Parental Overprotection and Perceptions of Child Vulnerability As Correlates of Parenting Stress Among Parents of Child with Cancer in Korea

Background and Purpose: Parents of children with cancer experience high levels of parenting stress. Parenting stress is an important variable to assess when working with families of children with cancer because the negative consequences of long-term stress can seriously affect outcomes in both children and parents. Parents often perceive their child as vulnerable and overprotect their child. Such parental perceptions and behaviors may be related to parenting stress. However, it is unclear to what extent this stress is related to parent variables such as parental perceptions of child vulnerability and overprotection. This study examined the relationships of perceptions of child vulnerability, parental overprotection, and parenting stress among Korean parents of children with cancer.

Methods: Participants were recruited from support groups for parents of children with cancer between May and November 2015 in Korea. A sample of 163 parents (117 mothers and 46 fathers) of a child with cancer aged 19 or younger completed three questionnaires: the Parenting Stress Index–Short Form (PSI/SF), Child Vulnerability Scale (CVS), and Parent Protection Scale (PPS). Four multiple regression analyses were performed to examine the relationships of perceptions of child vulnerability, parental overprotection, and parenting stress, controlling for parent and child characteristics. In the four models, the dependent variable (parenting stress) was measured via total PSI/SF score and three subscales scores: parental distress (PD), parent–child dysfunctional interaction (P-CDI), and difficult child (DC).

Results: In this sample, 15.7% of participants experienced clinically significant levels of parenting stress (> 90th percentile) and 68.6% perceived their child as highly vulnerable. Additionally, 14.4% reported engaging in parental overprotective behaviors toward their child with cancer. Multiple regression analyses revealed that each model accounted for substantial variance in PSI/SF total score (F = 4.758, p < .001) and the three subscale scores (PD: F = 7.648, p < .001; P-CDI: F = 2.158, p < .05; DC: F = 2.668, p < .01). Perceived child vulnerability was positively associated with PSI/SF total score (β = .275, p < .01) and the three PSI/SF subscales (PD: β = .245, p < .01; DC: β = .227, p < .01; P-CID: β = .219, p < .05). Parental overprotection was positively associated with PSI/SF total score (β = .261, p < .01) and two PSI/SF subscales (PD: β = .410, p <.001; DC: β = .178, p < .05), but not P-CDI. In the three models, having a diagnosis of brain tumor or central nervous system tumor was associated with lower P-CDI score.

Conclusion and Implications: Perceived child vulnerability and parental overprotection were important variables to explain parenting stress. The results inform psychosocial oncology professionals about the importance of developing parenting‐based interventions that assess parental beliefs about child vulnerability and appropriate parenting behaviors toward children with cancer. Systematic support and psychoeducation should be provided to parents to emphasize information related to their child’s vulnerability and encourage developmentally appropriate independence.