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Jennifer W. Mack, MD, MPH; Joanne Wolfe, MD, MPH; E. Francis Cook, ScD; Holcombe E. Grier, MD; Paul D. Cleary, PhD; Jane C. Weeks, MD, MSc

Arch Pediatr Adolesc Med. 2009;163(6):519-524.

Objective  To evaluate issues experienced by parents of children with cancer and factors related to parents' ability to find peace of mind.

Design  Cross-sectional survey.

Setting  Dana-Farber Cancer Institute and Children's Hospital, Boston, Massachusetts.

Participants  One hundred ninety-four parents of children with cancer (response rate, 70%) in the first year of cancer treatment.

Main Outcome Measure  The Functional Assessment of Chronic Illness Therapy–Spiritual Well-being sense of meaning subscale.

Results  Principal components analysis of Functional Assessment of Chronic Illness Therapy–Spiritual Well-being sense of meaning subscale responses identified 2 distinct constructs, peace of mind (Cronbach  = .83) and sense of purpose (Cronbach  = .71). Scores ranged from 1 to 5, with 5 representing the strongest sense of peace or purpose. One hundred forty-seven of 181 parents (81%) scored 4 or higher for questions related to sense of purpose (mean [SD] score, 4.4 [0.6]). Only 44 of 185 parents (24%) had scores in the same range for peace of mind (mean [SD] score, 3.2 [0.9]) (P < .001). In a multivariable logistic regression model, parents had higher peace of mind scores when they also reported that they trusted the oncologist's judgment (odds ratio [OR] = 6.65; 95% confidence interval [CI], 1.47-30.02), that the oncologist had disclosed detailed prognostic information (OR = 2.05; 95% CI, 1.14-3.70), and that the oncologist had provided high-quality information about the cancer (OR = 2.54; 95% CI, 1.11-5.79). Peace of mind was not associated with prognosis (OR = 0.74; 95% CI, 0.41-1.32) or time since diagnosis (OR = 1.00; 95% CI, 0.995-1.003).

Conclusions  Physicians may be able to facilitate formulation of peace of mind by giving parents high-quality medical information, including prognostic information, and facilitating parents' trust.

Author Affiliations: Department of Medicine, Children's Hospital, Boston, Massachusetts (Drs Mack, Wolfe, and Grier); Departments of Pediatric Oncology (Drs Mack, Wolfe, and Grier) and Medical Oncology (Dr Weeks), and the Center for Outcomes and Policy Research (Drs Mack, Wolfe, and Weeks), Dana-Farber Cancer Institute, Boston; Department of Epidemiology, Harvard School of Public Health, Boston (Dr Cook); Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut (Dr Cleary); and Department of Medicine, Brigham and Women's Hospital, Boston (Dr Weeks).

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