Trajectory of parental hope when a child has difficult-to-treat cancer: a prospective qualitative study

Psychooncology. 2013 Nov;22(11):2436-44. doi: 10.1002/pon.3305. Epub 2013 Jun 5.

Abstract

Objective: This prospective and longitudinal study was designed to further our understanding of parental hope when a child is being treated for a malignancy resistant to treatment over three time points during the first year after diagnosis using a qualitative approach to inquiry.

Methods: We prospectively recruited parents of pediatric cancer patients with a poor prognosis who were treated in the Hematology/Oncology Program at a large children's hospital for this longitudinal grounded theory study. Parents were interviewed at three time points: within 3 months of the initial diagnosis, at 6 months, and at 9 months. Data collection and analysis took place concurrently using line-by-line coding. Constant comparison was used to examine relationships within and across codes and categories.

Results: Two overarching categories defining hope as a positive inner source were found across time, but their frequency varied depending on how well the child was doing and disease progression: future-oriented hope and present-oriented hope. Under future-oriented hope, we identified the following: hope for a cure and treatment success, hope for the child's future, hope for a miracle, and hope for more quality time with child. Under present-oriented hope, we identified hope for day-to-day/moment-to-moment, hope for no pain and suffering, and hope for no complications.

Conclusions: For parents of children with a diagnosis of cancer with a poor prognosis, hope is an internal resource that can be present and future focused. These views fluctuated over time in response to changes in the child's well-being and disease progression.

Keywords: cancer; caregivers; longitudinal design; parental hope; pediatric oncology; qualitative methods.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attitude to Health*
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Pain
  • Parents / psychology*
  • Professional-Family Relations
  • Prognosis
  • Prospective Studies
  • Qualitative Research
  • Severity of Illness Index