The role of we-ness in child cancer

Principal investigators: Prof. Dr. M. Landolt, Prof. Dr. G. Bodenmann, Prof. Dr. M. Grotzer,  Prof. Dr. J. Rössler

Funding: Krebsforschung Schweiz

Duration of project: December 2014 – Juni 2021

In the last 20 years, several authors have been calling for family oriented and longitudinal research on child cancer (e.g., Fisher & Weihs, 2000; Landolt at al., 2012). The reason for this is threefold. First, child cancer (CC) can be considered a “we-family disease”, that is, a stressor that affects the patient, their parents and the interaction within all family members and subsystems, since they are an interdependent unit. Second, parents are the most influential context on child development. Third, the higher survivals rates and increased chronicity of CC demand an ongoing adaptation from the whole family to the illness-related stress. Thus, several studies have found associations between family and child variables during and after cancer treatment, and a few studies suggest a causal relationship of family functioning on child adjustment and quality of life (QoL). Nevertheless, questions regarding which family dimensions related with the process of stress and coping with CC and how changes and divergences within those dimensions predict child QoL over time, remain answered. Research on stress and coping in couples has identified two crucial dimensions for better relational and health outcomes that have the potential to provide those answers. These dimensions are: “we-appraisals” (1. we-ness: the process how individuals tend to evaluate what happens to them as a couple, that is, in a more relational-oriented way (“we” problem) or in a more individual way (“I/you” problem) and 2. we-disease: the process how individuals tend to evaluate what happens to them as a couple when faced with a chronic or life-threatening disease, i.e. either in a relation-oriented way (“our” concern) or in an individualistic way (“my/your” concern)) and dyadic coping (the process how couples support and cope together with stress).

Therefore, the aims of the study are to expand and understand these dimensions in the context of families coping with CC. From a preventive and clinical point of view, the results can be utilized to improve children’s QoL based on dyadic resources. More specifically the aims are:

• to examine how parents' we-appraisals, couple dyadic coping and parental-child dyadic coping at T1 (less than one month after the diagnosis) predict child QoL changes at T2 (six months after T1) and at T3 (twelve months after T1).
• to examine how changes in parents' we-appraisals, couple dyadic coping and parental-child coping from T1-T2 predict child QoL at T2 and T3.
• to examine how differences in parents' variables predict child QoL at T2 and T

Higher scores on parents' variables are expected to predict positive changes on child QoL during the first 12 months after cancer diagnosis. Changes on parents' variables are expected to predict child QoL at T2 and T3. Smaller differences in parents' variables are expected to predict higher child QoL.

For this research 100 children with newly diagnosed cancer and their mothers and fathers will be assessed three times during 24 months. Eligibility criteria are: child age at assessment between six and 16 years and a time span since diagnosis no longer than one month. The parents will complete several paper-pencil questionnaires assessing the variables of interest during hospitalization of their child or during routine doctoral appointments and children will be interviewed. Latent change score models with three factors (i.e., mother, father, child) will be used to analyze the hypothesis.

Contact: markus.landolt@kispi.uzh.ch; lasse.bartels@kispi.uzh.ch