Thoughts, Feelings, and Actions: A Retrospective Study of the Coping Efforts of Pediatric Cancer Patients in the Context of the Home, Institution, and Community

This study was a retrospective examination of the experiences of pediatric cancer patients and their families from a contextual perspective. The home, institution, and community contexts were investigated to reveal their influences on the coping efforts of the study participants. Ten families of children with cancer were interviewed, and data were analyzed qualitatively. Walker\u27s (1985) family stress model and Lazarus\u27 (1984) coping paradigm guided the study. The findings indicated that children were ambivalent in their attitudes toward the disease process. While they did not enjoy painful procedures, sickness, frequent hospitalizations, and baldness, they did welcome the special attention brought about by these stressors. Many of the children in the study understood the impact of their illness on the family. They felt guilty about family financial pressures, parental marital problems, and sibling conflicts that resulted from their cancer. Most feared relapse and death but hid their feelings to protect their parents. Mothers handled the stress of their child\u27s illness by learning all they could about the disease, focusing completely on the sick child, and protecting the child from further harm. Fathers tended to take on the role of strong one while worrying about finances and attempting to keep the families together. Differing ways of coping between mothers and fathers often caused feelings of resentment and marital difficulties. Parental attitudes toward the staff at the medical center varied from trust, to wariness, to dependency. Parents enjoyed the support of family, friends, and community during the diagnosis phase, but felt bitter about the lack of support they received during the treatment and completion stages. Some parents believed that their exposure to the stressors of the illness process led to personal growth that they would not have experienced otherwise. Many parents emerged from the cancer ordeal with a desire to help others who were battling childhood cancer. They became involved in a variety of community agencies that served the families of children with cancer