Parenting and Child Distress During Cancer Procedures: A Multidimensional Assessment

We examined the relationship between children's distress during invasive cancer procedures and patent anxiety, parent disciplinary attitudes, and parent behavior during the medical procedure. Sixty-six children with cancer and their parents were evaluated during a routine bone marrow aspiration. Significantly higher levels of distress were obtained for young (under age 8) versus older children. Patterns of relationships with parent variables also varied by age. Anxious parents of young children reported relying on less effective discipline strategies. They also were less reassuring prior to the medical procedure and were more agitated during the procedure. Young children's distress was positively associated with parental reassurance, ignoring, and agitation before the procedure and with information-giving during the procedure. Older children's distress was negatively associated with parental distraction during the procedure. Age differences in the correlations between child distress and parenting are discussed in terms of developmental differences in children's dependence on caregivers for emotional regulation and control. Implications for clinical distress reduction programs are also discussed.