Treatment adherence difficulties among children with cancer: the role of parenting style.

Investigated the prevalence of treatment adherence problems among children undergoing cancer treatment and explored the relationship of sociodemographic factors, child functional status, and parenting style to these difficulties. Nurse ratings of adherence difficulties encountered during the cancer treatment regimen were completed on 77 children and their caregivers. A subset of caregivers also completed a measure of parenting attitudes and practices. Results indicated that certain adherence difficulties were related to the child's age and functional status, the family's socioeconomic status (SES), and parenting style. The child's age was related to adherence to procedure-related tasks; younger children had more frequent problems with completing these tasks. More functional children had a greater number of adherence problems. Families with a lower SES had more difficulties with timeliness and cancellations/delays of clinic appointments and promptness of reporting of the child's reactions to treatment. Children of caregivers who had a more "supportive" parenting style (were more sensitive to children's input, had a less restrictive attitude towards parenting, and were more nurturant) canceled and delayed fewer appointments, were on time more frequently for appointments, and reported reactions to treatment with less delay. Implications of these findings for future research on treatment adherence and for clinical interventions are discussed.