Screening Tool May Predict Subsequent Distress Among Parents of Children With Cancer

Parents score on the electronic Psychosocial Assessment Tool (ePAT) 1 month after their child was diagnosed with cancer was predictive of future levels of parental distress, according to the results of a study published in Cancer.

Based on these results, “families should be monitored for distress throughout the treatment trajectory so that care can be tailored to specific family needs,” wrote Sasja A. Schepers, PhD, of St. Jude Children’s Research Hospital in New York, and colleagues.

Most families with children with cancer will experience significant distress at diagnosis and during treatment. Distress will often decrease during the first year after diagnosis, but some families are still at risk for ongoing psychosocial problems and ongoing distress.

In this study, Schepers and colleagues looked at 192 families who completed the ePAT 1 month after their child was diagnosed with cancer. At 6 months post-diagnosis, 119 mothers and 98 fathers also completed the Distress Thermometer for Parents (DT-P), which consists of a score ranging from 0 to 10, with a score of 4 or greater indicating clinical distress. These scores were then compared with scores from a reference group of mothers and fathers with healthy children. 

Among parents of children with cancer, fathers were three times more likely (odds ratio [OR], 3.06; 95% CI, 1.95–4.78) and mothers were more than twice as likely (OR, 2.32; 95% CI, 1.55–3.47) to report clinically elevated distress compared with fathers and mothers of healthy children. Fathers and mothers of children with cancer were also significantly more likely to desire a referral.

According to the researchers, this indicates that it is “important to closely monitor parental distress during the cancer care trajectory and to identify a possible need for psychosocial support.”

Compared with fathers with universal scores, fathers with elevated ePAT scores 1 month after their child’s diagnosis had significantly higher mean levels of distress 6 months after the diagnosis as measured by the DT-P thermometer. This was true of the total, practical, social, and emotional problems domains.

Similarly, mothers with elevated ePAT scores at baseline had significantly higher distress than mothers with universal scores in the total, practical, social, emotional, physical, and parenting domains.

“Our second hypothesis was partly confirmed because higher average parental distress 6 months after the diagnosis was related to higher levels of family psychosocial risk at diagnosis,” the researchers wrote. “Yet, we did not find differences in the percentages of DT-P clinical thermometer scores between parents with a universal ePAT score and parents with elevated ePAT scores. This might be explained by the fact that parents (especially mothers) in both groups had already reported rather high levels of distress on the DT-P thermometer score.”