Longitudinal Predictors of Caregiver Resilience Outcomes at the End of Childhood Cancer Treatment
Menée aux Etats-Unis auprès de 314 aidants familiaux d'enfants atteints d'un cancer (âge : inférieur ou égal à 17 ans), cette étude analyse l'association entre divers facteurs (démographiques, intra et inter-personnels, psychosociaux, etc.) et leur capacité de résilience à la fin des traitements anticancéreux
Objective : Caregiver resilience in the context of childhood cancer treatment has been described using cross‐sectional and retrospective studies, but little is known about prospective predictors of resilience outcomes. We examined associations of demographics, cancer‐related variables, and intrapersonal and interpersonal factors at diagnosis (family psychosocial risk, perceived social support, health care self‐efficacy) and psychosocial services provided during treatment with caregiver resilience outcomes at end of treatment. Methods : From a study validating a family psychosocial risk screener, 314 primary caregivers completed measures at diagnosis of their child (ages 0‐17 years) and when cancer treatment ended. Resilience outcomes were ratings of distress, posttraumatic stress, and posttraumatic growth. Multiple regression analyses evaluated the relative contribution of hypothesized predictors. Results : Caregivers endorsed clinically significant distress, moderate posttraumatic growth, and low posttraumatic stress based on norms. Posttraumatic growth was not associated with posttraumatic stress or distress, which were significantly associated with each other. Over and above resilience at diagnosis, family psychosocial risk was associated with resilience at end of treatment. Perceived social support, health care self‐efficacy, and psychosocial services provided demonstrated associations with resilience in univariate analyses, but demographics and cancer‐related variables did not. Conclusions : Resilience and family psychosocial risk at diagnosis were the strongest predictors of caregiver resilience outcomes at the end of treatment. Intra‐ and interpersonal predictors were weaker and varied by resilience measure. Consistent with psychosocial standards of care, broad evaluation of caregiver risks, resources, and resilience processes and outcomes is recommended at diagnosis and through the treatment trajectory including end of treatment.