Parental palliative cancer: psychosocial adjustment and health-related quality of life in adolescents participating in a German family counselling service

Cross-sectional data were derived from a multi-site research study of families before child-centered counselling. N=86 adolescents and young adults were included, their mean age 13.78 years (sd 2.45), 56% being female. Performed analyses included ANCOVA, multiple linear regression, and mediation analysis.Adolescents with parents suffering from palliative cancers reported significantly less total psychosocial problems, and better overall HRQoL. There were no significant group differences regarding coping frequency and efficacy. Our set of coping items significantly mediated the effect of parental disease stage on psychosocial problems and HRQoL. Further, parental disease status and general family functioning predicted psychosocial problems (R2adj =.390) and HRQoL (R2adj =.239) best.The study indicates distress among adolescents throughout the entire parental disease process. Our analysis suggests that counselling services could offer supportive interventions which focus particularly on adolescent coping as well as family functioning."The family is the centerpiece of palliative care in cancer"(p. 439) [1], and parental cancer affects the psychological well-being of patients, spouses, and children [1-3]. Regarding the percentage of minor children of cancer patients, estimations with differing reliability vary between 5-15% [4], 24% (see [5]), and 30% [6]. According to a US population-based estimate, 18% of cancer patients diagnosed within the last 2 years live with minor children [7]. But when families are confronted with a life-threatening parental disease, dependent children are still a "forgotten group" (p.459) [8].Considering recent reviews in the field, the following variables seem to be the ones which are theoretically best supported, regarding children's adjustment to parental illness, especially cancer: children's age [4,9-12], and gender [4,9,11-13], gender of the ill parent [9,12,13], and psychological functioning (esp. depressive symptoms) of the ill parent