Spirituality, Social Support, and Adjustment Among Parents of Children With Advanced Cancer

Objective: Pediatric cancer can impact the emotional health of both children and their caregivers. Although previous research has established that social support and spiritual involvement may be protective for parents of children with cancer, less is known about parents of children with an advanced cancer diagnosis. In this study of mothers and fathers of children with advanced cancer, we aimed to: (a) examine the direct effects of general and cancer-specific stress, spiritual involvement, and social support on depressive symptoms and (b) determine if spiritual involvement and social support moderate the association between stress (i.e., general and cancer-specific) and parents’ depressive symptoms. Method: Participants ( N = 72 families; n = 55 mothers; n = 30 fathers) were from a larger longitudinal study of families of children with advanced cancer at a large pediatric hospital. At enrollment, parents completed surveys on demographics, cancer-specific stress, general stress, spiritual values and beliefs, and self-reported depressive symptoms. Results: For mothers, significant predictors of greater depressive symptoms included higher general stress and lower social support. For fathers, the only significant predictor was general stress. Moderation analyses revealed that social support was a significant moderator of the impact of general stress on depressive symptoms for mothers and fathers. Spiritual involvement was also a significant moderator of the association between cancer-specific stress and depressive symptoms for mothers only. Conclusions: This study suggests that even in the context of advanced pediatric cancer social support and spiritual involvement can serve as protective factors for parents, but that mothers and fathers may have unique supportive care needs. Implications for Impact Statement This study suggests that social support and spiritual involvement may be points of intervention in mitigating the impact of parents’ stress from their child’s advanced cancer diagnosis on depressive symptoms. Thus, interdisciplinary cancer care teams are needed to develop and implement multidimensional psychosocial interventions to meet the unique social and spiritual needs of these families across their cancer trajectory.