Allen, Ruth; (2001) A prospective, longitudinal study of the family and patient coping with adolescent cancer from the time of diagnosis. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

This thesis reports a longitudinal, prospective study of the family and adolescent patient adjusting to cancer during the first year of diagnosis. Sixty families were recruited and completed questionnaires assessing mood and non mood variables. Mood variables assessed were anxiety, depression and anger. Non mood variables were dispositional optimism, illness cognitions, coping strategies, social support and health locus of control. The FAME questionnaire assessing family environment was developed specifically for the current study, as was an activities checklist for the adolescent patients. Factor analysis of the FAME identified three dimensions; cohesion, conflict resolution and routine. The families were studied at diagnosis and at 3, 6 and 12 months after diagnosis. At the end of the year, 39 adolescent patients (mean age 15 years), 30 mothers and 20 fathers completed questionnaires. There was some evidence that older adolescent patients, with more extensive disease, were less likely to complete a year on study. At diagnosis, there were low levels of distress in the adolescent patients. There were high levels of anxiety and depression in both mothers and fathers. There was no change in the mood states over the year in the adolescent patients. Adolescents girls consistently reported higher levels of depression than the adolescent boys. In mothers and fathers there was a decrease in state anxiety but no change in depression over the year. There were no relationships between mood states in the adolescent patient and their parents. As the year progressed mothers and fathers reported using more distracting coping strategies, such as behavioural and mental disengagement. There were few relationships between the use of coping strategies and mood. Similarly, there were few relationships between different family member's use of the same or different strategies. The results are discussed in the context of the initial hypotheses, and recommendations for future research identified.

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