A Three Factor Model of Parental Coping With Childhood Cancer.
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OBJECTIVES: Parents of children with cancer are at increased risk for anxiety, depression, and post-traumatic stress, although wide variability among parents has been documented. This cross-sectional study was designed to examine the individual contributions and simultaneous interaction of three coping constructs-coping strategy, repertoire of coping techniques, and flexibility in applying these techniques-in parental distress related to childhood cancer. METHODS: A sample of 88 mothers and 57 fathers (N = 145) of children undergoing active cancer treatment were recruited from a pediatric hematology-oncology department. Parents' ages ranged from 22 to 58 years. Parents completed standardized measures including the Brief COPE, Coping Flexibility Scale-Revised, the Pediatric Parenting Stress Inventory, and the Profile of Mood States. RESULTS: Avoidance-focused coping strategy, repertoire of coping techniques, and coping flexibility were individually found to be significantly correlated with parental distress. Bootstrap mediation analysis revealed that the collective model explained 37%-43% of the variance in parental distress, with avoidance-focused coping strategy emerging as the most significant predictor, accounting for approximately 29% of the total variance. CONCLUSIONS: These results suggest that clinical interventions should prioritize identifying and reducing parental reliance on avoidance-focused coping techniques as a primary target. Subsequently, expanding parents' repertoire of problem- and emotion-focused coping techniques and enhancing flexibility in their application could lead to better distress reduction. However, the cross-sectional design limits causal interpretation, and future longitudinal studies employing larger sample sizes are needed to establish the relationships between these constructs.