Parents resilient after their children undergo stem cell transplant

A child's illness can challenge a parent's well-being. However, a recent study shows that, in the case of stem cell transplantation in a child, parents feel increased distress at the time of the procedure, but eventually recover to normal levels of adjustment.

“Across all study groups, what we basically showed is that parents are resilient. Overall, parents get better over time,” said Jennifer Lindwall, PhD, assistant professor of psychiatry at the University of Colorado (CU) School of Medicine and teaching partner of the CU Cancer Center in Aurora. This study was published in Biology of Blood and Marrow Transplantation (2014; doi:10.1016/j.bbmt.2014.01.007).

The study measured psychological distress and positive affect in 171 parent/child pairs from time of admission for a child's stem cell transplant until 6 weeks after the procedure, and also measured depression, posttraumatic stress, and benefit-finding at the time of admission for the procedure and at 24 weeks after. Results in pediatric patients were previously reported in the journal Pediatrics. The current study reports on the results of distress in parents.

“The aim of the study was to examine an intervention to promote positive adjustment of patients and their parents. In one group, children were given humor and massage therapy; in a second group, parents were given relaxation/imagery training and massage therapy in addition to the child intervention; and a third group did not receive any additional intervention beyond standard care provided at the hospital,” Lindwall said.

Though no significant differences were found across treatment groups, Lindwall and colleagues from St. Jude Children's Research Hospital in Memphis, Tennessee, showed a consistent finding: “In many respects, a parent's distress parallels the child's distress. As things get better for the child, they get better for the parent as well. We saw this with distress in the acute period after transplant and also in global measures of depression, PTSD [posttraumatic stress disorder], and benefit-finding,” Lindwall said. Parents demonstrated remarkable recovery despite facing a significant life challenge.

Lindwall pointed out that the medical model in some hospital settings views patients and parents from a deficit perspective—it seeks to right what is wrong. However, Lindwall and colleagues also see the value in exploring the factors that create resilience in parents—to understand what has gone right in these cases despite facing significant challenges.

“While the study showed the norm is resilience and recovery, there are certainly some parents of children with significant medical illness who don't do well—parents who remain distressed. Our challenge now is to predict which parents are at the highest risk for difficulties and to design interventions that can help these parents cope during their child's medical challenges,” Lindwall said.

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