This study identifies variables that influence childhood psychosocial adjustment to cancer diagnosis and treatment by examining the illness-related factors of physical functionality, severity of illness, relapse status, and stage in treatment; family context factors of parenting stress and family psychosocial risk; and within-child factors of personal resiliency. These factors were assessed among 37 children with leukemia or lymphoma, one of their caretakers (29 mothers, 7 fathers, 1 grandmother), and one of their medical care providers (14 physicians, 22 nurse practitioners, 1 physician's assistant) through a one-time completion of questionnaires. Results revealed that several significant associations were found between child adjustment and independent variables. Specifically, the child's age at the time of diagnosis, the time since his/her diagnosis, his/her gender, the caregiver's stress related to parenting an ill child, and the child's personal resiliency were each identified as factors related to child psychosocial adjustment. Directionally, children who are diagnosed at a younger age, or who have been in treatment for a longer period of time may be at risk for psychosocial adjustment difficulties. Female gender and increased frequency and difficulty of parenting stress may also be risk factors associated with maladjustment. Personal child resiliency, as measured by presence of social and emotional strengths, can be protective in terms of preventing adjustment difficulties.
