Parents' perspectives on decisional conflict, anxiety, and perceived care involvement upon their children's cancer diagnosis: A longitudinal study

Abstract

Purpose: To examine (1) relationships among parents' decisional conflict, anxiety, and perceived care involvement; (2) the longitudinal trajectories of each variable following their children's cancer diagnosis.

Design and methods: A prospective longitudinal study included parents (> 20 years) of children had been newly diagnosed with cancer within one month of enrollment. Decisional conflict, perceived care involvement, and anxiety were measured at diagnosis and 1, 3, and 6 months thereafter. Generalized estimating equation and Spearman correlation were used to analyze time effects and their relationship.

Results: 86.7 % of parents had anxiety scores greater than 41 at diagnosis. Anxiety decreased significantly at 3 (β = -5.88, p < .01), and 6 (β = -6.88, p ≤0.01) months. No significant change in decisional conflict or perceived care involvement was observed, except the effective decision score was higher at 1 month than at diagnosis (β = 9.38, p < .01). Higher anxiety at diagnosis correlated significantly with 1-, 3-, and 6-month scores for anxiety (all p < .05) and decisional conflict (all p < .05). Perceived care involvement correlated negatively with decisional conflict across timepoints but showed no link to anxiety.

Conclusions: Parental anxiety significantly decreased over time, but 57.1 % of parents were still anxious at 6 months, while decisional conflict and perceived care involvement remained unchanged. Initial anxiety linked to later levels of anxiety and decisional conflict, and more parental perceived care involvement reduced decisional conflict.

Practice implications: Highlight parents' anxiety and decision-making challenges during their children's cancer treatment. Early and ongoing psychological and decisional support for these parents is recommended.

Keywords: Anxiety; Childhood cancer; Decisional conflict; Parents.