Screening for Distress and Sources of Distress in Parents With Advanced Cancer and Their Coparents

Context: Patients with metastatic cancer and their spousal caregivers who are parenting minor children are vulnerable to cancer-related parenting concerns and psychological distress. Objectives: The current study extends existing knowledge through identifying the extent to which patients and coparents endorse physical, emotional, social, practical, and spiritual concerns as sources of distress and examining the associations between these sources of distress and cancer-related parenting concerns and psychological symptoms. Methods: Patients and coparents (N = 51 dyads) parenting children under the age of 18 years completed cross-sectional measures on cancer-related distress and concerns (NCCN distress thermometer and Problem List), parenting concerns (PCQ), and psychological symptoms (HADS). Results: Compared with patients, coparents endorsed significantly greater psychological distress (P < .01). More than half of the patient and coparent samples endorsed problems with sleep, fatigue, and anxiety. Coparents (>50%) also reported practical problems (i.e., finances, work). For both patients and coparents physical, practical, emotional, social, and spiritual problems were significantly associated with cancer-related parenting concerns (patients, r = 0.40–0.58; coparents, r = 0.52–0.70). Multiple regression analyses revealed that parenting concerns are uniquely associated with patient depressive symptoms (β = 0.36, P < .05) even when accounting for physical, practical, social, and spiritual sources of distress. Conclusion: Parents are a vulnerable subpopulation endorsing concerns in various distress domains. Regular and comprehensive screening for supportive care needs for both patients and coparents, combined with the efforts of a multidisciplinary clinical team, is needed to address families’ cancer-related concerns.