Background: Despite advances in cancer prognosis and increased survival rates for childhood cancer, having a child diagnosed with cancer can be considered one of the most stressful life events in a parent’s life. The adverse psychological impact of childhood cancer on parents has been found to be higher than in any other childhood chronic illness. Parents can find it difficult to adjust and use effective coping strategies to deal with the illness-related demands. Dispositional optimism (i.e. positive outcome expectancies for the future) has become a key theoretical component in positive and health psychological research, aiming to explain adjustment and coping in distressing life situations. However, optimism in the context of caregiving for a child with chronic illness and especially cancer has received little research attention, but may be important as optimistic people tend to show greater psychological adjustment and effective coping. Aims: To identify the characteristics of optimistic parents of children with cancer. To examine the relationship between optimism, anxiety, depression, life satisfaction, coping and subjective health perception in parents of children with cancer and parents of healthy children. Also, to provide a more in-depth understanding of the needs and experiences of parents in relation to their level of optimism/pessimism. Methods: A mixed methodological approach (quantitative and qualitative methods) was adopted to study optimism as well as the impact and the experiences of parents caring for their child with cancer. The mixed method design comprised two phases of data collection and analysis. In Phase I, quantitative methods were used. 100 parents of children with cancer were recruited during attendance at Oncology Out-patients Clinics at a UK regional Cancer Centre. A comparison group of 117 parents of healthy children were also recruited. All parents completed a questionnaire, providing demographic and medical information relating to their child, dispositional optimism, psychological distress, life satisfaction, coping and subjective health perception. Descriptive statistics, unrelated t-tests and x2 tests were used where appropriate to examine differences on optimism, psychological distress, life satisfaction and coping variables between the SG and CG. Bivariate Pearson correlations were used to identify any possible differences between the two groups. In Phase II, qualitative data were collected and analysed using Interpretative Phenomenological Analysis (IPA). 10 semi-structured interviews were conducted with 5 high optimistic and 5 high pessimistic parents of children with cancer given their optimism score in the quantitative study. Results: In the Phase I of the study, findings showed that the parents of children with cancer had higher levels of anxiety, depression, lower levels of optimism, satisfaction with life and subjective health perception than the comparison group. Optimism was significantly correlated with satisfaction with life, subjective health perception, anxiety and depression in both groups. The interviews in Phase II of the study explained better the role of optimism and pessimism in parental experience of adjusting to and coping with childhood cancer. Interviewees described the way that their child’s diagnosis of cancer had affected their lives and their journey from shock to acceptance and adjustment for the optimistic parents or despair and feelings of helplessness and inability to cope for the pessimistic parents. Regardless of level optimism/pessimism, interviews underlined the importance and parents’ need for social support, ongoing communication with health professionals and contact with other parents of children with cancer. Conclusion: The findings highlight the importance of optimism and pessimism in relationship to psychological distress in parents of children with cancer. Interventions targeting parents’ optimism are recommended as a potential source of coping with adversity within this population.

The purpose of the study has been, by adopting a view of life and a learning perspective, to reach an understanding of the way in which cancer patients in a palliative care context understand and cope with their existential life situation. I asked the following questions: 1) How does their personal view of life influence the patients’ understanding and coping with the illness and existential life situation? 2) What existential questions are central to the patients? 3) What is personal learning all about? 4) What prerequisites are important for fostering the patients’ personal learning? Interviews focusing on narratives were conducted with ten patients who have an incurable cancer disease. The interviews were taped and transcribed into texts. A hermeneutic method was applied to understand the content and import of the patients’ narratives. The results show that the patients achieve closure, which involves them making reassessments, adapting their life to the illness, being reconciled with themselves and with their relation to their surroundings. It is also about them wishing to bequeath a legacy and hand down desirable qualities, values and merits for future generations. Taking this view of life as their basis, the patients interpret their illness, existential questions and life situation, and structure their existence so as to make it comprehensible and meaningful. Life narratives can serve as a tool in enabling caregivers to identify patients’ existential questions, view of life, learning requirements and the way they make sense of things (”meaning-making”). By means of view of life support counselling caregivers can identify the patients’ personal ideas, values and support their needs. The patients can reach an awareness of their personal view of life. Reappraising and developing this can be viewed as a form of perspective shift or learning.