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J Psychosoc Oncol. 2018 Sep-Oct;36(5):635-648. doi: 10.1080/07347332.2018.1485813.

In good times and in bad: what strengthens or challenges a parental relationship during a child's cancer trajectory?

Author information

a Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute , National Institutes of Health , Bethesda , Maryland , USA.
b Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute , Boston , Massachusetts , USA.
c Hematology/Oncology/Blood & Marrow Transplant Program, Alberta Children's Hospital , Calgary, Alberta , Canada.



To identify events during a child's cancer trajectory when parents perceived their marriage/partnership to be most strengthened and/or challenged.


Using a cross-sectional qualitative design, participants completed a self-administered questionnaire addressing changes in their relationship during their child's cancer trajectory, including events perceived to strengthen/challenge their relationship, and recommendations for other parents.


192 parents of pediatric oncology patients across three institutions. Data were analyzed using qualitative content analysis.


Themes included relationship-specific, illness experience-related, and external supports/stressors that impacted the relationship. Dyadic strategies, empathic communication, and supportive behaviors strengthened the couple's relationship, whereas physical and emotional distance most commonly challenged the relationship. Recommendations to other parents included open communication, couple's connectedness, and use of external supports.


Offering psychosocial support and helping parents anticipate when their relationship can be strengthened/challenged can be an important part of ongoing care. Implications for psychosocial providers: Teaching communication and dyadic coping strategies can help parents manage stress and build cohesion.


childhood cancer; communication; dyadic coping; fathers; mothers; parental relationships

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