Social comparisons and quality of life among survivors of childhood cancer and their mothers

Sixty-three survivors of childhood cancer (mean age 17 years), currently well and off-treatment, and their mothers were interviewed individually about their experiences and the impact of their illness on their lives. Survivors also completed four questionnaire measures of different aspects of quality of life (perceptions of illness experience. future worries, health problems and body image satisfaction), whereas mothers recorded their perceptions of their child's quality of life on the same four scales. These scales showed good internal consistency and convergent validity for both survivors and mothers. Mothers also completed a measure of their own quality of life (the SF-36). The interviews with both survivors and mothers were content-analysed for statements expressing social comparisons. These statements were coded according to whether the comparison implied a favourable, neutral or unfavourable evaluation of the individual survivor. Mothers who made a higher proportion of unfavourable comparisons reported worse adjustment for their child on all four scales and described their own quality of life more negatively. Among survivors, those who made a higher proportion of unfavourable comparisons gave significantly more negative self-ratings on one of the four scales. Correlations between survivors' and mothers' ratings on the four scales were positive, but comparatively low. This reinforces concerns about using parents as proxy judges of young people's quality of life, although the correlations were more satisfactory in the case of younger rather than older (>18.5 years) survivors. Mothers who rated their own quality of life as less satisfactory reported more problems for their child on all four scales, irrespective of how the survivors described themselves.