Post-traumatic stress in parents of long-term childhood cancer survivors compared to parents of the Swiss general population

Julia Baenziger; Katharina Roser; Luzius Mader; Erika Harju; Marc Ansari; Nicolas Waespe; Katrin Scheinemann; Gisela Michel

doi:10.1097/OR9.0000000000000024

Post-traumatic stress in parents of long-term childhood cancer survivors compared to parents of the Swiss general population

J Psychosoc Oncol Res Pract. 2020 Jul 28;2(3):e024. doi: 10.1097/OR9.0000000000000024. eCollection 2020 Oct.

Authors

Julia Baenziger¹, Katharina Roser¹, Luzius Mader^{1

2}, Erika Harju¹, Marc Ansari^{3

4}, Nicolas Waespe^{4

5}, Katrin Scheinemann^{6

7

8}, Gisela Michel¹

Affiliations

¹ Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
² Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.
³ Division of Pediatrics, Onco-Hematology Unit, Geneva University Hospitals, Geneva, Switzerland.
⁴ CANSEARCH research laboratory, Geneva University Medical School, Geneva, Switzerland.
⁵ Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
⁶ Division of Hematology/Oncology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.
⁷ Department of Pediatrics, Kantonsspital Aarau, Aarau, Switzerland.
⁸ Department of Pediatrics, McMaster University, Hamilton, Canada.

Abstract

Background: We describe post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in parents of long-term childhood cancer survivors (CCS-parents) and compare them to parents of similar-aged children (comparison-parents) of the Swiss general population (SGP). We compare type of reported stressful event, prevalence of PTSS and PTSD, and psychosocial and cancer-related characteristics associated with PTSS. We further describe the respective normative data for the SGP.

Methods: We conducted a nationwide cross-sectional questionnaire survey in a population-based sample of long-term CCS-parents (survivors aged ≤16 years at diagnosis, ≥20 years at study, >5 years post-diagnosis) and in the SGP. Using the Impact of Event Scale-Revised, we measured PTSS regarding the most stressful event experienced, and computed probable cases of PTSD.

Results: Participants included 663 CCS-parents (39.4% fathers) and 1035 individuals of the SGP (40.0% male), of which we identified 391 comparison-parents (41.2% fathers). Illness was most often indicated as stressful event (CCS-parents: 49.5%, comparison-parents: 27.6%, SGP: 25.3%). Prevalence of PTSS and PTSD (CCS-parents: 4.8%, comparison-parents: 6.7%, SGP: 5.6%) did not significantly differ. Lower education was associated with higher intrusion, avoidance, and hyperarousal in all samples (all P ≤ .003). Parents of children with a chronic illness reported higher intrusion (all P ≤ .004). We found no associations with cancer-related characteristics.

Conclusions: No increased risk for PTSS or PTSD was found among CCS-parents. Individuals with lower education and those with a chronically ill child might benefit from additional support to help manage and resolve the stress symptoms in the long term.

Keywords: Childhood cancer; Cohort; Parent; Population norm; Post-traumatic stress disorder; Post-traumatic stress symptoms; Survivor.