Having a child with cancer affects the dyadic relationship between caregivers and the child. This study focused on changes in parenting and discipline among mothers after their child was diagnosed with cancer. We used semistructured interviews to explore 20 mothers’ experiences of parenting a child who had been diagnosed with cancer during the prior 5 years and before the age of 19 years in South Korea. Thematic analysis yielded five themes related to parenting changes: parental overprotection, increased parental permissiveness, use of threats to ensure compliance, concern for the child’s stress levels, and mothers’ confusion about optimal parenting. All mothers reported uncertainty and concern regarding how best to parent their sick child to ensure optimal health outcomes. The findings inform best practices for integrating medical and mental health care to support optimal maternal parenting and encourage optimal health outcomes for children with cancer.
BaumrindD. (1971). Current patterns of parental authority. Developmental Psychology Monographs, 4, 1–103. doi:10.1037/h0030372
2.
BavelasJ. B.SegalL. (1982). Family systems theory: Background and implications. Journal of Communication, 32(3), 99–107.
3.
BjorkM.NordstromB.WiebeT.HallstromI. (2011). Returning to a changed ordinary life - Families lived experiences after completing a child’s cancer treatment. European Journal of Cancer, 20(2), 163–169. doi:10.1111/j.1365-2354.2009.01159.x
4.
BornsteinM. H. (2012). Cultural approaches to parenting. Parenting, 12(2–3), 212–221. doi:10.1080/15295192.2012.683359
5.
BraunV.ClarkeV. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. doi:10.1191/1478088706qp063oa
6.
CarpenterM. Y.MullinsL. L.Wolfe-ChristianseC.ChaneyJ. M. (2008). The relationship of parent self-focused negative attributions to ratings of parental overprotection, perceived child vulnerability, and parenting stress. Family Systems and Health, 26(2), 147–163. doi:10.1037/1091-7527.26.2.147
7.
ChuaA. (2011). Battle hymn of the tiger mother. New York: Penguin Books.
8.
Clarke-SteffenL. (1997). Reconstructing reality: Family strategies for managing childhood cancer. Journal of Pediatric Nursing, 12(5), 278–287. doi:10.1016/S0882-5963(97)80045-0
9.
CoxT. (2016). Caregivers reflecting on the early days of childhood cancer. European Journal of Cancer Care, 27(1), e12499. doi:10.1111/ecc.12499
10.
DeatrickJ. A.MullaneyE. K.Mooney-DoyleK. (2009). Exploring family management of childhood brain tumor survivors. Journal of Pediatric Oncology Nursing, 26(5), 303–311. doi:10.1177/1043454209343210
11.
FedeleD. A.MullinsL. L.Wolfe-ChristensenC.CarpentierM. Y. (2011). Longitudinal assessment of maternal parenting capacity variables and child adjustment outcomes in pediatric cancer. Journal of Pediatric Hematology/ Oncology, 33(3), 199–202. doi:10.1097/MPH.0b013e3182025221
12.
FluryM.CaflischU.Ullmann-BremiA.SpichigerE. (2011). Experiences of parents with caring for their child after a cancer diagnosis. Journal of Pediatric Oncology Nursing, 28(3), 143–153. doi:10.1177/1043454210378015
13.
ForinderU.NorbergA. L. (2010). “Now we have to cope with the rest of our lives”. Existential issues related to parenting a child surviving a brain tumour. Support Cancer in Care, 18(5), 543–551. doi 10.1007/s00520-009-0678-3
14.
GardinerH. W.KosmitzkiC. (2018). Lives across cultures: Cross-cultural human development (6th ed.). New York: Pearson.
15.
GibbinsJ.SteinhardtK.BeinartH. (2012). A Systematic review of qualitative studies exploring the experience of parents whose child is diagnosed and treated for cancer. Journal of Pediatric Oncology Nursing, 29(5), 253–271. doi:10.1177/1043454212452791
16.
HepburnA.PotterJ. (2011). Threats: Power, family mealtimes, and social influence. British Journal of Social Psychology, 50(1), 99–120. doi:10.1348/014466610X500791
17.
HillmanK. A. (1997). Comparing child rearing practices in parents of children with cancer and parents of healthy children. Journal of Pediatric Oncology Nursing, 14(2), 53–67.
18.
HuangG. H.GoveM. (2015). Asian parenting styles and academic achievement: Views from Eastern and Western perspectives. Education, 135(3), 389–397.
19.
HullmannS. E.Wolfe-ChristensenC.MeyerW. H.McNall-KnappR. Y.MullinsL. L. (2010). The relationship between parental overprotection and health-related quality of life in pediatric cancer: The mediating role of perceived child vulnerability. Quality of Life Research, 9(19), 1373–1380. doi:10.1007/s11136-010-9696-3
20.
JuangL. P.QinD. B.ParkI. J. (2013). Deconstructing the myth of the “Tiger mother”: An introduction to the special issue on tiger parenting, Asian-heritage families, and child/adolescent well-being. Asian American Journal of Psychology, 4(1), 1–6. doi:10.1037/a0032136
21.
KazakA. E.SimmsS.RourkeM. T. (2002). Family systems practice in pediatric psychology. Journal of Pediatric Psychology, 27(2), 133–143. doi:10.1093/jpepsy/27.2.133
22.
KentE. R.RowlandJ. H.NorthouseL.LitzelmanK.ChouW. S.ShelburneN.. . . HussK. (2016). Caring for caregivers and patients: Research and clinical priorities for informal cancer caregiving. Cancer, 122(13), 1987–1995. doi:10.1002/cncr.29939
23.
KhouryM. N.HuijerH.DoumitM. A. (2013). Lebanese parents’ experiences with a child with cancer. European Journal of Oncology Nursing, 17(1), 16–21. doi:10.1016/j.ejon.2012.02.005
24.
KimD. H.ChungN. G.LeeS. (2015). The effect of perceived parental rearing behaviors on health-related quality of life in adolescents with leukemia. Journal of Pediatric Oncology Nursing, 32(5), 295–303. doi:10.1177/1043454214563412
25.
KimW. O.KangH. S.ChoK. J.SongY.JiE. S. (2008). Comparative study on parenting stress, guilt, parenting attitude, and parenting satisfaction between mothers with a hemophilic child and a healthy child. Korean Journal of Women Health Nursing, 14(4), 270–277. doi:10.4069/kjwhn.2008.14.4.270
26.
KohlsdorfM.Costa JuniorA. L. (2012). Psychosocial impact of pediatric cancer on parents: A literature review. Paideia, 22(51), 119–129. doi:10.1590/S0103-863X2012000100014
27.
Korea Central Cancer Registry, National Cancer Center. (2017). Annual report of cancer statistics in Korea in 2015. Sejong, South Korea: Ministry of Health and Welfare.
28.
LandryS. H.SmithK.SwankP. R.AsselM. A.VelletS. (2001). Does early responsive parenting have a special importance for children’s development or is consistency across early childhood necessary?Developmental Psychology, 37(3), 387–403. doi:10.1037/0012-1649.37.3.387
29.
LandryS. H.SmithK. E.SwankP. R.Miller-LoncarC. L. (2000). Early maternal and child influences on children’s later independent cognitive and social functioning. Child Development, 71(2), 358–375. doi:10.1111/1467-8624.00150
30.
LauA. S.FungJ. (2013). Commentary: On better footing to understand parenting and family process in Asian American families. Asian American Journal of Psychology, 4(1), 71–75. doi:10.1037/a0032120
31.
LeeS.KimD. H. (2017). The relationship between perceived parental rearing behaviors and school adjustment of adolescent cancer survivors in Korea: A cross-sectional study. Medicine (Baltimore), 96(32), e7758. doi:10.1097/MD.0000000000007758
32.
LewisP.Mooney-SomersJ.JordensC. F.KerridgeI. H. (2015). Parents as advocates for the psychosocial survival of adolescents and young adults with cancer. Journal of Child and Family Studies, 24(4), 872–881. doi:10.1007/s10826-013-9896-x
33.
LiJ.YamamotoY. (2019). Western and East Asian sociocultural learning models: Evidence from cross-cultural and immigrant research. Asian Journal of Social Psychology. Published online ahead of print. doi:10.1111/ajsp.12384
34.
LongK. A.KeeleyL.Reiter PurtillJ.VannattaK.GerhardtC. A.NollR. B. (2014). Child-rearing in the context of childhood cancer: Perspectives of parents and professionals. Pediatric Blood & Cancer, 61(2), 326–332. doi:10.1002/pbc.24556
35.
MasaDehR.CollierJ.HallC. (2012). Parental stress when caring for a child with cancer in Jordan: A cross sectional survey. Health and Quality of Life Outcomes, 10(88), 1–7. doi:10.1186/1477-7525-10-88
36.
MooreT. E.PeplerD. J. (2006). Wounding words: Maternal verbal aggression and children’s adjustment. Journal of Family Violence, 21(1), 89–93. doi:10.1007/s10896-005-9007-x
37.
MoreiraP. L.AngeloM. (2008). Becoming a mother of a child with cancer: Building motherhood. Rev Lat Enfermagem, 16, 355–361. doi:10.1590/S0104-11692008000300004
38.
NeilL.ClarkeS. (2010). Learning to live with childhood cancer: A literature review of the parental perspective. International Journal of Palliative Nursing, 16(3), 110–119. doi:10.12968/ijpn.2010.16.3.47322
39.
NorbergA. L.StenebyS. (2009). Experiences of parents of children surviving brain tumour: A happy ending and a rough beginning. European Journal of Cancer Care, 18(4), 371–380. doi:10.1111/j.1365-2354.2008.00976.x
40.
ParkE. S.LeeK. H.OhW. O.ImY. J.ChoE. J. (2015). Parenting experience of parents with chronically ill children. Child Health Nursing Research, 21(3), 272–284. doi:10.4094/chnr.2015.21.3.272
41.
Respler-HermanM.MowderB. A.YasikA. E.ShamahR. (2012). Parenting beliefs, parental stress and social support relationships. Journal of Child and Family Studies, 21(2), 190–198. doi:10.1007/s10826-011-9462-3
42.
ShinJ. H.ShimH. W. (2011). The mediation effect of parenting attitude between maternal caring stress and social competence of child-adolescent cancer patients. Korean Journal of Youth Studies, 18(8), 117–140.
43.
SovetL.MetzA. J. (2014). Parenting styles and career decision-making among French and Korean adolescents. Journal of Vocational Behavior, 84(3), 345–355. doi:10.1016/j.jvb.2014.02.002
44.
SteeleR. G.LongA.ReddyK. A.LuhrM.PhippsS. (2003). Changes in maternal distress and child-rearing strategies across treatment for pediatric cancer. Journal of Pediatric Psychology, 28(7), 447–452. doi:10.1093/jpepsy/jsg035
45.
StenbergU.RulandC. M.MiaskowskiC. (2010). Review of the literature on the effects of caring for a patient with cancer. Psycho-Oncology, 19(10), 1013–1025. doi:10.1002/pon.1670
46.
StreisandR.KazakA. E.TercyakK. P. (2003). Pediatric-specific parenting stress and family functioning in parents of children treated for cancer. Children’s Health Care, 32(4), 245–256. doi:10.1207/S15326888CHC3204_1y
47.
ThiagarajanM. (2016). Beyond the tiger mom: East-West parenting for the global age. North Clarendon, VT: Tuttle Publishing.
48.
ThomasgardM.MetzW. P. (1993). Parental overprotection revisited. Child Psychiatry and Human Development, 24(2), 67–80. doi:10.1007/BF02367260
49.
ThomasgardM.MetzW. P.EdelbrockC.ShonkoffJ. P. (1995). Parent-child relationship disorders: I. Parental overprotection and the development of the Parent Protection Scale. Journal of Developmental and Behavioral Pediatrics, 16(4), 244–250. doi:10.1097/00004703-199508000-00006
50.
TilleryR.LongA.PhippsS. (2014). Child perceptions of parental care and overprotection in children with cancer and healthy children. Journal Clinical Psychology Medical Settings, 21(2), 165–172. doi:10.1007/s10880-014-9392-5
51.
VanceY.EiserC. (2004). Caring for a child with cancer - A systematic review. Pediatric Blood Cancer, 42(3), 249–253. doi:10.1002/pbc.10440
52.
WalkerA. J.LewisF. M.Al-MullaH.AlzawadZ.ChiN. C. (2018). Being fully present: Gains patients attribute to a telephone-delivered parenting program for child-rearing mothers with cancer. Cancer Nursing, 41(4), E12–17. doi:10.1097/NCC.0000000000000515
53.
WienerL.BattlesH.ZadehS.PelletierW.Arruda-ColiM. N. F.MurielA. (2017). The perceived influence of childhood cancer on parents’ relationship. Psycho-Oncology, 26(12), 2019–2117. doi:10.1002/pon.4313
54.
WillardV. W.QaddoumiI.ZhangH.HuangL.RussellK. M.BrennanR.. . . PhippsS. (2016). A longitudinal investigation of parenting stress in caregivers of children with retinoblastoma. Pediatric Blood & Cancer, 64(4), 1–7. doi:10.1002/pbc.26279
55.
WilliamsL. K.McCarthyM. C. (2015). Parent perceptions of managing child behavioural side-effects of cancer treatment: A qualitative study. Child: Care, Health and Development, 41(4), 611–619.
56.
WilliamsL. K.LambK. E.McCarthyM. C. (2014). Behavioral side effects of pediatric acute lymphoblastic leukemia treatment: The role of parenting strategies. Pediatric Blood & Cancer, 61(11), 2065–2070. doi:10.1002/pbc.25164
57.
WilliamsL. K.LambK. E.McCarthyM. C. (2015). Parenting behaviors and nutrition in children with leukemia. Journal of Clinical Psychology in Medical Settings, 22(4), 279–290. doi:10.1007/s10880-015-9429-4
58.
WilliamsL. K.McCarthyM. C.EylesD. J.DrewS. (2013). Parenting a child with cancer: Perceptions of adolescents and parents of adolescents and younger children following completion of childhood cancer treatment. Journal of Family Studies, 19(1), 80–89. doi:10.5172/jfs.2013.19.1.80
59.
YiJ. (2009). Cultural influences on the survivorship of families affected by childhood cancer: A case for using family systems theories. Families, Systems, & Health, 27(3), 228–236. doi:10.1037/a0017150
60.
YoungB.Dixon-woodsM.FindlayM.HeneyD. (2002). Parenting in a crisis: Conceptualizing mothers of children with cancer. Social Science & Medicine, 55(10), 1835–1847. doi:10.1016/S0277-9536(01)00318-5
61.
YoungB.Dixon-woodsM.WindridgeK. C.HeneyD. (2003). Managing communication with young people who have potentially life threatening chronic illness: Qualitative study of patients and parents. British Medical Journal, 326(7384), 305–309.
