted support interventions to mitigate the impact on HRQL.