Parental mental health, parenting behaviours and the quality of life of children with cancer
Two central themes were assessed in this thesis involving children with cancer. First, the relationship between the child's medical functioning and their overall quality of life (QOL). Second, how the child's illness and subsequent QOL related to parental mental health and parenting behaviours. These themes were explored using the Risk and Resilience model developed by Wallander et al. (1989b). Study one involved children diagnosed with acute lymphoblastic leukaemia (ALL), the most common form of childhood cancer. Results showed that the child's medical functioning (e.g., time since diagnosis) did not relate to the child's QOL, but did relate to parental mental health. Furthermore, child QOL was significantly related to both parental mental health (depression) and parenting behaviours (endorsement of force). In an attempt to explore these themes in greater detail, Study two involved two groups of cancer survivors, those with ALL or tumours of the central nervous system (CNS). Medically, these groups have different prognoses, treatments, and long-term consequences. Results showed that those with poorer medical functioning, i.e., CNS tumours, had poorer QOL than both the ALL group and population norms, confirming the relationship between the child's medical and psychological adaptation. Furthermore, the child's adaptation was strongly related to both parental mental health and parenting behaviours, again providing evidence for the relationship between child and parent functioning. The results of both studies in this thesis go some way to demonstrate the wide-ranging effects that cancer can have on both the child and family. The child's QOL can be compromised by the illness. Moreover, cancer has a detrimental effect on the family life, from pervasive feelings of depression and worry, to longterm concerns about child-rearing. This thesis has shown that those children with CNS involvement, and their families, are particularly at-risk. To conclude, a section outlining clinical interventions which can help reduced the impact of childhood cancer on the family are discussed.