Parents' attributions about childhood cancer: implications for relationships with medical staff

Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However, the aggressiveness of therapy and uncertainty about prognosis are associated with many adverse effects, psychological as well as physical, for both the child and family. This study investigates family coping with treatment in relation to attributions about cause and responsibility for onset of the disease. We interviewed parents of 30 children with cancer (28 mothers and 23 fathers) about their attributions of causality, and perceptions of responsibility for the diagnosis and care of the child. Coping strategies which were found to be helpful were assessed using the Coping Health Inventory for Parents (CHIP). Fathers were more likely than mothers to accept that there was no known cause for the child's illness. Fathers who blamed doctors for failing to diagnose the condition found medical staff less helpful up to 2 years later. The theoretical importance of blaming others more than oneself is discussed, along with practical implications for services in paediatric oncology.