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Parent Psychological and Physical Health Outcomes in Pediatric Hematopoietic Stem Cell Transplantation

Ward, Jessica, PhD, MPH, RN, CPNP; Fogg, Louis, PhD; Rodgers, Cheryl, PhD, RN, CPNP, CPON; Breitenstein, Susie, PhD, RN; Kapoor, Neena, MD; Swanson, Barbara A., PhD, RN, FAAN, ACRN

doi: 10.1097/NCC.0000000000000652
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Background Parents of children undergoing hematopoietic stem cell transplantation (HSCT) are at risk of adverse health outcomes due to their intense caregiver demands.

Objective The aim of this study was to describe adverse health outcomes in parents of children who survived an allogeneic HSCT done within the past 1 to 10 years.

Methods This cross-sectional study, conducted at a children's hospital in the western United States, enrolled English- and Spanish-speaking parents of children who survived allogeneic HSCT between 2005 and 2015. Outcome measures included Beck Anxiety and Depression Inventories, Perceived Stress and Parent Stress Scales, Physical Symptom Inventory, and Short-Form 36 version 2. Parent scores were compared with normative means. Subsequently, the parent sample was stratified by the amount of time since their child's HSCT for comparison between groups.

Results Fifty-four mothers and 7 fathers (n = 61) were enrolled. Global mental health scores were lower for parents in the sample compared with norms (P = .003). Parents in the sample reported moderate anxiety and depression (20% and 23%, respectively), yet reported less parenting stress and superior health outcomes compared with norms (P < .001). Social functioning and general health scores were lower for parents whose children survived an allogeneic HSCT done within the past 1 to 4.99 years (P = .012).

Conclusion Parents of survivors of allogeneic HSCT may concurrently experience posttraumatic growth and stress following their child's HSCT.

Implications for Practice Health screening and psychological support for parents of children post-HSCT may help to identify parents at risk of adverse outcomes and allow for early, targeted interventions.

Author Affiliations: Children's Hospital Los Angeles, California (Drs Ward and Kapoor); University of Southern California, Keck School of Medicine, Los Angeles (Dr Kapoor); Rush University College of Nursing, Chicago, Illinois (Drs Ward, Fogg, Breitenstein, and Swanson); and Duke University School of Nursing, Durham, North Carolina (Dr Rodgers).

This research was supported by the Children's Hospital Los Angeles, Clinical Services Research Council Grant, and the Rush University College of Nursing, Golden Lamp Dissertation Award.

The authors have no funding or conflicts of interest to disclose.

Correspondence: Jessica Ward, PhD, MPH, RN, CPNP, Center for Cancer and Blood Disorders, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027 (jward@chla.usc.edu).

Accepted for publication July 5, 2018.

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