Correlates and trajectories of family functioning in parents with cancer and their adolescent and young adult children.

PURPOSE: Parental cancer can disrupt family dynamics, particularly in families with adolescent and young adult (AYA) children. While strong family functioning supports better psychosocial outcomes, factors that influence this functioning remain underexplored. This study examined correlates and trajectories of family functioning among AYA and their parents following a cancer diagnosis.

METHODS

In this longitudinal study, quantitative surveys were completed by parents diagnosed with cancer and their AYA offspring at two timepoints: within 12 months of diagnosis (T1) and 6 months later (T2). Outcomes included perceived family functioning, family resilience, communication avoidance about cancer, individual distress, parental self-efficacy, and AYA support needs.

RESULTS

At T1, 55 AYA (aged 12-24 years) and 71 parents (aged 32-62 years), both predominantly female, participated; 31 AYA and 52 parents completed both timepoints. When controlling for age and gender, T1 better family functioning (low scores) was associated with greater family resilience (high scores, AYA: β = -0.57, p < .001; parents: β = -0.21, p = .035) and lower communication avoidance about cancer (low scores, AYA: β = 0.29, p = .04; parents: β = 0.39, p < .001). T2 family functioning was associated with T1 family functioning (AYA: β = 0.75, p < .001; parents: β = 0.67, p < .001), with higher T1 AYA distress additionally being associated with poorer AYA family functioning (β = 0.42, p = .001). Most participants maintained high family functioning over time (parents: 78%; AYA: 71%), while 16-19% showed persistent low functioning.

CONCLUSIONS

Family resilience and open communication about cancer facilitate adaptation 0-12 months after a parental cancer diagnosis in both parents and their AYA children. While initial T1 parent and AYA perceived family functioning was associated with family functioning 12-18 months post-diagnosis, initial distress was associated with T2 functioning only among AYA. Although most participants show stable, high family functioning post-diagnosis, targeted support is essential for those at risk. Findings underscore the importance of early psychosocial interventions to promote healthy family dynamics in the context of parental cancer.