Existential Distress Among Parents of Children with Cancer or Chronic Illness: Screening and a Meaning-Based Intervention

Yi Ling Tay

Parents of children with cancer or a chronic illness not only face practical challenges in the management of their child’s condition, but also experience intense psychological and existential distress in the period after diagnosis that can have detrimental effects in the long run if left undetected. To date, neither the option of using an ultra-short screening tool for measuring parents’ distress, nor a meaning-based intervention to reduce parents’ distress, have been investigated. The current research comprised two studies. Study 1 aimed to evaluate the accuracy of an adaptation of Mitchell et al.’s (2010) Emotional and Help Thermometers in detecting the level of distress. Mitchell et al.’s instrument consisted of four emotion thermometers – Distress, Anxiety, Depression, Anger – and a Need Help thermometer. Our adaptation added the “Crushed Universe” thermometer designed to measure existential distress. All six thermometers were compared against a battery of assessment tools that measure depression, anxiety (Depression, Anxiety and Stress Scale-21 items), loss of meaning (Sense of Coherence-13 items), and post-traumatic stress (Impact of Events Scale-Revised). Participants were main caregivers whose children were diagnosed with cancer or chronic illness (n = 172). The thermometers had good diagnostic accuracy in predicting various forms of distress, and the Crushed Universe Thermometer was able to predict parents’ sense of meaningfulness and post-traumatic stress symptoms. The Crushed Universe Thermometer was also the optimal thermometer in predicting depression, anxiety, and stress. Study 2 aimed to evaluate the applicability and efficacy of a meaning-based intervention in reducing parents’ distress in relation to the context, particularly meaning-related distress. Participants were two mothers, one with a child with cancer, the other with a chronic illness. In both cases, contextual stressors influenced participants’ distress more than the child’s illness. Together, the results suggest that existential distress is a significant component of psychological distress for parents of chronically-ill children.

Existential Distress Among Parents of Children with Cancer or Chronic Illness: Screening and a Meaning-Based Intervention

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