ObjectivePatients with advanced cancer who parent minor children report parenting concerns and increased psychological distress. This cross‐sectional study seeks to understand parenting‐related issues in patients and spousal caregivers from a relationship perspective.MethodsPatients with a metastatic solid malignancy and their spouses independently completed cross‐sectional assessments of psychological distress (Hospital Anxiety and Depression Scale), parenting concerns (Parenting Concern Questionnaire) and efficacy (Cancer‐Related Parenting Self‐Efficacy Scale), and relationship measures (DAS‐7, Couples' Illness Communication Scale, and Family Relationship Index).ResultsOf the 51 patients (57% female, 49% NHW, mean age 42 years) and spouses (43% female, 43% NHW, mean age of 42 years), approximately 50% couples endorsed psychological distress and were at risk for family dysfunction. Spouses reported significantly higher levels of parenting‐related concerns (t = −2.0, p < 0.05) and anxiety (t = −2.8, p < 0.001) than patients. Parenting concerns were significantly associated with illness communication (r = −0.56, p < 0.001) and family function (r = −0.38, p < 0.001). Although the expected interactions between parenting concerns and relationship variables (i.e., illness communication, dyadic adjustment, and family function) were significant for depressive symptoms at p < 0.05, the associations were not in the expected direction. Relationship function buffered against depressive symptoms for those with low rather than high parenting concerns.ConclusionsNot only patients but also spouses report cancer‐related parenting concerns. The associations between parenting concerns and distress were stronger for spouses than patients. Dual caregiving appears to be a particularly stressful role. Because relationship function was associated with parenting concerns, we suggest that parent support programs that are couple‐based and include both parenting‐specific and relationship‐specific content may be most effective in reducing distress for this vulnerable population.

中文翻译：

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晚期癌症患者及其养育未成年子女的配偶：关系背景在养育问题中的作用

目的 养育未成年子女的晚期癌症患者报告养育问题和心理困扰增加。这项横断面研究旨在从关系角度了解患者和配偶照顾者的育儿相关问题。方法患有转移性实体瘤的患者及其配偶独立完成了心理困扰（医院焦虑和抑郁量表）、育儿问题的横断面评估（育儿关注问卷）和功效（癌症相关育儿自我效能量表）以及关系测量（DAS-7、夫妻疾病沟通量表和家庭关系指数）。结果 51 名患者（57% 为女性，49% 为 NHW） ，平均年龄 42 岁）和配偶（43% 女性，43% NHW，平均年龄 42 岁）中，大约 50% 的夫妇表示存在心理困扰，并面临家庭功能障碍的风险。配偶报告的与养育相关的担忧水平明显更高（t=−2.0，p< 0.05) 和焦虑 (t=−2.8，p< 0.001) 比患者。养育子女的担忧与疾病沟通显着相关（r=-0.56，p< 0.001) 和家庭功能 (r=−0.38，p< 0.001）。尽管养育问题和关系变量（即疾病沟通、二元调整和家庭功能）之间的预期相互作用对于抑郁症状来说是显着的。p< 0.05，关联未达到预期方向。关系功能可以缓冲患有抑郁症的人的抑郁症状低的而不是高度的养育问题。结论不仅患者而且配偶也报告了与癌症相关的养育问题。对于配偶来说，养育问题和痛苦之间的关联比患者更强。双重照顾似乎是一个压力特别大的角色。由于关系功能与养育问题相关，因此我们建议以夫妻为基础并包含养育特定内容和关系特定内容的父母支持计划可能最有效地减少这一弱势群体的痛苦。