Household material hardship and distress among parents of children with advanced cancer: A report from the PediQUEST Response trial.

Autor: Eche-Ugwu IJ; The Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA., Orellana L; Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia., Becker D; Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia., Bona K; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.; Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA., Avery M; Department of Pediatrics, Pediatric Palliative Care Research, Massachusetts General Hospital, Boston, Massachusetts, USA., Feudtner C; Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Freedman JL; Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Kang TI; Palliative Care, Texas Children's Hospital, Houston, Texas, USA., Rosenberg AR; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.; Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Waldman ED; Great Ormond Street Hospital for Children, London, UK., Ullrich CK; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.; Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Dussel V; Department of Pediatrics, Pediatric Palliative Care Research, Massachusetts General Hospital, Boston, Massachusetts, USA., Wolfe J; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.; Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Pediatrics, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2024 Oct 15; Vol. 130 (20), pp. 3540-3548. Date of Electronic Publication: 2024 Jun 12.
DOI: 10.1002/cncr.35432
Abstrakt: Background: The prevalence and characteristics of household material hardship (HMH) in families of children with advanced cancer and its association with parent distress are unknown and herein described.
Methods: Parents of children aged ≥2 years with advanced cancer at five cancer centers completed baseline surveys as part of the PediQUEST Response trial. HMH (housing, energy, and food) was operationalized as binary (≥1 HMH domains), ordinal (zero, one, or two or more HMH domains), and housing based (none, nonhousing [food and/or energy], only housing, or housing + other). Associations between HMH and parent distress measured by the State-Trait Anxiety Inventory-State and the 10-item Center for Epidemiologic Studies Depression Scale were estimated via linear models adjusting for confounders.
Results: Among 150 parents, 41% reported ≥1 HMH (housing, 28% [only housing, 8%; housing + other, 20%]; energy, 19%; food, 27%). HMH was more prevalent among Hispanic, other non-White race, Spanish-speaking, and single parents and those with lower education (associate degree or less) or who were uninsured/Medicaid-only insured. Parents endorsing HMH reported higher anxiety (mean difference [MD], 9.2 [95% CI, 3.7-14.7]) and depression (MD, 4.1 [95% CI, 1.7-6.5]) scores compared to those without HMH. Distress increased with the number of hardships, particularly housing insecurity. Specifically, parents experiencing housing hardship, alone or combined, reported higher distress (housing only: anxiety: MD, 10.2 [95% CI, 1.8-18.5]; depression: MD, 4.9 [95% CI, 1.3-8.6]; housing + other HMH: anxiety: MD, 12.0 [95% CI, 5.2-18.9]; depression: MD, 4.8 [95% CI, 1.8-7.8]).
Conclusions: HMH is highly prevalent in pediatric advanced cancer, especially among historically marginalized families. Future research should investigate whether interventions targeting HMH, particularly housing stabilization efforts, can mitigate parent distress.
Plain Language Summary: In our cohort of parents of children with advanced cancer, household material hardship (HMH) was highly prevalent and significantly associated with higher parent distress. Housing hardship was the primary driver of this association. Families of children with advanced cancer may benefit from systematic HMH screening as well as targeted HMH interventions, especially stabilizing housing.
(© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)
Databáze: MEDLINE
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