The Moderating Effect of Family Functioning on the Association Between Family Burden and Posttraumatic Stress Symptoms Among Parents of Children With Leukemia in Northwest China: A Cross-Sectional Study.

Abstract

Background: Parents of children with leukemia are at a high risk of developing posttraumatic stress symptoms (PTSS). Evidence suggests that family functioning, family burden, and PTSS are closely related, but there is a lack of exploration of the relationships between these three. This study aimed to analyze the current levels of PTSS among parents of children with leukemia in Xinjiang, China, and to explore whether family functioning moderates the association between family burden and PTSS. Method: A cross-sectional survey was conducted with 197 parents of children with leukemia from a tertiary hospital in Xinjiang, China. Participants completed a social demographic questionnaire, the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Index for measuring family functioning, the Family Burden Scale of Disease, and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). The PROCESS macro was performed to analyze the moderating effect of family functioning. Results: In our study, the prevalence of parental PTSS was 35.0%. Family burden had a significant positive effect on PTSS (β = .263, p < .001), and family functioning significantly moderated this relationship (β = -.634, p = .018). For the same family burden scores, the high family functioning group exhibited lower levels of PTSS compared with the low family functioning group. Discussion: Family functioning could mitigate the negative impact of family burden on PTSS among parents of children with leukemia. Health professionals should develop targeted family-centered care measures to ameliorate family functioning and decrease family burden, thus improving parents' mental health.