Tunisian children ans adolescents coping with parental cancer

Abstract Purpose: We aimed to investigate the coping mechanisms of children of cancer parents in the Tunisian context where cancer remains a taboo subject in many families. Methods: Parents treated for cancer (n=103) how have children<18 years old, were asked to complete a questionnaire between July and December 2020.The questionnaire included items about: emotional and behavioral impact on children. Results: We interviewed 75 women (72.8%), mean age was 43 years old. Forty percent of the patients had adolescents (aged 12-18 years), 35% had school-aged children (6-12 years) and 25% had children preschoolers (<6 years). In our study, 82.5% of parents told their children about the disease. Among the children who were not aware of their parent’s illness, we observed significantly more preschoolers (61% vs 17.6%, p=0.001). In 41.7% of cases, parents didn’t disclose the whole truth to their kids. The announcement procedure was perceived as a stressful task by half of the participants. In our study, 96% of participants observed a behavioral change in their kids: anxiety in 35.1%, depression in 21.6%, violent behavior and aggression in 21.6%, emotional dependency in 10.3% and addiction in 6.2% of the cases. School failure was reported in 58.7% of cases mainly seen in children aged 6-12 years. Parent’s gender (OR=2.88 [0.38-21]), educational level (OR=0.59 [0.059-5.894]) didn’t significantly predict kids’ behavior change. Conclusion: Tunisian parents with cancer seemed to lift the taboo surrounding their disease by involving their children in the acceptance process of the disease despite the developmental disruption it can generate.