Fear of Progression in Parents of Children with Cancer: Results of An Online Expert Survey in Pediatric Oncology

Abstract

Background Fear of Progression (FoP) is a commonly reported psychological strain in parents of children with cancer. This expert survey investigates how professionals in pediatric oncology estimate the burden and consequences of FoP in parents and how they assess and treat parental FoP.

Method N=77 professionals in pediatric oncology (members and associates of the Psychosocial Association in Paediatric Oncology and Haematology, PSAPOH) were examined in an online survey with a self-developed questionnaire. Data were analyzed via descriptive statistics and qualitative content analysis.

Results Three of four experts in clinical practice were (very) often confronted with parental FoP which was associated with more negative (e. g., psychosomatic reactions, reduced family functioning) than positive (e. g., active illness processing) consequences. N=40 experts indicated that they mainly assess parents’ anxiety via clinical judgment (72.5%) and/or according to ICD-10/DSM-5 diagnostic criteria (37.5%), whereas standardized methods such as psycho-oncological questionnaires (12.5%) were applied less often. Only n=6 experts named a specific diagnostic approach to assess parental FoP. The most common treatment approaches for FoP were supportive counseling (74.0%), psychotherapy (59.7%) and/or relaxation techniques (55.8%).

Discussion Parental FoP is frequently perceived by experts in clinical practice. A standardized diagnostic procedure would increase comparability of diagnostic judgments and harmonize treatment indications.

Zusammenfassung

Hintergrund Progredienzangst (PA) gehört zu den häufigsten psychischen Belastungen bei Eltern krebskranker Kinder. In dieser Studie wurden Experten hinsichtlich der Auftretenshäufigkeit und Konsequenzen von PA bei Eltern sowie zur diagnostischen Erfassung und Behandlung elterlicher PA befragt.

Methode N=77 Mitglieder und assoziierte Kollegen der Psychosozialen Arbeitsgemeinschaft in der Gesellschaft für Pädiatrische Onkologie und Hämatologie (PSAPOH) wurden mit einem selbstentwickelten Online-Fragebogen befragt. Es wurden Häufigkeitsanalysen sowie eine qualitative Inhaltsanalyse durchgeführt.

Ergebnisse Drei von vier Experten wurden in ihrer klinischen Tätigkeit (sehr) oft mit elterlicher PA konfrontiert und gaben mehr negative (z. B. psychosomatische Reaktionen, eingeschränkte Familienfunktion) als positive (z. B. aktive Krankheitsverarbeitung) Konsequenzen elterlicher PA an. N=40 Experten gaben an, elterliche Ängste vor allem durch klinisches Expertenurteil (72.5%) bzw. anhand diagnostischer Kriterien nach ICD-10/DSM-5 (37.5%) zu erfassen, während der Einsatz standardisierter Instrumente wie psychoonkologische Fragebögen (12.5%) seltener angegeben wurde. Nur n=6 Experten nannten einen spezifischen diagnostischen Ansatz zur Erfassung elterlicher PA. Supportive Beratung (74.0%), Psychotherapie (59.7%) und/oder Entspannungstechniken (55.8%) wurden als gängige Behandlungsansätze für PA genannt.

Diskussion PA wird bei Eltern krebskranker Kinder von Experten sehr oft beobachtet. Ein standardisiertes diagnostisches Vorgehen könnte klinische Urteile vergleichbar machen und Behandlungsempfehlungen vereinheitlichen.

Key words

fear of progression - pediatric oncology - psychosocial care - recurrence

Schlüsselwörter

Progredienzangst - Pädiatrische Onkologie - Psychosoziale Versorgung - Rezidiv

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