parenting concerns in cancer patients with minor children: a scoping review

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Therefore, the group of young and middle-aged cancer deserves more attention from society, medical treatment, and nursing. Objectives： to summarise the influencing factors of rearing anxiety of young and middle-aged cancer patients with minor children. Design: Scoping review Data sources: the scope review report framework of Arksey and O'Malley was used to search China Knowledge Network (CNKI),China Biomedical Literature Database (CBM),Wanfang database,PubMed,Web of Science, Embase and Cochrane Library From the establishment of the database to July 20,2024,the included literatures were screened and analysed. Results: A total of 13 articles were included. the results showed that the level of parenting anxiety of cancer patients at home and abroad was higher, which was mostly affected by personal characteristics, disease characteristics and psychosocial characteristics. Conclusion: Cancer patients are affected by many factors in the process of disease and parenting,and face the challenge of parenting,which leads to a high level of parenting anxiety. Therefore,future medical workers should pay close attention to the parenting concerns of cancer patients and regard them as the core part of psychological care. cancer patients minor children parenting worries Scoping review Introduction According to the latest data released by the International Agency for Research on Cancer of the World Health Organisation,there will be approximately 19.3 million new cancer cases globally in 2020,of which nearly 10 million patients will die of cancer [1] 。 Cancer has become an important public health issue of global concern. Approximately 7–14 per cent of cancer patients are parents of dependent children under 18 years of age [2] . Their role is particularly critical as they are experiencing the prime of their lives and are not only dealing with the challenges of family and society,but are also the core strength of their families,societies and nations [3] . The role of these parents is particularly critical. Parenting concern [4] describes the concerns of cancer patients arising from concerns about child rearing,which relate not only to the potential impact of the disease on the child,but also to the patient's concern about his or her spouse's ability to provide for and care for the child. In addition to the burden of disease,cancer patients with minor children are more affected by parenting issues,and parents worry about the guilt they may feel if they are unable to adequately meet their children's needs. Therefore,this study summarises and analyses the literature on the influencing factors of parenting apprehension in young and middle-aged cancer patients through the framework of a scoping review report proposed by Arksey et al. in order to provide a reference for subsequent research in this area [5] . Information and methodology 1.1 Defining the research question The main research questions of this study are 1) the current status of parenting concerns in cancer patients with minor children,2 assessment tools for parenting concerns in cancer patients with minor children,and 3) factors influencing parenting concerns in cancer patients with minor children.4) Intervention for Parenting concern of Cancer Patients with Minor Children 1.2 Literature inclusion and exclusion criteria Inclusion criteria: the target population was aged 18 years or older,living with at least one child under the age of 18 years who had received a cancer diagnosis (of any stage and/or type); the study was an analysis of factors influencing Parenting concern in cancer patients; and primary literature with original data was included once. Exclusion criteria: literature not reported in Chinese or English; literature from various types of reviews,personal opinions,and poor data descriptions. 1.3 Search strategy Chinese literature was searched in the Chinese databases China National Knowledge Infrastructure,Wanfang, China Science and Technology Journal Database and China Biomedical Literature Database with the search terms "cancer/cancer/tumour/malignant tumour" and "Parenting concern",and English literature was searched in the databases PubMed,Web of science,EMbase,CINAHL,the Cochrane Library,etc. The English search terms were"tumor*ORoncolog*ORcarcinomaORmalignancyORcancer* OR/neoplasms","children","parent concern,parenting",and the search period was from the establishment of the database to 20 July 2024. Boolean operators AND and OR were used to formulate search terms,and the search was conducted using a combination of free words and subject terms. 1.4 Literature screening and data extraction Relevant literature was imported into endnotes9 for de-duplication,and two professionally trained researchers independently read the titles and abstracts of the literature for initial screening,and after reading the entire text,screening was performed again,and any differences of opinion were discussed and resolved with a third researcher. A data extraction form was created to standardise the data extraction of the final included literature,including authors,year of publication,country,type of study,study population,sample size,parenting apprehension assessment tool and influencing factors. Results 2.1 Literature search results and basic characteristics of literature After searching the database, literature (n = 1860); CNKI (n = 11), Wanfang database (n = 13), Chinese biomedical literature database (n = 9), Web of Science (n = 1576), PubMed (n = 523), EMbase (n = 536) Cochrane Library (n = 18).And 13 papers were finally included. Among them,six were in Chinese and five in foreign languages,with a total sample size of 3234 cases; the publication period was from 2012 to 2024. 2.2 Basic characteristics of studies included in the literature Year of publication, author nations Type of study research target sample size score factor 1 2012, Anna C. Muriel [6] usa Cross-sectional studies tumour patient 173 2.33 Women,single-parent families,metastatic or recurrent cancer,subjective understanding of incurable disease,co-morbid chronic health conditions and current mental health treatment 2 2015, C. W. Moore [7] Usa Cross-sectional studies Adult cancer patients 194 / Decreased parenting self-efficacy beliefs are associated with treatment,health-related quality of life,depression and distress,and concerns about the impact of cancer on dependent children 3 2016, ElizaM.Park [8] Usa Cross-sectional studies tumour patient 63 2.3 Marital Status,Depressive Symptoms,Anxiety Symptoms,and QOL Scores 4 2017, LauraInhestern [9] German Cross-sectional studies Cancer patients with minor children 1416 / Living alone,younger age of youngest child,higher tumour stage and comorbidities 5 2018, Eliza M. Park [10] usa Cross-sectional studies Stage IV solid tumour or recurrent/refractory haematological cancer 211 2.2 Anxiety and depression,symptom severity,and HRQOL 6 2019, ElizaM.Park [11] usa Cross-sectional studies Patients with solid tumour cancers who have at least one child < 18 years of age 149 2.21vs.2.00 Gender,marital status,employment status,household income,number of children,CCI score,prior mental health diagnosis or treatment,metastatic cancer or not 7 2020, Kang Tingting [4] China Cross-sectional studies cancer patient 206 3.72 ± 0.31 Stage of disease,number of minor children,age of youngest minor child,whether patient subjectively believes disease cannot be cured,marital status,parenting competence,and perceived social support 8 2023, MeaganWhisenant [12] usa Hybrid studies Diagnosed with a stage III-IV solid malignancy 21 2.2 Parenting issues and family functioning 9 2023, Hao Limin [13] China Cross-sectional studies Young and middle-aged ovarian cancer patients 235 3.56 ± 0.54 Marital Status,Disease Staging,Cancer Patient Information Needs,Perceived Disease,and Family Caringness Indices 10 2024, K. Milbury [14] China Cross-sectional studies Patients with metastatic solid malignant tumours and their spouses 51 / Illness communication and family functioning 11 2024, Liu Jie [15] China Cross-sectional studies Breast cancer patients 247 37.34 ± 2.56 Parenting competence,literacy,number of minor children,per capita monthly family income and tumour clinical stage 12 2024, Yuan Yuan [16] China Cross-sectional studies cancer patient 232 3.41 ± 0.28 Gender,tumour clinical stage,primary caregiver, CRCPscores andAAQ-Ⅱ 13 2024, Qin Haixiao [17] China Cross-sectional studies Young and middle-aged patients with ovarian cancer treated with postoperative chemotherapy 120 53.92 ± 8.19 Marital status and disease staging 2.3 Assessment tools 2.3.1 Instruments for measuring parenting stress In the 1980s the American scholar Abidin developed a parenting stress scale consisting of 120 question items,which is also known as the Long-form Parenting Stress Scale because of its large number of items [18] .The scale uses the Likert scale. The scale is rated on a 5-point Likert scale and is centred on three main areas: parental stress,children's living conditions and quality of daily life. The Long-form Parenting Stress Scale is a comprehensive and in-depth assessment tool that helps to understand the stressful situation of parents in the parenting process. By carefully completing and analysing the results of the questionnaire,parents can be provided with more specific advice and support to help them better cope with the challenges of parenting. At the same time,however,attention needs to be paid to the difficulty and time-consuming nature of its operation to ensure that adequate support and co-operation can be obtained in its use. The Parenting Stress Short Form was adapted by Abidin from the Long-form Parenting Stress Questionnaire,which simplified the original questions to 36. The reliability of the PSI-SF scale obtained high scores during the rigorous testing process,and the reliability measure scores of the total scale and the subscales ranged from 0.68 to 0.85,and the Hong Kong scholars Chinese-relativised the scale,which has been used widely [19] The Hong Kong scholars have Chineseised the scale and it has been widely used. 2.3.2 Clinical Nurse Childcare Stress Scale The Chinese version of this scale,the Clinical Nurse Parenting Stress Scale,was developed by Zeng Mengqin et al [20] 2022 based on lee's Chinese version,which includes 4 dimensions with 19 entries. The Chinese version of the Clinical Nurse Parenting Stress Scale includes 4 dimensions with 19 entries,and the Cronbach's alpha coefficient of this scale is 0.906,with a re-test reliability of 0.888. 2.3.3 Parenting Concerns Questionnaire (PCQ) The Parenting concern Questionnaire was developed by Muriel et al [6] developed in 2012 to measure the level of Parenting concern in cancer patients raising minor children. The questionnaire consists of 15 items with 3 dimensions,i.e.,worries about the emotional impact on the child,worries about the practical impact on the child,and worries about the child's father/mother. The questionnaire was rated on a Liket 5 scale from 1 (not at all concerned) to 5 (very concerned). Higher scores indicate that parents are more concerned. The questionnaire had an overall Cronbach's alpha coefficient of 0.83,giving it good reliability and validity. The questionnaire entries are concise and easy to understand,and can fully meet the special needs of the special group of cancer patients raising minor children for parenting worry assessment,and has been widely used. Kang Tingting et al. [21] In 2020,the Chinese version of the Parenting Concerns Questionnaire (PCQ) was Chineseised,and the Cronbach's alpha coefficient of the Chinese version of the PCQ was 0.850,and the total content validity of the questionnaire was 0.94,which makes it an effective tool for assessing parenting concerns of cancer patients. Factors influencing Parenting concern in young and middle-aged cancer patients 3.1 Socio-demographic factors In most families,women tend to face higher levels of Parenting concern,which can mean that their mothers take on most of the childcare duties and obligations [22] . Mothers have a significant impact on their own health and the development of their children. The stronger attachment between mothers and their children compared to fathers also makes sick mothers more concerned about their children's well-being,so mothers have more serious parenting concerns than fathers. Cancer,as a common malignant tumour disease,brings great pain to many people,and cancer patients often face problems such as high financial pressure,expensive medical expenses and difficulties in getting effective relief from mental aspects,etc. A study by Inhestern [23] s study revealed that the lower the income of cancer patients,the more intense their worries about life and support. Depression in cancer patients rises with age and is accompanied by anxiety symptoms. Cancer patients may have deep concerns about their health and the financial stress. There is a correlation between the literacy level of a family and its financial situation,and generally speaking,the lower the literacy level,the less favourable the financial situation of the family. Different types of medical insurance and differences in disease treatment options can affect the financial pressure on families of cancer patients. Reimbursement rates for cancer can vary due to differences in health insurance systems,which also leads to different levels of financial stress for cancer families. An increase in the types of health insurance coverage and a relative reduction in the financial pressure on the families of cancer patients may mean that they are under less pressure to raise their minor children. In addition,the increased number and younger age of their minor children means that parents with cancer will invest more time and energy in raising their children,resulting in greater parenting stress,which may mean a corresponding increase in their parenting concerns. 3.2 Cancer-related factors Several studies [7,24] have shown that the stage of the disease,metastasis or recurrence of the cancer,the cancer patient's need for information,perception of the disease,and a variety of factors associated with other chronic illnesses in cancer patients have an impact on the level of Parenting concern. The stage of the disease is an important factor influencing Parenting concern,with higher levels of Parenting concern in cancer patients in stages II,III,and IV compared to those in stage I. Patients with advanced stage cancer spend progressively less time with and caring for their children in their daily lives as they are in constant fear of passing away due to their recurrent illness. They are deeply worried that their spouses cannot shoulder the burden of raising their children alone. At the same time,they are also afraid that their own deteriorating health condition may cause a great impact on their children's emotions and cognition,which may adversely affect their children's future physical and mental health,and thus,the level of parenting apprehension among cancer patients is relatively high. There is now much evidence to suggest that parents with cancer have higher levels of Parenting concern,particularly during tumour treatment,however,E.M. Park et al [11] state that parents with metastatic and non-metastatic cancers are similar in the intensity of Parenting concern,with no significant differences,and this needs to be further researched and investigated. Meanwhile,for parents with cancer,the stronger their need for information about the disease,the more likely they are to feel insecure and fearful.They are more concerned that the disease may place a heavy burden on their children's lives and the family's finances,and they feel uncertain about the future direction of their lives,which may lead to greater psychological stress and higher levels of Parenting concern. In addition,the longer the course of the cancer and the more comorbidities,the higher the level of parenting anxiety after the illness. 3.3 Individual psychological factors Cancer patients' own anxiety,depression,and distress can increase parenting stress because of difficulties in meeting the needs of the child,and high levels of parenting stress may be detrimental to the caregiver's mental health. Parents with cancer tend to experience anxiety and depressive symptoms associated with worrying about their children,inability to carry out usual parenting activities,and the stress of multiple roles when ill,and for metastatic cancer patients with minor children,parenting issues may be a major predictor of their anxiety and depression. In addition cancer patients with deep emotional distress and lower parenting competence have higher Parenting concern,and increased support for parenting confidence in cancer patients is necessary. 3.4 Intra-family factors 3.4.1 Types of family structures Single parents and widows who have lost their partners face growing parenting concerns [4,25] . Cancer patients who have lost a partner or died from separation often struggle to afford parenting responsibilities while battling the disease,often in the absence of family support and companionship,which significantly limits the ability to care for children after an outbreak of disease [13,24] . 3.4.2 Intra-family support As the family is the basic unit of human social life,patients' well-being is enhanced when they perceive their partner's responsiveness,which helps both partners to express their emotions more deeply,thus improving overall well-being. Thus,patients perceive their partner's responsiveness to be relatively low,whereas concerns about support are relatively high. Meanwhile,communication about the illness between couples not only had a positive impact on the patients' psychological adjustment and illness management,but also enhanced the intimacy of the couple and reduced the patients' sense of stress in the two-way interaction of "showing" and "listening". In families with poor family functioning,the lack of communication between spouses is associated with higher levels of parenting anxiety [26,27] . Milbury [14] A cross-sectional survey of 51 patients and spouses also confirmed that parenting concerns were significantly associated with disease ditching and family functioning. Therefore,in order to alleviate parenting concerns,there is a need to focus on tapping into the potential strengths and dynamics within the family,to motivate family members to become actively involved,and to enhance proactive communication and bonding among family members. 3.5 Social support Social support is an important factor influencing Parenting concern in cancer patients [4] . Providing the necessary social assistance to parents with cancer can help to increase their confidence in raising their children; it also helps to improve the mental health of the person with cancer and the family. Intervention methods 4.1 Provision of psychosocial support These issues of how to communicate with children about cancer and cope with changing parental roles can be challenging for parents with cancer. Cancer parents are often at their wits' end,and providing appropriate information can support affected parents and their children [28] , X. SkrabalRoss et al [29] explored the need for the implementation of the Parent Support Worker (PSW) role,where the PSW provides direct support to parents with cancer and their partners,including counselling,psychoeducation and practical information about cancer,the impact of cancer on the family and parenting roles,and how to talk about cancer in the family.The model aims to provide in-hospital psycho-social support,the introduction of the PSW role has increased the capacity of the healthcare team to fill a gap in the provision of specialised support and continuity of care for parents with cancer and their families,and is worthy of consideration.E.M. Park et al [30] 2023 developed Families Coping with Cancer Together (FACT),a web-based psychoeducational support intervention.The content of FACT focuses on describing strategies for cancer and treatment,explaining changes in health status as well as responding to the child's questions and common reactions,and encouraging open communication. Parents with cancer were assessed for communication self-efficacy and other psychosocial outcomes at 2 and 12 weeks post-intervention,and results showed that parents' psychosocial outcomes improved after the intervention,although not significantly,in terms of concerns about talking to their child and communication problems.The FACT intervention is feasible and acceptable,and FACT's web-based and tailored interventions can be useful for many people who have difficulties with communication in settings that lack access to specialised social psycho-oncology services to support patients receiving treatment in settings that lack such services. 4.2 Improvement of communication skills between parents and children Good parent-child communication is thought to help families adjust more easily during stressful events such as parental cancer. Faced with a diagnosis of cancer,parents face further challenges in caring for their children's information and communication needs,with one-third of parents feeling difficulty regarding illness-related communication with their children,and parenting capacity being compromised,with parents wanting clinical help to support their children's coping and developmental outcomes [31,32] .F.M. Lewis et al [33] 2020 designed an Enhanced Connections-Palliative Care (EC-PC) programme for parents diagnosed with advanced cancer,which focused more on parenting and parent-child communication. The intervention programme is organised by trained nurses and requires parents to attend telephone sessions every fortnight,which are held over five sessions. Sessions included written and interactive assignments between parents and nurses,and focused on family skill building between parents and children,including deep listening and paying attention to their children's thoughts and feelings,and helping sick parents manage their own cancer-related emotional skills,etc. Behavioural assessments of parental depression and anxiety,parenting skills,and parenting self-efficacy were carried out at the end of the 3-month period,and it was found that the EC-PC Parenting programme could improve parents' skills and confidence in supporting their children to cope with cancer,and was feasible. Domestic Sun Yining et al [34] 2021 constructed a programme for communicating about the condition between breast cancer patients and their minor children,and the results of the study showed that the programme was effective in alleviating the anxiety and depression of breast cancer patients and their minor children,and helped to enhance the functionality of the family. Cancer-related communication is 2021 constructed a programme for communicating about the condition between breast cancer patients and their minor children,and the results of the study showed that the programme was effective in alleviating the anxiety and depression of breast cancer patients and their minor children,and helped to enhance the functionality of the family. Cancer-related communication is critical to both parents' and children's adjustment to the disease. To target communication between parents and children with cancer,A. Liénard et al. [35] 2022 also developed an informational brochure and a 4-session parent-supported intervention programme aimed at increasing parents' communication self-efficacy and perceived communication competence,and reducing parent-child communication difficulties about cancer. The intervention was held using a combination of offline and teleconferences,with four sessions of 1.5 hours each. To promote changes in parental communication styles,the researchers combined the information resources of the booklet with experiential techniques,while inviting a clinical psychologist to provide participants with personalised information that was used to understand the cancer patient's understanding of their child's responses and needs,as well as the cancer patient's difficulties or challenges,behaviours,and self-efficacy in the communication process. Although this study was conducted with a small sample and further modification and refinement of the intervention content is still needed to improve parental competence,it provides preliminary evidence of the effectiveness of the intervention.C.J. Semple et [36] also found that medical professionals play a crucial role in providing parents with the support they need for key parent-child communication issues. 4.3 Improving the capacity of medical personnel For young cancer patients with minor children,parenting is the main focus of daily activities,but when a parent is diagnosed with cancer,it presents unique challenges for the family. It is often difficult for parents to know how best to meet their child's emotional needs during this harrowing time. Whilst healthcare professionals are willing to support families in this challenging and vulnerable situation,research has highlighted a lack of knowledge,confidence in their skills and training around this important aspect of care.C. J. Semple et al [37] Development of an e-learning intervention model integrating a communication framework on how healthcare professionals can have these conversations with parents,as well as role-playing videos and original artwork from children expressing their views on their parents' cancer-related perspectives,to increase the ability of oncology staff to provide support and information to parents with advanced cancer to help their children cope. j. Turner et al [38] Self-directed learning manual developed to improve the ability of oncology nurses to provide supportive care to patients with advanced cancer who have dependent children was studied and supplemented with a one-day training workshop on communication skills. Results showed nurses were highly receptive to the educational intervention and felt more confident in their ability to initiate discussions and provide support and information to patients. Medical professionals are important players in health literacy communication,and L.M. Johannsen et al [39] 2022 developed a 3-hour intervention with training consisting of three modules focusing on the impact of illness on the family,children's reactions to parental illness,and communication within the family as a way of empowering healthcare workers to care for cancer patients. The results of the study showed that healthcare workers improve their communication skills and competence in oncology when caring for cancer patients with minor children [40] which facilitates better communication with the families of cancer patients in the future. Summary The current studies mainly assess parenting apprehension from the individual level of patients,and the results show that cancer patients have higher parenting apprehension. Therefore,it is necessary for relevant scholars to gain a deeper understanding of the level of parenting apprehension in cancer patients and incorporate it into the psychological care of cancer patients,which can be studied in the future from the holistic perspective of the family or binary relationship,by considering cancer families or couples as a whole,and by constructing coping strategies that support each other among family members,so as to improve parenting apprehension with the family as a whole. Declarations 7 Conflict of Interest The authors declare that there are no conflict of interests, we do not have any possible conflicts of interest. 6 Fundings We did not receive any form of financial support during the conduct of this study / project. All required funds are financed by the investigator personally or its affiliates. The study design, implementation, data analysis, and writing of the conclusions were not influenced by any of the funding sponsors. 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Eur J Cancer,2009,45(10): 1798-806. JOHANNSEN L M,FRERICHS W,PHILIPP R,et al. Effectiveness of a training programme for healthcare professionals on parental cancer: results of a randomised controlled pilot-study [J]. Psychooncology,2023,32(10): 1567-77. FRERICHS W,GEERTZ W,JOHANNSEN L M,et al. Child- and family-specific communication skills trainings for healthcare professionals caring for families with parental cancer: a systematic review [J]. PLoS One,2022,17(11): e0277225. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5584478","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":391823049,"identity":"b6860c28-7aa1-4354-a52f-a8ed866a4c0d","order_by":0,"name":"Sai-nan Gu","email":"","orcid":"","institution":"Shanghai University of Medicine \u0026 Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Sai-nan","middleName":"","lastName":"Gu","suffix":""},{"id":391823051,"identity":"3f480d07-9657-4296-84bf-f1ee6dcb8a0b","order_by":1,"name":"Ai-yong ZHU","email":"","orcid":"","institution":"Shanghai University of Medicine \u0026 Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Ai-yong","middleName":"","lastName":"ZHU","suffix":""},{"id":391823052,"identity":"041847eb-209d-4861-a0e6-42d662f9a0e5","order_by":2,"name":"Shan-shan Sun","email":"","orcid":"","institution":"Shanghai University of Medicine \u0026 Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Shan-shan","middleName":"","lastName":"Sun","suffix":""},{"id":391823053,"identity":"c03f6ae2-a123-4286-94ce-d127bcff5c59","order_by":3,"name":"Ling-ling Shen","email":"","orcid":"","institution":"Shanghai University of Medicine \u0026 Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Ling-ling","middleName":"","lastName":"Shen","suffix":""},{"id":391823054,"identity":"c7ee24dc-1c53-4b85-9765-0b182a8e3a36","order_by":4,"name":"Fang Zhao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2ElEQVRIiWNgGAWjYBACNv7+jw8SftjI8csfbAQxCGvhkzhgbPCwJ81YcgZzM4hBWIscQ4KZ4AO2w4kGN9jbJIEMIhzGcCCNIYHncILk7Ma2CiCDgb+9OwG/FuaGYw8SLNLz+GUOtt0AMhgkzpzdQMCWg+0GCTzWxZINiUAtPNYMBhK5hLQks0kksDEnbjiQ2FYAZBCjJQ2kxTlxw43ENgYggwgtEmeYDRJBgdxzsFkCyOAh6Bf5/h7Ghz9AUcne/vAjmNHei18LBuAhTfkoGAWjYBSMAqwAAPSkS/TgZxWqAAAAAElFTkSuQmCC","orcid":"","institution":"Shanghai University of Medicine \u0026 Health Sciences","correspondingAuthor":true,"prefix":"","firstName":"Fang","middleName":"","lastName":"Zhao","suffix":""}],"badges":[],"createdAt":"2024-12-05 07:08:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5584478/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5584478/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":79869748,"identity":"b74f3b17-72ed-4797-8861-51276e83c60d","added_by":"auto","created_at":"2025-04-03 20:46:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":530366,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5584478/v1/988b0b63-f284-40e0-bf5a-f65d185960ab.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"parenting concerns in cancer patients with minor children: a scoping review","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAccording to the latest data released by the International Agency for Research on Cancer of the World Health Organisation,there will be approximately 19.3\u0026nbsp;million new cancer cases globally in 2020,of which nearly 10\u0026nbsp;million patients will die of cancer\u003csup\u003e[1]\u003c/sup\u003e \u003csub\u003e。\u003c/sub\u003eCancer has become an important public health issue of global concern. Approximately 7–14 per cent of cancer patients are parents of dependent children under 18 years of age\u003csup\u003e[2]\u003c/sup\u003e. Their role is particularly critical as they are experiencing the prime of their lives and are not only dealing with the challenges of family and society,but are also the core strength of their families,societies and nations\u003csup\u003e[3]\u003c/sup\u003e. The role of these parents is particularly critical. Parenting concern\u003csup\u003e[4]\u003c/sup\u003e describes the concerns of cancer patients arising from concerns about child rearing,which relate not only to the potential impact of the disease on the child,but also to the patient's concern about his or her spouse's ability to provide for and care for the child. In addition to the burden of disease,cancer patients with minor children are more affected by parenting issues,and parents worry about the guilt they may feel if they are unable to adequately meet their children's needs. Therefore,this study summarises and analyses the literature on the influencing factors of parenting apprehension in young and middle-aged cancer patients through the framework of a scoping review report proposed by Arksey et al. in order to provide a reference for subsequent research in this area\u003csup\u003e[5]\u003c/sup\u003e.\u003c/p\u003e "},{"header":"Information and methodology","content":"\u003cp\u003e1.1 Defining the research question\u003c/p\u003e\u003cp\u003eThe main research questions of this study are 1) the current status of parenting concerns in cancer patients with minor children,2 assessment tools for parenting concerns in cancer patients with minor children,and 3) factors influencing parenting concerns in cancer patients with minor children.4) Intervention for Parenting concern of Cancer Patients with Minor Children\u003c/p\u003e\u003cp\u003e1.2 Literature inclusion and exclusion criteria\u003c/p\u003e\u003cp\u003eInclusion criteria: the target population was aged 18 years or older,living with at least one child under the age of 18 years who had received a cancer diagnosis (of any stage and/or type); the study was an analysis of factors influencing Parenting concern in cancer patients; and primary literature with original data was included once. Exclusion criteria: literature not reported in Chinese or English; literature from various types of reviews,personal opinions,and poor data descriptions.\u003c/p\u003e\u003cp\u003e1.3 Search strategy\u003c/p\u003e\u003cp\u003eChinese literature was searched in the Chinese databases China National Knowledge Infrastructure,Wanfang, China Science and Technology Journal Database and China Biomedical Literature Database with the search terms \"cancer/cancer/tumour/malignant tumour\" and \"Parenting concern\",and English literature was searched in the databases PubMed,Web of science,EMbase,CINAHL,the Cochrane Library,etc. The English search terms were\"tumor*ORoncolog*ORcarcinomaORmalignancyORcancer* OR/neoplasms\",\"children\",\"parent concern,parenting\",and the search period was from the establishment of the database to 20 July 2024. Boolean operators AND and OR were used to formulate search terms,and the search was conducted using a combination of free words and subject terms.\u003c/p\u003e\u003cp\u003e1.4 Literature screening and data extraction\u003c/p\u003e\u003cp\u003eRelevant literature was imported into endnotes9 for de-duplication,and two professionally trained researchers independently read the titles and abstracts of the literature for initial screening,and after reading the entire text,screening was performed again,and any differences of opinion were discussed and resolved with a third researcher. A data extraction form was created to standardise the data extraction of the final included literature,including authors,year of publication,country,type of study,study population,sample size,parenting apprehension assessment tool and influencing factors.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e2.1 Literature search results and basic characteristics of literature\u003c/p\u003e\n\u003cp\u003eAfter searching the database, literature (n\u0026thinsp;=\u0026thinsp;1860); CNKI (n\u0026thinsp;=\u0026thinsp;11), Wanfang database (n\u0026thinsp;=\u0026thinsp;13), Chinese biomedical literature database (n\u0026thinsp;=\u0026thinsp;9), Web of Science (n\u0026thinsp;=\u0026thinsp;1576), PubMed (n\u0026thinsp;=\u0026thinsp;523), EMbase (n\u0026thinsp;=\u0026thinsp;536) Cochrane Library (n\u0026thinsp;=\u0026thinsp;18).And 13 papers were finally included. Among them,six were in Chinese and five in foreign languages,with a total sample size of 3234 cases; the publication period was from 2012 to 2024.\u003c/p\u003e\n\u003cp\u003e2.2 Basic characteristics of studies included in the literature\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Taba\" border=\"1\"\u003e\u003ccolgroup\u003e\u003c/colgroup\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eYear of publication, author\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003enations\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eType of study\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eresearch target\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003esample size\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003escore\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003efactor\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2012, Anna C. Muriel \u003csup\u003e[6]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eusa\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003etumour patient\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e173\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.33\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eWomen,single-parent families,metastatic or recurrent cancer,subjective understanding of incurable disease,co-morbid chronic health conditions and current mental health treatment\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2015, C. W. Moore\u003csup\u003e[7]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUsa\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAdult cancer patients\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e194\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e/\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDecreased parenting self-efficacy beliefs are associated with treatment,health-related quality of life,depression and distress,and concerns about the impact of cancer on dependent children\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2016, ElizaM.Park\u003csup\u003e[8]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUsa\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003etumour patient\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMarital Status,Depressive Symptoms,Anxiety Symptoms,and QOL Scores\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2017, LauraInhestern\u003csup\u003e[9]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGerman\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCancer patients with minor children\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1416\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e/\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLiving alone,younger age of youngest child,higher tumour stage and comorbidities\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2018, Eliza M. Park\u003csup\u003e[10]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eusa\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStage IV solid tumour or recurrent/refractory haematological cancer\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e211\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnxiety and depression,symptom severity,and HRQOL\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2019, ElizaM.Park\u003csup\u003e[11]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eusa\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePatients with solid tumour cancers who have at least one child\u0026thinsp;\u0026lt;\u0026thinsp;18 years of age\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e149\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.21vs.2.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGender,marital status,employment status,household income,number of children,CCI score,prior mental health diagnosis or treatment,metastatic cancer or not\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2020, Kang Tingting\u003csup\u003e[4]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChina\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ecancer patient\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e206\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStage of disease,number of minor children,age of youngest minor child,whether patient subjectively believes disease cannot be cured,marital status,parenting competence,and perceived social support\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2023, MeaganWhisenant\u003csup\u003e[12]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eusa\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHybrid studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDiagnosed with a stage III-IV solid malignancy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eParenting issues and family functioning\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2023, Hao Limin\u003csup\u003e[13]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChina\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYoung and middle-aged ovarian cancer patients\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e235\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.56\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMarital Status,Disease Staging,Cancer Patient Information Needs,Perceived Disease,and Family Caringness Indices\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2024, K. Milbury\u003csup\u003e[14]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChina\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePatients with metastatic solid malignant tumours and their spouses\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e51\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e/\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIllness communication and family functioning\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2024, Liu Jie\u003csup\u003e[15]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChina\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBreast cancer patients\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e247\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e37.34\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eParenting competence,literacy,number of minor children,per capita monthly family income and tumour clinical stage\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2024, Yuan Yuan\u003csup\u003e[16]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChina\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ecancer patient\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e232\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.41\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGender,tumour clinical stage,primary caregiver, CRCPscores andAAQ-Ⅱ\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2024, Qin Haixiao\u003csup\u003e[17]\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChina\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCross-sectional studies\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYoung and middle-aged patients with ovarian cancer treated with postoperative chemotherapy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e120\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e53.92\u0026thinsp;\u0026plusmn;\u0026thinsp;8.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMarital status and disease staging\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e2.3 Assessment tools\u003c/p\u003e\n\u003cp\u003e2.3.1 Instruments for measuring parenting stress\u003c/p\u003e\n\u003cp\u003eIn the 1980s the American scholar Abidin developed a parenting stress scale consisting of 120 question items,which is also known as the Long-form Parenting Stress Scale because of its large number of items \u003csup\u003e[18]\u003c/sup\u003e .The scale uses the Likert scale. The scale is rated on a 5-point Likert scale and is centred on three main areas: parental stress,children's living conditions and quality of daily life. The Long-form Parenting Stress Scale is a comprehensive and in-depth assessment tool that helps to understand the stressful situation of parents in the parenting process. By carefully completing and analysing the results of the questionnaire,parents can be provided with more specific advice and support to help them better cope with the challenges of parenting. At the same time,however,attention needs to be paid to the difficulty and time-consuming nature of its operation to ensure that adequate support and co-operation can be obtained in its use. The Parenting Stress Short Form was adapted by Abidin from the Long-form Parenting Stress Questionnaire,which simplified the original questions to 36. The reliability of the PSI-SF scale obtained high scores during the rigorous testing process,and the reliability measure scores of the total scale and the subscales ranged from 0.68 to 0.85,and the Hong Kong scholars Chinese-relativised the scale,which has been used widely\u003csup\u003e[19]\u003c/sup\u003e The Hong Kong scholars have Chineseised the scale and it has been widely used.\u003c/p\u003e\n\u003cp\u003e2.3.2 Clinical Nurse Childcare Stress Scale\u003c/p\u003e\n\u003cp\u003eThe Chinese version of this scale,the Clinical Nurse Parenting Stress Scale,was developed by Zeng Mengqin et al\u003csup\u003e[20]\u003c/sup\u003e 2022 based on lee's Chinese version,which includes 4 dimensions with 19 entries. The Chinese version of the Clinical Nurse Parenting Stress Scale includes 4 dimensions with 19 entries,and the Cronbach's alpha coefficient of this scale is 0.906,with a re-test reliability of 0.888.\u003c/p\u003e\n\u003cp\u003e2.3.3 Parenting Concerns Questionnaire (PCQ)\u003c/p\u003e\n\u003cp\u003eThe Parenting concern Questionnaire was developed by Muriel et al\u003csup\u003e[6]\u003c/sup\u003e developed in 2012 to measure the level of Parenting concern in cancer patients raising minor children. The questionnaire consists of 15 items with 3 dimensions,i.e.,worries about the emotional impact on the child,worries about the practical impact on the child,and worries about the child's father/mother. The questionnaire was rated on a Liket 5 scale from 1 (not at all concerned) to 5 (very concerned). Higher scores indicate that parents are more concerned. The questionnaire had an overall Cronbach's alpha coefficient of 0.83,giving it good reliability and validity. The questionnaire entries are concise and easy to understand,and can fully meet the special needs of the special group of cancer patients raising minor children for parenting worry assessment,and has been widely used. Kang Tingting et al.\u003csup\u003e[21]\u003c/sup\u003e In 2020,the Chinese version of the Parenting Concerns Questionnaire (PCQ) was Chineseised,and the Cronbach's alpha coefficient of the Chinese version of the PCQ was 0.850,and the total content validity of the questionnaire was 0.94,which makes it an effective tool for assessing parenting concerns of cancer patients.\u003c/p\u003e"},{"header":" Factors influencing Parenting concern in young and middle-aged cancer patients","content":"\u003cp\u003e3.1 Socio-demographic factors\u003c/p\u003e\n\u003cp\u003eIn most families,women tend to face higher levels of Parenting concern,which can mean that their mothers take on most of the childcare duties and obligations\u003csup\u003e[22]\u0026nbsp;\u003c/sup\u003e. Mothers have a significant impact on their own health and the development of their children. The stronger attachment between mothers and their children compared to fathers also makes sick mothers more concerned about their children\u0026apos;s well-being,so mothers have more serious parenting concerns than fathers. Cancer,as a common malignant tumour disease,brings great pain to many people,and cancer patients often face problems such as high financial pressure,expensive medical expenses and difficulties in getting effective relief from mental aspects,etc. A study by Inhestern \u003csup\u003e[23]\u003c/sup\u003e s study revealed that the lower the income of cancer patients,the more intense their worries about life and support. Depression in cancer patients rises with age and is accompanied by anxiety symptoms. Cancer patients may have deep concerns about their health and the financial stress. There is a correlation between the literacy level of a family and its financial situation,and generally speaking,the lower the literacy level,the less favourable the financial situation of the family. Different types of medical insurance and differences in disease treatment options can affect the financial pressure on families of cancer patients. Reimbursement rates for cancer can vary due to differences in health insurance systems,which also leads to different levels of financial stress for cancer families. An increase in the types of health insurance coverage and a relative reduction in the financial pressure on the families of cancer patients may mean that they are under less pressure to raise their minor children. In addition,the increased number and younger age of their minor children means that parents with cancer will invest more time and energy in raising their children,resulting in greater parenting stress,which may mean a corresponding increase in their parenting concerns.\u003c/p\u003e\n\u003cp\u003e3.2 Cancer-related factors\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSeveral studies\u003csup\u003e[7,24]\u0026nbsp;\u003c/sup\u003ehave shown that the stage of the disease,metastasis or recurrence of the cancer,the cancer patient\u0026apos;s need for information,perception of the disease,and a variety of factors associated with other chronic illnesses in cancer patients have an impact on the level of Parenting concern. The stage of the disease is an important factor influencing Parenting concern,with higher levels of Parenting concern in cancer patients in stages II,III,and IV compared to those in stage I. Patients with advanced stage cancer spend progressively less time with and caring for their children in their daily lives as they are in constant fear of passing away due to their recurrent illness. They are deeply worried that their spouses cannot shoulder the burden of raising their children alone. At the same time,they are also afraid that their own deteriorating health condition may cause a great impact on their children\u0026apos;s emotions and cognition,which may adversely affect their children\u0026apos;s future physical and mental health,and thus,the level of parenting apprehension among cancer patients is relatively high. There is now much evidence to suggest that parents with cancer have higher levels of Parenting concern,particularly during tumour treatment,however,E.M. Park et al\u003csup\u003e[11]\u003c/sup\u003e state that parents with metastatic and non-metastatic cancers are similar in the intensity of Parenting concern,with no significant differences,and this needs to be further researched and investigated. Meanwhile,for parents with cancer,the stronger their need for information about the disease,the more likely they are to feel insecure and fearful.They are more concerned that the disease may place a heavy burden on their children\u0026apos;s lives and the family\u0026apos;s finances,and they feel uncertain about the future direction of their lives,which may lead to greater psychological stress and higher levels of Parenting concern. In addition,the longer the course of the cancer and the more comorbidities,the higher the level of parenting anxiety after the illness.\u003c/p\u003e\n\u003cp\u003e3.3 Individual psychological factors\u003c/p\u003e\n\u003cp\u003eCancer patients\u0026apos; own anxiety,depression,and distress can increase parenting stress because of difficulties in meeting the needs of the child,and high levels of parenting stress may be detrimental to the caregiver\u0026apos;s mental health. Parents with cancer tend to experience anxiety and depressive symptoms associated with worrying about their children,inability to carry out usual parenting activities,and the stress of multiple roles when ill,and for metastatic cancer patients with minor children,parenting issues may be a major predictor of their anxiety and depression. In addition cancer patients with deep emotional distress and lower parenting competence have higher Parenting concern,and increased support for parenting confidence in cancer patients is necessary.\u003c/p\u003e\n\u003cp\u003e3.4 Intra-family factors\u003c/p\u003e\n\u003cp\u003e3.4.1 Types of family structures\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e Single parents and widows who have lost their partners face growing parenting concerns\u003csup\u003e[4,25]\u003c/sup\u003e . Cancer patients who have lost a partner or died from separation often struggle to afford parenting responsibilities while battling the disease,often in the absence of family support and companionship,which significantly limits the ability to care for children after an outbreak of disease\u003csup\u003e[13,24]\u003c/sup\u003e .\u003c/p\u003e\n\u003cp\u003e3.4.2 Intra-family support\u003c/p\u003e\n\u003cp\u003eAs the family is the basic unit of human social life,patients\u0026apos; well-being is enhanced when they perceive their partner\u0026apos;s responsiveness,which helps both partners to express their emotions more deeply,thus improving overall well-being. Thus,patients perceive their partner\u0026apos;s responsiveness to be relatively low,whereas concerns about support are relatively high. Meanwhile,communication about the illness between couples not only had a positive impact on the patients\u0026apos; psychological adjustment and illness management,but also enhanced the intimacy of the couple and reduced the patients\u0026apos; sense of stress in the two-way interaction of \u0026quot;showing\u0026quot; and \u0026quot;listening\u0026quot;. In families with poor family functioning,the lack of communication between spouses is associated with higher levels of parenting anxiety\u003csup\u003e[26,27]\u003c/sup\u003e\u003csub\u003e\u0026nbsp;.\u003c/sub\u003eMilbury\u003csup\u003e\u0026nbsp;[14]\u003c/sup\u003e A cross-sectional survey of 51 patients and spouses also confirmed that parenting concerns were significantly associated with disease ditching and family functioning. Therefore,in order to alleviate parenting concerns,there is a need to focus on tapping into the potential strengths and dynamics within the family,to motivate family members to become actively involved,and to enhance proactive communication and bonding among family members.\u003c/p\u003e\n\u003cp\u003e3.5 Social support\u003c/p\u003e\n\u003cp\u003eSocial support is an important factor influencing Parenting concern in cancer patients\u003csup\u003e[4]\u003c/sup\u003e . Providing the necessary social assistance to parents with cancer can help to increase their confidence in raising their children; it also helps to improve the mental health of the person with cancer and the family.\u003c/p\u003e"},{"header":"Intervention methods ","content":"\u003cp\u003e4.1 Provision of psychosocial support\u003c/p\u003e\n\u003cp\u003eThese issues of how to communicate with children about cancer and cope with changing parental roles can be challenging for parents with cancer. Cancer parents are often at their wits' end,and providing appropriate information can support affected parents and their children\u003csup\u003e[28]\u003c/sup\u003e\u003csub\u003e,\u003c/sub\u003eX. SkrabalRoss et al\u003csup\u003e[29] \u003c/sup\u003eexplored the need for the implementation of the Parent Support Worker (PSW) role,where the PSW provides direct support to parents with cancer and their partners,including counselling,psychoeducation and practical information about cancer,the impact of cancer on the family and parenting roles,and how to talk about cancer in the family.The model aims to provide in-hospital psycho-social support,the introduction of the PSW role has increased the capacity of the healthcare team to fill a gap in the provision of specialised support and continuity of care for parents with cancer and their families,and is worthy of consideration.E.M. Park et al\u003csup\u003e[30]\u003c/sup\u003e 2023 developed Families Coping with Cancer Together (FACT),a web-based psychoeducational support intervention.The content of FACT focuses on describing strategies for cancer and treatment,explaining changes in health status as well as responding to the child's questions and common reactions,and encouraging open communication. Parents with cancer were assessed for communication self-efficacy and other psychosocial outcomes at 2 and 12 weeks post-intervention,and results showed that parents' psychosocial outcomes improved after the intervention,although not significantly,in terms of concerns about talking to their child and communication problems.The FACT intervention is feasible and acceptable,and FACT's web-based and tailored interventions can be useful for many people who have difficulties with communication in settings that lack access to specialised social psycho-oncology services to support patients receiving treatment in settings that lack such services.\u003c/p\u003e\n\u003cp\u003e4.2 Improvement of communication skills between parents and children\u003c/p\u003e\n\u003cp\u003eGood parent-child communication is thought to help families adjust more easily during stressful events such as parental cancer. Faced with a diagnosis of cancer,parents face further challenges in caring for their children's information and communication needs,with one-third of parents feeling difficulty regarding illness-related communication with their children,and parenting capacity being compromised,with parents wanting clinical help to support their children's coping and developmental outcomes\u003csup\u003e[31,32]\u003c/sup\u003e .F.M. Lewis et al\u003csup\u003e[33]\u003c/sup\u003e 2020 designed an Enhanced Connections-Palliative Care (EC-PC) programme for parents diagnosed with advanced cancer,which focused more on parenting and parent-child communication. The intervention programme is organised by trained nurses and requires parents to attend telephone sessions every fortnight,which are held over five sessions. Sessions included written and interactive assignments between parents and nurses,and focused on family skill building between parents and children,including deep listening and paying attention to their children's thoughts and feelings,and helping sick parents manage their own cancer-related emotional skills,etc. Behavioural assessments of parental depression and anxiety,parenting skills,and parenting self-efficacy were carried out at the end of the 3-month period,and it was found that the EC-PC Parenting programme could improve parents' skills and confidence in supporting their children to cope with cancer,and was feasible. Domestic Sun Yining et al\u003csup\u003e[34] \u003c/sup\u003e2021 constructed a programme for communicating about the condition between breast cancer patients and their minor children,and the results of the study showed that the programme was effective in alleviating the anxiety and depression of breast cancer patients and their minor children,and helped to enhance the functionality of the family. Cancer-related communication is 2021 constructed a programme for communicating about the condition between breast cancer patients and their minor children,and the results of the study showed that the programme was effective in alleviating the anxiety and depression of breast cancer patients and their minor children,and helped to enhance the functionality of the family. Cancer-related communication is critical to both parents' and children's adjustment to the disease. To target communication between parents and children with cancer,A. Li\u0026eacute;nard et al.\u003csup\u003e[35] \u003c/sup\u003e2022 also developed an informational brochure and a 4-session parent-supported intervention programme aimed at increasing parents' communication self-efficacy and perceived communication competence,and reducing parent-child communication difficulties about cancer. The intervention was held using a combination of offline and teleconferences,with four sessions of 1.5 hours each. To promote changes in parental communication styles,the researchers combined the information resources of the booklet with experiential techniques,while inviting a clinical psychologist to provide participants with personalised information that was used to understand the cancer patient's understanding of their child's responses and needs,as well as the cancer patient's difficulties or challenges,behaviours,and self-efficacy in the communication process. Although this study was conducted with a small sample and further modification and refinement of the intervention content is still needed to improve parental competence,it provides preliminary evidence of the effectiveness of the intervention.C.J. Semple et\u003csup\u003e[36] \u003c/sup\u003ealso found that medical professionals play a crucial role in providing parents with the support they need for key parent-child communication issues.\u003c/p\u003e\n\u003cp\u003e4.3 Improving the capacity of medical personnel\u003c/p\u003e\n\u003cp\u003eFor young cancer patients with minor children,parenting is the main focus of daily activities,but when a parent is diagnosed with cancer,it presents unique challenges for the family. It is often difficult for parents to know how best to meet their child's emotional needs during this harrowing time. Whilst healthcare professionals are willing to support families in this challenging and vulnerable situation,research has highlighted a lack of knowledge,confidence in their skills and training around this important aspect of care.C. J. Semple et al\u003csup\u003e[37] \u003c/sup\u003eDevelopment of an e-learning intervention model integrating a communication framework on how healthcare professionals can have these conversations with parents,as well as role-playing videos and original artwork from children expressing their views on their parents' cancer-related perspectives,to increase the ability of oncology staff to provide support and information to parents with advanced cancer to help their children cope. j. Turner et al\u003csup\u003e[38] \u003c/sup\u003eSelf-directed learning manual developed to improve the ability of oncology nurses to provide supportive care to patients with advanced cancer who have dependent children was studied and supplemented with a one-day training workshop on communication skills. Results showed nurses were highly receptive to the educational intervention and felt more confident in their ability to initiate discussions and provide support and information to patients. Medical professionals are important players in health literacy communication,and L.M. Johannsen et al\u003csup\u003e[39]\u003c/sup\u003e 2022 developed a 3-hour intervention with training consisting of three modules focusing on the impact of illness on the family,children's reactions to parental illness,and communication within the family as a way of empowering healthcare workers to care for cancer patients. The results of the study showed that healthcare workers improve their communication skills and competence in oncology when caring for cancer patients with minor children\u003csup\u003e[40]\u003c/sup\u003e which facilitates better communication with the families of cancer patients in the future.\u003c/p\u003e"},{"header":"Summary","content":"\u003cp\u003eThe current studies mainly assess parenting apprehension from the individual level of patients,and the results show that cancer patients have higher parenting apprehension. Therefore,it is necessary for relevant scholars to gain a deeper understanding of the level of parenting apprehension in cancer patients and incorporate it into the psychological care of cancer patients,which can be studied in the future from the holistic perspective of the family or binary relationship,by considering cancer families or couples as a whole,and by constructing coping strategies that support each other among family members,so as to improve parenting apprehension with the family as a whole.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003e7 Conflict of Interest\u003c/h2\u003e \u003cp\u003eThe authors declare that there are no conflict of interests, we do not have any possible conflicts of interest.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003e6 Fundings\u003c/h2\u003e \u003cp\u003eWe did not receive any form of financial support during the conduct of this study / project. All required funds are financed by the investigator personally or its affiliates. The study design, implementation, data analysis, and writing of the conclusions were not influenced by any of the funding sponsors.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAll authors as follows:\u0026gt;Gu Sai-nan (First Author): Review the topic selection and overall design, find the literature, write and revise the paper\u0026gt;ZHU Ai-yong : paper guidance\u0026gt; Sun Shan-shan : paper guidance\u0026gt;Shen Ling-ling: Paper guidance and literature search\u0026gt;Zhao Fang(Corresponding Author):Summarize and write the written articles And paper modification.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSUNG H,FERLAY J,SIEGEL R L,et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries [J]. 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Cancer,2012,118(22): 5671-8.\u003c/li\u003e\n\u003cli\u003e INHESTERN L,BULTMANN J C,BEIERLEIN V,et al. Parenting Concerns and Psychological Burden in Cancer Patients with Minor and Young Adult Children [J] . . PPmP Psychotherapie Psychosomatik Medizinische Psychologie,2017,67(7): 279-87.\u003c/li\u003e\n\u003cli\u003e SCHMITT F,PIHA J,HELENIUS H,et al. Multinational study of cancer patients and their children: factors associated with family functioning [J]. J Clin Oncol,2008,26(36): 5877-83.\u003c/li\u003e\n\u003cli\u003e DENCKER A,MURRAY S A,MASON B,et al. Disrupted biographies and balancing identities: a qualitative study of cancer patients' communication with healthcare professionals about dependent children [J]. Eur J Cancer Care (Engl),2019,28(2): e12991.\u003c/li\u003e\n\u003cli\u003e SHANDS M E,LEWIS F M. Parents With Advanced Cancer: Worries About Their Children's Unspoken Concerns [J]. Am J Hosp Palliat Care,2021,38(8): 920-6.\u003c/li\u003e\n\u003cli\u003e SKRABAL ROSS X,MCDONALD F E J,KONINGS S,et al. Cancer patients as parents: implementation of a cross sector service for families with adolescent and young adult children [J]. BMC Health Serv Res,2023,23(1): 472.\u003c/li\u003e\n\u003cli\u003e PARK E M,DEAL A M,HEILING H M,et al. Families Addressing Cancer Together (FACT): feasibility and acceptability of a web-based psychosocial intervention for parents with cancer [J]. Support Care Cancer,2022,30(10): 8301-11.\u003c/li\u003e\n\u003cli\u003e TAVARES R,BRAND\u0026atilde;O T,MATOS P M. Communication concerns in mothers with cancer: development and psychometric properties of a new measure [J]. European journal of cancer care,2022,31(6): e13701.\u003c/li\u003e\n\u003cli\u003e HAILEY C E,YOPP J M,DEAL A M,et al. Communication with children about a parent's advanced cancer and measures of parental anxiety and depression: a cross-sectional mixed-methods study [J]. 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Palliat Med,2021,35(5): 933-42.\u003c/li\u003e\n\u003cli\u003e SEMPLE C J,MCCAUGHAN E,SMITH R,et al. Parent's with incurable cancer: 'Nuts and bolts' of how professionals can support parents to communicate with Parent's with incurable cancer: 'Nuts and bolts' of how professionals can support parents to communicate with their dependent children [J]. Patient Educ Couns,2022,105(3): 775-80.\u003c/li\u003e\n\u003cli\u003e TURNER J,CLAVARINO A,BUTOW P,et al. Enhancing the capacity of oncology nurses to provide supportive care for parents with advanced cancer. evaluation of an educational intervention [J]. Eur J Cancer,2009,45(10): 1798-806.\u003c/li\u003e\n\u003cli\u003e JOHANNSEN L M,FRERICHS W,PHILIPP R,et al. Effectiveness of a training programme for healthcare professionals on parental cancer: results of a randomised controlled pilot-study [J]. Psychooncology,2023,32(10): 1567-77.\u003c/li\u003e\n\u003cli\u003e FRERICHS W,GEERTZ W,JOHANNSEN L M,et al. Child- and family-specific communication skills trainings for healthcare professionals caring for families with parental cancer: a systematic review [J]. PLoS One,2022,17(11): e0277225.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"cancer patients, minor children, parenting worries, Scoping review","lastPublishedDoi":"10.21203/rs.3.rs-5584478/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5584478/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Parenting problems are prevalent in cancer patients, and breast cancer patients themselves are more prone to depression, anxiety, fear of illness and other negative emotions, and the role of motherhood requires female cancer patients to be treated while raising their children, and patients must balance managing their illness with caring for their minor children. Therefore, the group of young and middle-aged cancer deserves more attention from society, medical treatment, and nursing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives：\u003c/strong\u003eto summarise the influencing factors of rearing anxiety of young and middle-aged cancer patients with minor children.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDesign:\u003c/strong\u003eScoping review\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData sources:\u003c/strong\u003ethe scope review report framework of Arksey and O'Malley was used to search China Knowledge Network (CNKI),China Biomedical Literature Database (CBM),Wanfang database,PubMed,Web of Science, Embase and Cochrane Library From the establishment of the database to July 20,2024,the included literatures were screened and analysed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eA total of 13 articles were included. the results showed that the level of parenting anxiety of cancer patients at home and abroad was higher, which was mostly affected by personal characteristics, disease characteristics and psychosocial characteristics.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eCancer patients are affected by many factors in the process of disease and parenting,and face the challenge of parenting,which leads to a high level of parenting anxiety. Therefore,future medical workers should pay close attention to the parenting concerns of cancer patients and regard them as the core part of psychological care.\u003c/p\u003e","manuscriptTitle":"parenting concerns in cancer patients with minor children: a scoping review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-20 10:51:51","doi":"10.21203/rs.3.rs-5584478/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a7499d64-358a-4c30-b5c0-09d8395929ea","owner":[],"postedDate":"December 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-04-03T20:38:29+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-20 10:51:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5584478","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5584478","identity":"rs-5584478","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}