Children of parents with cancer may respond differently in terms of adjustment and maladjustment. We aimed to investigate the coping mechanisms of children of cancer parents in the Tunisian context where cancer remains a taboo subject in many families.
Parents treated for cancer (n=103) who have children<18 years old, were asked to complete a questionnaire between July and December 2020.The questionnaire included items about emotional and behavioral impact on children.
We interviewed 75 women (72.8%) and 28 men (27.2%); mean age was 43 years old. Forty percent of the patients had adolescents (aged 12-18 years), 35% had school-aged children (6-12 years) and 25% had children preschoolers (<6 years). In our study, 82.5% of parents told their children about the disease. Among the children who were not aware of their parent’s illness, we observed significantly more preschoolers (61% vs 17.6%, p=0.001). The reasons given by the parents in these cases were the young age of their children (60%) and the fear of generating emotional and behavioral trauma and threatening their psychosocial equilibrium (40%). In 41.7% of cases, parents didn’t disclose the whole truth to their kids. De-dramatizing approach was particularly adopted with preschoolers in 94.1%, vs 62.5% in school-aged vs 17.9% in adolescents, p<0.01. The announcement procedure was perceived as a stressful task by half of the participants and 88.3% reported communication disorders with their children when referring to the parental illness. In our study, 96% of participants observed a behavioral change in their kids: anxiety in 35.1%, depression in 21.6%, violent behavior and aggression in 21.6%, emotional dependency in 10.3% and addiction in 6.2% of the cases. School failure was reported in 58.7% of cases mainly seen in children aged 6-12 years. Parent gender (OR=2.88 [0.38-21]) and educational level (OR=0.59 [0.059-5.894]) didn’t significantly predict kids’ behavior change. Only nine parents (8.7%) consulted a pedopsychiatrist.
Tunisian parents with cancer seemed to lift the taboo surrounding their disease by involving their children in the acceptance process of the disease despite the developmental disruption it can generate.
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All authors have declared no conflicts of interest.