Paediatric Medical Traumatic Stress in Children with Cancer and their Parents: Difference in Stress Levels Due to Illness and Treatment Factors

Pediatric medical traumatic stress (PMTS) is a set of children’s and their parents’ psychological and physiological responses to pain, injuries, serious illnesses, and other experiences with the medical environment. Pediatric cancer patients have the highest prevalence of PMTS as the illness its treatment involve a set of stressors that trigger many negative psychological reactions. The current study examined the difference in levels of traumatic stress in children with cancer and their parents due to medical factors (type of cancer, outcome, duration, and intensity of treatment, time since diagnosis, relapse, and hospitalization in ICU). The study involved 183 parents of 133 children and 62 children and adolescents who were treated between 2009 and 2019 at the Clinical Department of Pediatric Hematology and Oncology of University Children’s Hospital in Ljubljana. We collected the data using The Intensity of Treatment Rating Scale 2.0 [IRT-2], PTSD Checklist for Children/Parent [PCL-C/PR], The PTSD Checklist for DSM-5 [PCL-5] and The Child PTSD Symptoms Scale for DSM-5 [CPSS-5]. Traumatic stress symptoms are frequently present in both children and their parents, regardless of the cancer type, treatment duration, and treatment outcome. Children with relapse, children with more intensive treatment, and parents of the latter are at higher risk for PMTS occurrence. Additionally, we found a decreasing trend of traumatic responses after five or more years post-cancer diagnosis. What is Known: • Paediatric cancer is still perceived as a life-threatening illness that despite the advance in medical science is still often accompanied by painful and consequently traumatic medical procedures. • Stress and uncertainty due to cancer and its treatment can lead to traumatic experiences in both, children and parents. What is New: • Children with relapse, children with more intensive treatment, and parents of the latter are at higher risk for paediatric medical traumatic stress occurrence. • Despite the fact of declining trend of traumatic responses after more than five years since diagnosis, psychological interventions are needed in both, during and after the treatment.