The purpose of this qualitative study of families where a parent has cancer was to explore ways of informing the child of the parent's illness, how the child perceives the parent's emotional state, how the child copes with the parent's illness, and how this coping relates to the parent's coping and concerns for the child. Twenty-one children from 15 families and their parents were interviewed. In 13 families the mother was ill, in two the father. Children were aware of the facts of the illness, but there was limited emotional communication between the generations. The children were very observant of both the ill and the healthy parent's emotional condition. The children's observations and expressions led us to identify five coping strategies the younger generation used: Helping others, parentification, distraction, keeping it in the head, and wishful thinking. Both adaptive and destructive examples of parentification were found. Communication patterns and parental coping seemed to be highly related to the child's coping repertoire. Even though most children seemed to manage rather well, all children were strongly affected by the illness. The `healthiest' adaptation related to factors within the family system, which has implications for the provision of help.
Armsden, G.C., & Lewis, F.M. (1994). Behavioral adjustment and self-esteem of school-age children of women with breast cancer. Oncology Nursing Forum , 21, 39—45.
2.
Barnett, B., & Parker, G. (1998). The parentified child: Early competence or childhood deprivation. Child Psychology & Psychiatry Review,3, 146—155.
Christ, G.H. (2000). Healing children's grief. New York: Oxford University Press.
5.
Christ, G.H., Siegel, K., Freund, B., Langosch, D., Hendersen, S., Sperber, D., et al. (1993). Impact of parental terminal cancer on latency-age children. American Journal of Orthopsychiatry, 63, 417—425.
6.
Christ, G.H., Siege, K., & Sperber, D. (1994). Impact of Parental terminal cancer on adolescents . American Journal of Orthopsychiatry, 64, 604—613.
7.
Compas, B.E., Worsham, N.L., Eppingjordan, J.E., Grant, K.E., Mireaul, G., Howell, D.C., et al. (1994). When mom or dad has cancer: Markers of psychological distress in cancer-patients, spouses, and children. Health Psychology, 13, 507—515.
8.
Compas, B.E., Worsham, N.L., Ey, S., & Howell, D.C. (1996). When mom or dad has cancer II: Coping, cognitive appraisals, and psychological distress in children of cancer patients. Health Psychology, 15, 167—175.
9.
Edwards, B., & Clarke, V. (2004). The psychological impact of a cancer diagnosis on families: The influence of family functioning and patients' illness characteristics on depression and anxiety. Psycho-oncology,13, 562—576.
10.
Epstein, N., Bishop, D., Ryan, C., Miller, I., & Keitner, G. (1993). The McMaster model: View of healthy family functioning . In F. Walsh (Ed.), Normal family processes. New York: Norton.
11.
Flick, U. (1999). An introduction to qualitative research. London: SAGE Publications.
12.
Giorgi, A.P., & Giorgi, B.M. (2003). The descriptive phenomenological psychological method. In P. M.Camic, J. E. Rhodes, & L. Yardley (Eds.), Qualitative research in psychology (pp. 243—274). Washington, DC: American Psychological Association .
13.
Godsall, R.E., Jurkovic, G.J., Emshoff, J., Anderson, L., & Stanwyck, D. (2004). Why some kids do well in bad situations: Relation of parental alcohol misuse and parentification to children's self-concept . Substance Use & Misuse,39, 789—809.
14.
Grant, K.E., & Compas, B.E. (1995). Stress and anxious-depressed symptoms among adolescents: Searching for mechanisms of risk. Journal of Consulting and Clinical Psychology, 63, 1015—1021.
15.
Harris, C.A., & Zakowski, S.G. (2003). Comparisons of distress in adolescents of cancer patients and controls. Psycho-oncology,12, 173—182.
16.
Heiney, S.P., Bryant, L.H., Walker, S., Parrish, R.S., Provenzano, F.J., & Kelly, K.E. (1997). Impact of parental anxiety on child emotional adjustment when a parent has cancer. Oncology Nursing Forum , 24, 655—661.
17.
Hoke, L.A. (2001). Psychosocial adjustment in children of mothers with breast cancer. Psycho-oncology,10, 361—369.
18.
Howes, M.J., Hoke, L., Winterbottom, M., & Delafield, D. (1994). Psychosocial effects of breast cancer on the patients' children. Journal of Psychosocial Oncology, 12, 1—21.
19.
Huizinga, G.A., Visser, A., van der Graaf, W.T., Hoekstra, H.J., & Hoekstra-Weebers, J.E. (2005). The quality of communication between parents and adolescent children in the case of parental cancer. Annals ofOncology, 16, 1956—1961.
20.
Hymovich, D.P. (1993). Child-rearing concerns of parents with cancer . Oncology Nursing Forum, 20, 1355—1360.
21.
Issel, L.M., Ersek, M., & Lewis, F.M. (1990). How children cope with mothers breast cancer. Oncology Nursing Forum, 17, 5—13.
22.
Jackson, S., Bijstra, J., Oostra, L., & Bosma, H. (1998). Adolescents' perceptions of communication with parents relative to specific aspects of relationships with parents and personal development. Journal of Adolescence, 21, 305—322.
23.
Jurkovic, G.J. (1997). Lost childhoods: The plight of the parentified child. Philadelphia, PA: Brunner/Mazel .
24.
Krahn, G.L., & Eisert, D. (2000). Qualitative methods in clinical psychology. In D. Drotar (Ed.), Handbook of research in pediatric and clinical child psychology (pp. 145—164). New York: Kluwer Academic.
25.
Kvale, S. (1996). Interviews. An introduction to qualitative research interviewing. London: SAGE Publications .
26.
Lackey, N.R., & Gates, M.F. (2001). Adults' recollections of their experiences as young caregivers of family members with chronic physical illnesses. Journal of Advanced Nursing, 34, 320—328.
27.
Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
28.
Lewandowski, L.A. (1992). Needs of children during the critical illness of a parent or sibling. Critical Care Nursing Clinics of North America, 4, 573—585.
29.
Noller, P. & Callan, V.J. (1990). Adolescents perceptions' of the nature of their communication with parents. Journal of Youth and Adolescence , 19, 349—362.
Romer, G., Barkmann, C., Schulte-Markwort, M., Thomalla, G., & Riedesser, P. (2002). Children of somatically ill parents: A methodological review. Clinical Child Psychology and Psychiatry, 7, 17—38.
32.
Shands, M.E., Lewis, F.M., Zahlis, E.H. (2000). Mother and child interactions about the mother's breast cancer: An interview study. Oncology Nursing Forum , 27, 77—85.
33.
Siegel, K., Mesagno, F.P., Karus, D., Christ, G., Banks, K., & Moynihan, R. (1992). Psychosocial adjustment of children with a terminally ill parent. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 327—333.
34.
Visser, A., Huizinga, G.A., Hoekstra, H.J., van der Graaf, W.T., Klip, E.C., Pras, E., et al. (2005). Emotional and behavioural functioning of children of a parent diagnosed with cancer: A cross-informant perspective . Psycho-oncology,14, 746—758.
35.
Welch, A.S.,, Wadsworth, M.E., & Compas, B.E. (1996). Adjustment of children and adolescents to parental cancer: Parents' and children's perspectives. Cancer, 77, 1409—1418.
36.
Worsham, N.L., Compas, B.E., & Sydney, E.Y. (1997). Children's coping with parental illness. In W. Sandler (Ed.), Handbook of children's coping: Linking theory and intervention (pp. 195—214). New York: Plenum Press.
37.
Zahlis, E.H. (2001). The child's worries about the mother's breast cancer: Sources of distress in school-age children. Oncology Nursing Forum, 28, 1019—1025.
