Family-centred psycho-oncological counselling for parents with cancer: a longitudinal secondary data analysis of psychological distress, family functioning and parental concerns.
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BACKGROUND: When a parent is diagnosed with cancer, it can place a significant burden on the entire family. The aim of this study is therefore to analyse the psychological distress experienced over time among cancer patients or their partners who are raising minor children and who utilize a family-oriented counselling service (COSIP), and to compare these data with those of a group receiving routine psycho-oncological care (PO). METHODS: We conducted a secondary, longitudinal observational study based on routine care data from users of an outpatient psycho-oncological clinic. The database comprised assessments at baseline and at 6- and 12-month follow-ups, including measures of distress, anxiety and depression for COSIP and PO users. For COSIP users additional data on health-related quality of life (HRQoL), parental concerns, and family functioning was included. We conducted descriptive analyses and examined baseline group differences using t-tests and Pearson's chi-square tests. Longitudinal trajectories were analysed using linear mixed-effects models. RESULTS: Data from n = 34 parents who had registered themselves and their families for a COSIP counselling session between 2020 and 2022 were included in the analyses. Among the COSIP users, the time since the initial diagnosis was shorter on average (p = .017) and the parents were separated less frequently (p = .015) than in the group of PO users (n = 34). At baseline, PO and COSIP users exhibited elevated levels of psychological burden, with over 80% of parents reporting clinically significant distress, 54% presenting with moderate to severe anxiety symptoms, and 50% showing elevated levels of depressive symptoms. In the adjusted model, a significant main effect of time, for distress F(2, 107.24) = 14.72, p < .001, depression F(2, 69.61) = 12.27, p < .001 and anxiety F(2, 84.11) = 17.02, p < .001, but no group difference were found. We identified a significant effect of time for parental concerns F(2, 17.24) = 7.41, p = .006, parental HRQoL F(2, 31.52) = 4.34, p = .022 and children's HRQoL F(2, 28.11) = 5.21, p = .012 among COSIP users. CONCLUSION: Parents who are confronted with a cancer diagnosis show high levels of psychological distress. Over time, a significant decrease in psychological distress among both groups and family-related outcomes in COSIP users was identified. Interestingly, no significant differences were observed between the groups, suggesting that the type of psycho-oncological support (individual or family-centred) may not differentially affect parental burden.