Children with cancer adapt to the consequences of their illness extremely well. They are less pessimistic than their healthy peers, adjust difficult goals and focus on the positive aspects of being ill. This process starts during the first months after the diagnosis. These are among the conclusions from research conducted by paediatric nurse and pedagoge Esther Sulkers from the University Medical Center Groningen. Parents also adjust quickly to the new care tasks they face. Sulkers will be awarded a PhD for her thesis by the University of Groningen on 4 February.
Very few children with cancer, or their parents, have psychological problems dealing with the disease. This is despite the far-reaching consequences of the diagnosis and treatment for both child and parent. But little is known about why children are so resilient. Esther Sulkers explored the factors underlying this resilience. She focused on the coping mechanisms that children develop during the first year after the diagnosis, and the progress of care-related stress among parents.
Sulkers’ research showed that children with cancer are less pessimistic than their healthy peers. They do not necessarily expect more good things to happen, but they tend to focus less on the things that could go wrong in the future. This relatively low degree of pessimism could explain why this group has so few psychological problems.
Diagnosis and treatment can drastically change a child’s life and often have an adverse effect on their well-being. Sulkers shows that these children are able to adjust their personal goals to suit their current situation. They do this by ‘parking’ their goals or setting new, more feasible goals. In addition, they aspire to more intrinsic goals than their peers, and consider them more important. The goals of children with cancer are generally more concrete than those of their healthy counterparts, and do not change during the first year after the diagnosis.
According to Sulkers’ research, young cancer patients attribute positive experiences in their lives to having cancer. All the children were able to name at least one such positive experience within six months of the diagnosis. These included ‘knowing who my best friends are’, ‘knowing how much people love me’ and ‘being happy and enjoying the good things in life’. These experiences were still evident six months later.
Sulkers also included the parents of childhood cancer patients in her study. It would seem that although the new care-related tasks initially cause them stress, this feeling recedes during the first three months after the diagnosis. Single mothers and mothers of only children experience the most stress.
According to Sulkers, the swift development of coping mechanisms explain why children with cancer and their parents are so resilient. Sulkers: ‘This provides a good starting point for counselling those children and parents who are coping less well’. She would like to see more research into the precise impact that the underlying mechanisms have on the adjustment process.
E. Sulkers (1962, Delft) studied Orthopedagogy at the University of Groningen. She carried out her research at the Research Institute SHARE and the Department of Child Oncology in the UMCG. Her thesis is entitled: ‘Psychological adaptation to childhood cancer: underlying mechanisms’. Sulkers will continue her work as a researcher in the UMCG after obtaining her PhD.
Source: press release UMCG
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