Common themes and ethnic differences in family caregiving the first year after diagnosis of childhood cancer: Part II.

Chinese immigrant and North American white family caregiving for a child with cancer was compared in a 1-year study. This second of a two-part report describes interview results after first remission and at 1-year postdiagnosis. (The first part reported results of the initial interview and family function, symptom and caregiving inventories administered at diagnosis and at first remission). In follow-up interviews, the ill child remained the family priority in both groups, with sequelae for siblings and parents. All children were physically well cared for, with strict adherence to Western medical protocols. Cultural differences and immigrant status contributed to lower verbal expression of distress, more isolation, and lower attention to emotional distress for the Chinese. Caregiving emphases were dietary for the Chinese; emotional for the Caucasians. Differences over time in family caregiving and coping were determined by demands of care and evolving expertise. Care inclusive routines were established by most families by the second interview, in spite of extent of continued difficulties. Emotional care demands, concern for needs of siblings, and marital conflict increased over time. At 1 year, all families complained of emotional and physical fatigue and the need to adapt to a tentative future with their child.