Dyadic emotional and behavioral experiences in pediatric leukaemia: An interpretative phenomenological analysis of parent-child dynamics in Pakistan.

PURPOSE: Pediatric leukaemia disrupts children's emotional development and places sustained psychological demands on parents. In Pakistan, formal psychological rehabilitation services remain limited, and little is known about how emotional coping unfolds within parent-child relationships during illness. This study aims to explore the lived emotional and behavioral experiences of children with leukaemia and their parents using a dyadic interpretative framework.

METHODS

An interpretative phenomenological analysis (IPA) was conducted with 15 parent-child dyads recruited from the pediatric oncology unit in Peshawar, Pakistan. Semi-structured interviews were conducted separately with children and their primary caregivers in Urdu or Pashto, transcribed verbatim, translated into English, and analyzed using IPA. NVivo 14 facilitated data organization and management, while coding and interpretation remained researcher-led. Ethical approvals were obtained from Zhengzhou University, China, and Hayatabad Medical Complex, Pakistan.

RESULTS

Three superordinate themes were identified: (1) emotional distress and meaning-making in diagnosis and treatment-related changes, (2) dyadic emotional regulation and mutual protection, including role reversal, protective silence, and shared normalcy, and (3) faith and spiritual meaning-making through prayer, patience, hope, and gratitude. Across themes, dyadic emotional symmetry captured how children and parents mutually interpreted and regulated distress, hope, silence, and coping within the parent-child relationship.

CONCLUSIONS

Coping with pediatric leukaemia in Pakistan is a relational, culturally embedded process rather than an individual psychological response. Oncology nursing practice may benefit from dyad-focused psychological assessment and interventions that support safe emotional expression, structured parent-child communication, therapeutic play, and spiritually sensitive care.