Health  Vol.9 No.7 , July 2017
Coping Strategies among Parents of Children with Acute Lymphoblastic Leukemia
Background: Having a child with acute lymphoblastic leukemia represents challenges to the family which may impact their quality of life. In such circumstances, parents use various coping strategies to face this stressful situation, and understanding the relation of coping strategies on quality of life among parents of children with acute lymphoblastic leukemia may provide professionals with ideas about how to support them which in turn may improve their quality of life. Aim: The aim of the present study was to assess the correlation between coping strategies and the health related quality of life of parents whose children are suffering from acute lymphoblastic leukemia. Study design: A cross-sectional design using guided self-administered questionnaire by a single researcher was used. Methods: A universal sample consisted of 299 parents of children with acute lymphoblastic leukemia (ALL) was recruited from Hospital Universiti Kebangsaan Malaysia and Kuala Lumpur Institute Pediatrics. The response rate was 98%. The data collection tools were WHOQOL BREF which is the World Health Organization Quality of Life shorter version and Brief COPE questionnaires. Results: The results revealed that half of the parents perceived their health related quality of life as good. The highest scores for parents were reported on the social relationship domain meanwhile the lowest were reported on the environmental health domain. In regard to the coping strategies, it was found that religion was most frequently used while humor was the least to be used. Moreover, there was a significant positive relationship between quality of life of the parents and problem-focused coping and a significant negative relationship with emotion-focused coping . Conclusion: On the basis of the finding of present study, an appropriate intervention could be design to include program that promote the use of problem-focused copings such as active coping and planning and discourage the use of emotion-focused copings such as self-blaming to enhance parents’ health related quality of life.
Cite this paper: Sutan, R. , Al-Saidi, N. , Latiff, Z. and Ibrahim, H. (2017) Coping Strategies among Parents of Children with Acute Lymphoblastic Leukemia. Health, 9, 987-999. doi: 10.4236/health.2017.97071.

[1]   Zainal Ariffin, O. and Nor Saleha, I. (2011) National Cancer Registry Report 2007. Ministry of Health, Malaysia.

[2]   Erkan, S. and Kaplan, Y. (2009) A study on the Depression Levels of Mothers of Leukemic Children. Pakistan Journal of Social Sciences, 6, 42-47.

[3]   Iqbal, A. and Siddiqui, K.S. (2002) Depression among Parents of Children with Acute Lymphoblastic Leukemia. Blue Collar, 6, 9.

[4]   Kholasehzadeh, G., Shiryazdi, S., Neamatzadeh, H. and Ahmadi, N. (2014) Depression Levels among Mothers of Children with Leukemia. Iranian Journal of Pediatric Hematology Oncology, 4, 109-113.

[5]   Barakat, L.P., Kazak, A.E., Meadows, A.T., Casey, R., Meeske, K. and Stuber, M.L. (1997) Families Surviving Childhood Cancer: A Comparison of Posttraumatic Stress Symptoms with Families of Healthy Children. Journal of Pediatric Psychology, 22, 843-859.

[6]   Kazak, A.E., Alderfer, M., Rourke, M.T., Simms, S., Streisand, R. and Grossman, J.R. (2004) Posttraumatic Stress Disorder (PTSD) and Posttraumatic Stress Symptoms (PTSS) in Families of Adolescent Childhood Cancer Survivors. Journal of Pediatric Psychology, 29, 211-219.

[7]   Masa’Deh, R., Collier, J. and Hall, C. (2012) Parental Stress When Caring for a Child with Cancer in Jordan: A Cross-Sectional Survey. Health and Quality of Life Outcomes, 10, 88.

[8]   Zarina, A., Radhiyah, R., Hamidah, A., Zakaria, S.Z.S. and Jamal, R. (2012) Parenting stress in Childhood Leukaemia. Medicine & Health, 7, 73-83.

[9]   Best, M., Streisand, R., Catania, L. and Kazak, A.E. (2001) Parental Distress during Pediatric Leukemia and Posttraumatic Stress Symptoms (PTSS) after Treatment Ends. Journal of Pediatric Psychology, 26, 299-307.

[10]   Kazak, A.E. and Barakat, L.P. (1997) Brief Report: Parenting Stress and Quality of Life during Treatment for Childhood Leukemia Predicts Child and Parent Adjustment after Treatment Ends. Journal of Pediatric Psychology, 22, 749-758.

[11]   Norberg, Lindblad and Boman (2005) Parental Traumatic Stress during and after Paediatric Cancer Treatment. Acta Oncologica, 44, 382-388.

[12]   Vrijmoet-Wiersma, C.M., van Klink, J.M., Kolk, A.M., Koopman, H.M., Ball, L.M. and Maarten Egeler, R. (2008) Assessment of Parental Psychological Stress in Pediatric Cancer: A Review. Journal of Pediatric Psychology, 33, 694-706.

[13]   WHO (1999) Annotated Bibliography of the WHO Quality of Life Assessment Instrument—WHOQOL. WHO/MNH/MHP/98.4.Rev.2.

[14]   Lawoko, S. and Soares, J.J. (2003) Quality of Life among Parents of Children with Congenital Heart Disease, Parents of Children with Other Diseases and Parents of Healthy Children. Quality of Life Research, 12, 655-666.

[15]   Okurowska-Zawada, B., Kulak, W. and Sienkiewicz, D. (2011) Quality of Life of Parents of Children with Cerebral Palsy. Progress in Health Sciences, 1, 116-123.

[16]   Yamada, A., Kato, M., Suzuki, M., Suzuki, M., Watanabe, N., Akechi, T. and Furukawa, T.A. (2012) Quality of Life of Parents Raising Children with Pervasive Developmental Disorders. BMC Psychiatry, 12, 119.

[17]   Van den Tweel, X.W., Hatzmann, J., Ensink, E., van der Lee, J.H., Peters, M., Fijnvandraat, K. and Grootenhuis, M. (2008) Quality of Life of Female Caregivers of Children with Sickle Cell Disease: A Survey. Haematologica, 93, 588-593.

[18]   Eiser, C., Eiser, J.R. and Stride, C.B. (2005) Quality of Life in Children Newly Diagnosed with Cancer and Their Mothers. Health and Quality of Life Outcomes, 3, 29.

[19]   Klassen, A.F., Klaassen, R., Dix, D., Pritchard, S., Yanofsky, R., O’Donnell, M., Sung, L., et al. (2008) Impact of Caring for a Child with Cancer on Parents’ Health-Related Quality of Life. Journal of Clinical Oncology, 26, 5884-5889.

[20]   Pathirana, T.I., Goonawardena, C. and Wijesiriwardane, I. (2014) Quality of Life of Caregivers and Impact on the Nuclear Family of Children with Leukaemia in the National Cancer Institute of Sri Lanka. Journal of the Postgraduate Institute of Medicine, 2, E18.

[21]   Yamazaki, S., Sokejima, S., Mizoue, T., Eboshida, A. and Fukuhara, S. (2005) Health-Related Quality of Life of Mothers of Children with Leukemia in Japan. Quality of Life Research, 14, 1079-1085.

[22]   Lim, J.W. and Zebrack, B. (2004) Caring for Family Members with Chronic Physical Illness: A Critical Review of Caregiver Literature. Health and Quality of Life Outcomes, 2, 50.

[23]   Yusoff, N., Low, W. and Yip, C. (2010) Reliability and Validity of the Malay Version of Brief COPE Scale: A Study on Malaysian Women Treated with Adjuvant Chemotherapy for Breast Cancer. Malaysian Journal of Psychiatry, 18.

[24]   Green, S.B. (1991) How Many Subjects Does It Take to Do a Regression Analysis. Multivariate Behavioral Research Journal, 26, 499-510.

[25]   Hasanah, C.I., Naing, L. and Rahman, A.R. (2003) World Health Organization Quality of Life Assessment: Brief Version in Bahasa Malaysia. Medical Journal of Malaysia, 58, 79-88.

[26]   Carver, C.S. (1997) You Want to Measure Coping but Your Protocol’s Too Long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92-100.

[27]   Lazarus, R.S. and Folkman, S. (1984) Stress, Appraisal, and Coping. Springer, New York.

[28]   Judge, S.L. (1998) Parental Coping Strategies and Strengths in Families of Young Children with Disabilities. Family Relations, 47, 263-268.

[29]   Cordella, M. and Poian, S. (2014) Behavioural Oncology: Psychological, Communicative, and Social Dimensions, Springer, Berlin.

[30]   Townsend, A., Noelker, L., Deimling, G. and Bass, D. (1989) Longitudinal Impact of Inter-Household Care-Giving on Adult Children’s Mental Health. Psychology and Aging, 4, 393.

[31]   Goldbeck, L. (2006) The Impact of Newly Diagnosed Chronic Paediatric Conditions on Parental Quality of Life. Quality of Life Research, 15, 1121-1131.

[32]   Kalyva, E. and Melonashi, E. (2015) Parental Perceptions of Health-Related Quality of Life of Albanian Children with Epilepsy. Health Psychology Research, 3, 2244.

[33]   Geok, C.K., Abdullah, K.L. and Kee, L.H. (2013) Quality of Life among Malaysian Mothers with a Child with Down Syndrome. International Journal of Nursing Practice, 19, 381-389.

[34]   Hashemi, F., Sh, R., Sharif, F. and Shahriari, M. (2007) Coping Strategies Used by Parents of Children with Cancer in Shiraz, Southern Iran. Iranian Red Crescent Medical Journal, 2007, 124-128.

[35]   Kohlsdorf, M. and Costa Junior, á.L. (2011) Coping Strategies and Caregiver’s Anxiety in Pediatric Oncohematology. Psicologia: Reflexao e Crítica, 24, 272-280.

[36]   Nair, D. (2014) Coping Strategies Used by Mothers’ of Children with Leukemia in Pune, India. Acta Medica Scientia, 1, 6-8.

[37]   Grootenhuis, M.A. and Last, B.F. (1997) Adjustment and Coping by Parents of Children with Cancer: A Review of the Literature. Support Care Cancer, 5, 466-484.

[38]   Compas, B.E., Bemis, H., Gerhardt, C.A., Dunn, M.J., Rodriguez, E.M., Desjardins, L., Vannatta, K., et al. (2015) Mothers and Fathers Coping with Their Children’s Cancer: Individual and Interpersonal Processes. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 34, 783-793.

[39]   Greening, L. and Stoppelbein, L. (2007) Brief Report: Pediatric Cancer, Parental Coping Style, and Risk for Depressive, Posttraumatic Stress, and Anxiety Symptoms. Journal of Pediatric Psychology, 32, 1272-1277.

[40]   Norberg, Lindblad and Boman (2005) Coping Strategies in Parents of Children with Cancer. Social Science & Medicine, 60, 965-975.

[41]   Grootenhuis, M.A. and Last, B.F. (1997) Predictors of Parental Emotional Adjustment to Childhood Cancer. Psycho-Oncology, 6, 115-128.<115::AID-PON252>3.0.CO;2-D

[42]   Trask, P.C., Paterson, A.G., Trask, C.L., Bares, C.B., Birt, J. and Maan, C. (2003) Parent and Adolescent Adjustment to Pediatric Cancer: Associations with Coping, Social Support, and Family Function. Journal of Pediatric Oncology Nursing, 20, 36-47.