Multiple losses in families with cancer children: sociological analysis

Introduction. The success of medicine at the present stage determines the high survival rate of children with various nosological forms of malignant tumors, which shifts the focus of specialists' attention from the development of therapeutic protocols to the study of early and long-term effects of antitumor therapy in a child and his family. One of the urgent problems of psychological and social rehabilitation in pediatric oncology is the analysis of psychotraumatic factors of treatment and long-term medical and social consequences for the child's family when developing a strategy for effective psychological support of this group at the treatment stage.

The purpose of the study is to conduct a sociological analysis of the specifics of losses in families with cancer children.

Materials and methods. The article presents a retrospective analysis of data obtained during a sociological study of parents (N=1298) whose children have completed treatment of various malignant tumors. The study conducted by questionnaire survey of mothers (N=1131) and fathers (N=167) living in 78 regions of the Russian Federation allowed to qualify the problems of family members of a child with cancer, in terms of multiple loss and grief, and to justify the strategy of psychological assistance to this group.

The results of the study. During diagnosis and antitumor treatment, the family experiences a number of traumatic events associated with drastic changes, losses, deterioration in their vital activity, health, life prospects: possible death and disability of the child as a result of fatal disease; dismissal from work or demotion of the mother, and sometimes the father; a drop in the family income level; forced relocation of the mother and a sick child, and sometimes the whole family to another city to the place of treatment; deterioration of housing conditions; prolonged separation from the family due to hospitalization; deterioration of family relations between spouses and with healthy children; divorces; deterioration and rupture of relations with relatives and friends; deterioration of somatic, mental and reproductive health; forced abortions and death of other family members. Each of these events is perceived as a loss, and together they trigger a grieving process in parents that requires the professional help of a clinical psychologist trained to work with loss and grief. At the same time, the level of psychological assistance remains extremely low in domestic pediatric oncology clinics.

Conclusion. The dynamics of the development of psychological and social rehabilitation in Russian pediatric oncology determines the need to develop strategies and methods of psychological support for family members of a sick child at the treatment stage, taking into account the early and long-term medical and social consequences of antitumor therapy.