The relation between parental relationship adjustment and sibling emotional adjustment in pediatric cancer

In 2016, approximately 10,000 children were diagnosed with cancer (American Cancer Society, 2016). A diagnosis of cancer can have a negative psychological impact on parents, the marital relationship, and the family unit (McGrath et al. 2005; Yeh 2002). For most siblings, psychological distress is highest close to time of diagnosis but distress may return to average levels after 6 months (Alderfer, 2010). Research shows that factors such as age and gender are related to sibling emotional distress (Alderfer & Kazak., 2006; Hamama, Ronen, & Feigin, 2000; Houtzager, Grootenhuis, Hoekstra-Weebers, Caron, & Last., 2003; Sloper & While, 1996). Parents of newly diagnosed cancer patients report higher levels of marital dissatisfaction, than parents of children in other treatment phases, and mothers report higher levels of marital dissatisfaction when the child is off treatment or in remission (Yeh, 2002). However, research has yet to explore whether parents’ relationship adjustment impacts siblings’ emotional adjustment in families of pediatric cancer patients. The current study examined the relationship between mothers’ report of relationship adjustment and siblings’ emotional adjustment in families of pediatric cancer patients, controlling for time since diagnosis, and whether sibling age and gender moderated the relationship between relationship adjustment and sibling emotional adjustment. The study also used a sequential mixed methods approach to incorporate qualitative data on father perspectives. Results showed that a large proportion of siblings met or exceeded the clinical cutoff score for emotional problems, and sibling age was significantly related to sibling emotional adjustment. Parent relationship adjustment was not related to sibling emotional adjustment, and age and gender did not moderate the relationship between relationship adjustment and sibling emotional adjustment. Qualitative results showed that partner communication and communication challenges were important aspects of overall relationship adjustment. Further, couples identified parent emotional adjustment, cancer stressors, and roles as important factors affected by a cancer diagnosis. Overall, siblings continue to be at risk for emotional adjustment problems and age may be a risk factor for poor emotional adjustment. However, relationship adjustment does not appear to be a factor involved in sibling emotional adjustment to cancer.