The Effects of Family Characteristics, Emotional Expression and Early Social Work Intervention on Illness Adaptation Among Children with Cancer and Their Parents

Abstract Purpose: This study investigated how family characteristics affect emotional expression and illness adaptation among children with cancer and their parents, using structural equation modeling (SEM). It also examined the moderating role of early social work intervention in this process, emphasizing its importance in addressing emotional, psychological, financial, and social support needs to strengthen coping, resilience, and quality of life during pediatric oncology treatment. Methods: The study included 68 families of pediatric cancer patients (154 children and parents). Data were collected via structured questionnaires and analyzed using SEM with the lavaan package in R. The measurement model’s validity and reliability were assessed, and direct, indirect, and moderating effects were examined. Results: The SEM showed good fit to the proposed illness adaptation model. Family characteristics significantly affected emotional expression (γ = −.27) and illness adaptation (γ = −.34). Emotional expression negatively impacted illness adaptation (β = −.53), indicating that greater emotional distress was linked to poorer adaptation. Early social work intervention had significant positive effects on emotional expression (β = .65) and illness adaptation (β = .68), and moderated the effect of family characteristics on adaptation, especially benefiting families with fewer internal resources. Conclusion: Early social work intervention plays a vital role in pediatric oncology by reducing emotional distress, buffering negative family dynamics, and promoting resilience. These findings support integrating social work services early in treatment to enhance adaptation and family well-being.