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“You can only take so much, and it took everything out of me”: Coping strategies used by parents of children with cancer

Published online by Cambridge University Press:  18 June 2010

Baukje Miedema ,
Ryan Hamilton ,
Pierrette Fortin ,
Julie Easley  and
Maria Matthews
Baukje Miedema*
Affiliation:
Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, Fredericton, New Brunswick, Canada
Ryan Hamilton
Affiliation:
Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, Fredericton, New Brunswick, Canada
Pierrette Fortin
Affiliation:
Secteur des Sciences Humaines, Université de Moncton, Campus d'Edmundston, Moncton, New Brunswick, Canada
Julie Easley
Affiliation:
Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, Fredericton, New Brunswick, Canada
Maria Matthews
Affiliation:
Division of Community Health & Humanities, Memorial University of Newfoundland, Newfoundland and Labrador, Canada
*
Address correspondence and reprint requests to: Baukje Miedema, Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, P.O. Box 9000, Fredericton, New Brunswick, CanadaE3B 5N5. E-mail: bo.miedema@rvh.nb.ca
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Abstract

Objective: This study qualitatively assesses the coping strategies of parents who care for a child with cancer.

Method: Semi-structured interviews were conducted with 28 French and English families who had had a child diagnosed with cancer in the last ten years in two Eastern Canadian provinces. Interviews were transcribed verbatim and coded with a focus on parental coping strategies.

Results: Using coping behaviors as described and categorized in the Family Adjustment and Adaptation Response (FAAR) model as a foundation, we found that families used a variety of appraisal-, emotion-, and problem-focused coping. Appraisal-focused coping strategies involved trying to stay “positive” and “making positive comparisons.” Problem-focused coping involved behaviors such as being an advocate for the child and seeking information. The majority of parents, however, described using emotion-focused coping behaviors such as trying to avoid “feeling too much” by hiding difficult emotions and “escaping” from problems. Others used more positive emotion-focused coping behaviors such as humor, seeking support (informal or formal), or writing diaries. A small group of parents used ineffective coping strategies (alcohol abuse, misdirected anger) that added to family stress. These ineffective strategies have led to a modification of the FAAR model indicating that not all coping behaviors are beneficial to family adjustment in crisis. Overall, many parents felt that their coping strategies were effective; however, a few described having a complete “coping breakdown”.

Significance of results: Parents used a range of coping strategies of which emotion-focused coping was the most prominent. We have enhanced the FAAR model by including additional coping behaviors as well as a description of how some coping behaviors add to the daily stressors for parents dealing with a child's illness. Professional health care providers need to understand the variability of the coping behaviors in order to appropriately assist parents to avoid coping breakdowns.

Keywords

ChildhoodCancerParentsCopingEmotion
Type
Original Articles
Information
Palliative & Supportive Care , Volume 8 , Issue 2 , June 2010 , pp. 197 - 206
Copyright
Copyright © Cambridge University Press 2010

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