The role of parental distress in children's health‐related quality of life in pediatric acute lymphoblastic leukemia

Objective: The diagnosis of childhood acute lymphoblastic leukemia (ALL) and the subsequent treatment‐related challenges impact the children's health‐related quality of life (HRQoL) and parental distress (psychological morbidity and traumatic stress symptoms). This study examined the relationship between parental distress and children's HRQoL, focusing on preschool‐aged children and toddlers. The aims were: to assess changes in children's HRQoL over time, compare HRQoL between children with ALL and healthy children, and evaluate the longitudinal association between parental distress and children's HRQoL.
Methods: The sample consisted of 46 parents of children with ALL, 58 parents of healthy children, and their children. Assessments were conducted in the first week of three treatment phases, (T0‐Consolidation; T1‐Intensification; T2‐Maintenance).
Linear mixed models and Mann‐Whitney U tests were performed. Results revealed significant improvements in children's HRQoL over time, although lower than the healthy group. Parental psychological morbidity was associated with children's HRQoL at T1 but not at T2. Traumatic stress symptoms showed no association with children's HRQoL.
Conclusion: These findings underscore the importance of targeting parental psychological morbidity (anxiety and depression symptoms) during more intensive treatment phases. Incorporating family‐centered care strategies that address parents' psychological morbidity can promote better outcomesfor both children and parents,supporting adaptation during this challenging period.
This study was conducted at the Psychology Research Center (CIPsi/UM), School of Psychology, University of Minho, supported by the Foundation for Science and Technology [Fundação para a Ciência e a Tecnologia, I.P] (FCT) through the Portuguese State Budget (UIDB/01662/2020). The first author (A.F.) was supported by a PhD fellowship from FCT (grant number: 2020.09043.BD).