Psychological Outcomes in Adolescents With a Parent Dying of Cancer


Key Points

  • Participants with distrust of care were more likely to report self-destructiveness, such as self-injury.
  • Those with distrust were more likely to report moderate to severe depression.

In a study in the Swedish population reported by Beernaert et al in the Journal of Clinical Oncology, distrust in the end-of-life care provided to a parent with cancer was associated with long-term adverse emotional/psychological effects among bereaved adolescents.

Study Details

The study involved a population-based nationwide survey in 2009 to 2010 of sons and daughters who had lost a parent to cancer during their teenage years. The Swedish Cause of Death Register was used to identify individuals (potential parents) who died of cancer at age < 65 years; linkage to the Multigenerational Register at Statistics Sweden allowed identification of former adolescents who had been 13 to 16 years old at the time of their parent’s death, were 18 to 25 years old at the time of data collection, and had been living with both parents. A total of 622 participants (73% of those eligible to participate) who had lost a parent 6 to 9 years earlier were identified.

Trust Level and Outcomes

Overall, 105 participants (18%) reported no or little trust in the health care provided to their dying parent. Compared with participants reporting moderate or much trust (n = 488), those with distrust were more likely to have bitterness toward health-care professionals for not having done everything that was possible (crude risk ratio [RR] = 3.5, 95% confidence interval [CI] = 2.3–5.1) and for having stopped treatment (RR = 3.4, 95% CI = 2.1–6.0). Those with distrust were more likely to report self-destructiveness, such as self-injury (RR = 1.7, 95% CI = 1.2–2.4), and psychological problems, such as moderate to severe depression (RR = 2.3, 95% CI = 1.5–3.5).

The investigators concluded: “In cancer-bereaved former adolescents, distrust in the health care provided to the dying parent is associated with a higher risk of negative long-term outcomes. The health care professionals involved in this care might play an important role in safeguarding the trust of adolescents.”

The study was funded by Cancerfonden CAN 2008/758, the Gålö Foundation, Research Foundation Flanders, and the Erling-Persson Family Foundation.

Kim Beernaert, PhD, of Vrije Universiteit Brussel and Ghent University, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.