Quality of Life Research

, Volume 22, Issue 3, pp 625–634 | Cite as

Psychosocial and emotional adjustment for children with pediatric cancer and their primary caregivers and the impact on their health-related quality of life during the first 6 months

  • Ming-Horng Tsai
  • Jen-Fu Hsu
  • Wen-Jiun Chou
  • Chao-Ping Yang
  • Tang-Her Jaing
  • Iou-Jih Hung
  • Hwey-Fang Liang
  • Hsuan-Rong Huang
  • Yu-Shu Huang



To evaluate caregiver-reported psychosocial adjustment and health-related quality of life (HrQoL) of Taiwanese children with newly diagnosed cancer and their caregivers during the first 6 months of treatment.


Caregivers of 89 newly diagnosed children completed the child behavior checklist, the pediatric quality of life inventory (PedsQL 4.0), the Parenting Stress Index, and the SF-36 questionnaire at diagnosis, and again 3 and 6 months into treatment. They were compared with a group of age- and sex-matched controls from general community.


Significantly worse HrQoL in both children and their caregivers and greater parenting stress were noted in the cancer group than the controls during the first 6 months. Children with cancer were found to have significantly more internalizing behavioral problems and somatic complaints, especially those younger than 12 years old. After starting chemotherapy, significant decrease in parenting stress and improvements of both caregivers and children’s HrQoL were noted within the first 6 months, although not to the level comparable with normal controls.


Although children and their caregivers can adjust themselves gradually during the first 6 months after diagnosis of cancer, intervention and efforts aimed at reducing their distress and promoting adjustments are still required during this period.


Psychosocial adjustment Quality of life Children Cancer Stress 



Health-related quality of life


The child behavior checklist


Parenting stress index


Socioeconomic status

PedsQL 4.0

The pediatric quality of life inventory version 4.0



Statistical analyses were done by Pro. Chang Chee-Jen (e-mail:cjchang@mail.cgu.edu.tw). We declared no conflict of interest for each authors and no funding about this work. We thank all nursing staff working in our Pediatric Hematology/Oncology ward for taking care of these patients.

Conflict of interest

None of the sponsors played any role in the study design, the collection, analysis, or interpretation of data, the writing of the manuscript, or in the decision to submit it for publication.


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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Ming-Horng Tsai
    • 1
    • 5
    • 6
  • Jen-Fu Hsu
    • 5
  • Wen-Jiun Chou
    • 2
  • Chao-Ping Yang
    • 1
    • 5
  • Tang-Her Jaing
    • 1
    • 5
  • Iou-Jih Hung
    • 1
    • 5
  • Hwey-Fang Liang
    • 6
  • Hsuan-Rong Huang
    • 5
  • Yu-Shu Huang
    • 3
    • 4
    • 5
  1. 1.Division of Pediatric Hematology/Oncology, Department of PediatricsChang Gung Memorial HospitalTaoyuanTaiwan
  2. 2.Division of Child PsychiatryChang Gung Memorial HospitalKaohsiungTaiwan
  3. 3.Division of Pediatric PsychiatryChang Gung Memorial HospitalTaoyuanTaiwan
  4. 4.Department of Child Psychiatry and Sleep CenterChang Gung Memorial HospitalKwei-ShanTaiwan
  5. 5.College of Medicine, Chang Gung UniversityTaoyuanTaiwan
  6. 6.Chang Gung Institute of TechnologyChiayiTaiwan

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