• Vol. 41 No. 4, 170–175
  • 15 April 2012

The Hidden Impact of Childhood Cancer on the Family: A Multi-Institutional Study from Singapore



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Introduction: The care of children with cancer creates emotional and financial hardships for their families. There is a lack of information on the impact of childhood cancer on the family as a whole in Singapore. Thus, we set out to assess the financial impact as well as its psychosocial impact in our local context.

Materials and Methods: All patients diagnosed and treated for cancer at the Departments of Paediatrics, KK Women’s and Children’s Hospital and National University Hospital, Singapore were eligible for this study. Families of these patients completed 2 self-administered questionnaires: (i) About you and your-family and (ii) the Impact-On-Family scale. For the latter, the total score was obtained by the summation of all scores, where high scores correlated to high impact.

Results: Seventy-nine parents were enrolled during the study period from October 2008 to February 2009. Being of Malay/Indian origin was associated with a high overall family burden. On the other hand, being of Malay/Indian origin was also associated with most successful at mastery when a child was diagnosed with cancer (P = 0.001). In addition, when compared to caregivers who remained employed, those who were asked to quit their job, experienced a higher Financial Burden (P = 0.03), a high Familial/Social Burden (P = 0.05) and a high Personal Strain (P = 0.03).

Conclusion: Childhood cancer impacted family life in Singapore at many levels. In particular, the factors involved are various cultural discourses; employment status of caregivers; and those whose leave/pay are affected.

Chronic childhood illnesses have varying degrees of impact on the children and their families. Some chronic conditions that have little or no impact on the children and their families whereas those at the other end of the spectrum that has a high impact, for example, the diagnosis of cancer. Childhood cancer diagnosis has considerable consequences for the family. It is an extremely distressing experience for everyone involved and requires a significant degree of support, coping, and adaptation. The impact on the family can be in the form of increased burden and responsibility of caring for the sick child or adolescent at home for which families have varying physical and emotional capabilities. Furthermore, as most of medical treatments are delivered during the working hours, there is a potential for increased loss of income for the caregivers in the family leading to financial strain.

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