Coping Strategies Used by Both Parents of Children Currently Undergoing Cancer Treatment at The Philippine General Hospital

University of the Philippines Manila
College of Arts and Sciences

Department of Behavioral Sciences
Coping Strategies Used by Both Parents

of Children Currently Undergoing Cancer
Treatment at the Philippine General Hospital
An Undergraduate Thesis
Presented to
The Faculty of the Department of Behavioral Sciences
In Partial Fulfillment of the Requirements

for the Degree in Bachelor of Arts
Major in Behavioral Sciences
Presented by
Steve R. Arcilla
2007-68603
March 2011
UNIVERSITY OF THE PHILIPPINES MANILA

COLLEGE OF ARTS AND SCIENCES
Padre Faura, Ermita, Manila
APPROVAL SHEET
This thesis entitled Coping Strategies Used by Both Parents of Children

Currently Undergoing Cancer Treatment at the Philippine General Hospital,
prepared and submitted by Steve Rojano Arcilla, is hereby accepted and
approved in partial fulfillment of the requirements for the Degree of Bachelor of
Arts Major in Behavioral Sciences.
Professor Nymia P. Simbulan

Thesis Adviser
This undergraduate thesis has been accepted as partial fulfillment of the

course requirements for the Degree of Bachelor of Arts Major in Behavioral
Sciences.
Professor Leonardo R. Estacio, Jr.

Chairperson
Acknowledgements
To my family and friends

who showed their support,
To my respondents
who trusted and helped me out,
To my very supportive and patient thesis adviser,
Prof. Nymia P. Simbulan;

And to you who is sparing some time to read this,
THANK YOU.
ii
Table of Contents
Approval Sheet
Acknowledgements
ii
List of Tables and Figures
vi
Abstract
vii
Chapter I Introduction
General State of the Topic
Statement of the Problem
Objectives of the Study
Hypothesis of the Study
Significance of the Study
1
1
3
6
7
7
Chapter II Research Frameworks

Theoretical Framework
Conceptual Framework
Operational Framework
10
10
11
13
Chapter III Review of Related Literature

Psychological Distress among Parents
Socio-demographic Characteristics of Parents
and Their Level of Distress
Some Positive Responses by Parents
Coping Strategies Adapted by Parents
Social Support
Communication
Search for Meaning
Other Coping Strategies
Factors Influencing Adjustment or Adaptation
Characteristics of Children
Characteristics of Parents
Coping Resources and Strategies
Life Events and Other Stressors
15
15
16
18
18
19
19
20
21
22
23
24
25
27
iii
Chapter IV Methodology
Research Design
Reference & Source Population
Sampling Design
Instrumentation
Data Gathering Procedure
Ethical Consideration
Scope and Limitations
29
29
31
31
33
38
40
40
Chapter V Presentation of Results

Socio-Demographic Profile of Respondents/Parents
Socio-Demographic Profile of Children with Cancer
Results of the Coping Strategies Questionnaire
Coping Strategies of Parents in Relation to
their Socio-Demographic Profile
Results of Kessler Psychological Distress Scale (K10)
Results of K10 in Relation to the Coping Strategies Adapted
Key-Informant Interviews
Couple with the Highest Monthly Family Income
Couple with the Lowest Monthly Family Income
Single Father
Single Mother
42
42
44
46
53
Chapter VI Discussion of Results

Socio-Demographic Profile of Parents
Common Problems/Difficulties Experienced by Parents
Financial Problems
Occupational Problems
Social-Relational Problems
Emotional and Psychological Problems
Factors Associated with Type of Coping Strategies Adapted
by Parents
Sex of Parent
Age of Parent
Marital Status of Parent
Educational Attainment of Parent
Monthly Gamily Income
Effects of the Coping Strategies on the Parents
84
84
86
86
88
89
90
93
99
60
65
67
68
72
76
80
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102
103
104
105
107
iv
Chapter VII Summary, Conclusion, and Recommendations

Summary
Conclusion
Recommendations
Recommendations to Parents
Recommendations to Cancer Institutions
Recommendations to Future Researchers
110
110
113
114
114
114
115
Bibliography
116
Appendices
Grammarian Letter of Certification
English Cover Letter and Informed Consent Form
to Participate in the Survey
English Questionnaire
Filipino Cover Letter and Informed Consent Form
Filipino Questionnaire
English Interview Guide
Filipino Interview Guide
121
122
123
124
128
129
133
134
Biodata
ix
List of Tables and Figures

Tables
1 Socio-Demographic Profile of Parents
2 Socio-Demographic Profile of Children
3 Communicating with Medical Staff and Other Parents
4 Acquiring Social Support
5 Self-Isolation
6 Wishful Thinking
7 Seeking Spiritual Support
8 Self-blame
9 Being Optimistic About the Situation
10 Using Passive Appraisal
11 Positive Reframing
12 Substance Use
13 Coping Strategies in Relation to Sex
14 Coping Strategies in Relation to Age
15 Coping Strategies in Relation to Marital Status
16 Coping Strategies in Relation to Educational Attainment
17 Coping Strategies in Relation to Monthly Family Income
18 Item Scores on Kessler Psychological Distress Scale
19 K10 Scores in Relation to Coping Strategies
44
45
46
47
48
48
49
50
50
51
52
52
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57
58
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63
66
Figures
1 Conceptual Model of the Study
2 Total Scores of Parents on K10
11
65
vi
Abstract
Today, cancer continues to be one of the major chronic illnesses among

children. When a family is confronted with the diagnosis of childhood cancer,
various emotional reactions arise. The word cancer is associated with death,
and for most people cancer cannot be associated with children, especially for the
parents. It is said that for parents, having a child with cancer is both a
psychological and existential challenge that is very difficult to cope with. Hence,
this study focused on the assessment of the coping strategies of both parents, i.e.
the mother and father, of children currently undergoing cancer treatment at the
Philippine General Hospital (PGH).
The purpose of the study was to determine the different coping strategies
and resources that parents of children with cancer use in order to adapt or adjust
to their situation in a healthy and well-balanced manner. It also aimed to
determine the factors associated with the type of coping strategies that they
adapted, as well as to describe the common problems and difficulties
experienced by these parents with regard to their situation. A total of 83 parents,
including 42 mothers and 41 fathers, participated in the study.
The researcher used both quantitative and qualitative methods in
conducting the research. Using the Kessler Psychological Distress Scale (K10),
the depression and anxiety experienced by the respondents was determined, and
using the Coping Strategies Questionnaire, a survey questionnaire created by the
researcher, the different types of coping strategies adapted by the parents were
vii
identified. Likewise, the researcher conducted Key-Informant Interviews with six

of the 83 respondents to further investigate the coping behavior as well as the
quality of life of the parents after the diagnosis of their childs cancer. Finally,
both descriptive and inferential statistical analysis was performed by the
researcher to analyze the data gathered.
The results revealed that parents significantly used Seeking Spiritual
Support among the other coping strategies, with Substance Use as the least
adapted coping strategy. The remaining coping strategies were Being Optimistic
about the Situation, Communicating with Medical Staff and Other Parents,
Wishful Thinking, Acquiring Social Support, Positive Reframing, Using
Passive Appraisal, Self-blame, and Self-Isolation. Factors identified to have
influence over the type of coping strategies adapted by parents included sex, age,
marital status, educational attainment, and monthly family income. Furthermore,
results of the K10 showed that majority of the parents were likely to be well,
although a significant percentage was observed as likely to have moderate to
severe disorder.
Finally, it was also reported that those parents who adapted the positive
coping strategies were observed to have lower scores on K10, indicating that
they experience less psychological distress. Thus, the hypothesis of the study
stating that familiarity, as well as adequate and proper use, of the appropriate
coping strategies would help the parents cope or adapt with their childs cancer
in a healthy and well-balanced manner was accepted.
viii
CHAPTER I
Introduction
General State of the Topic

It is likely for children, starting from infancy to their childhood, to have
different health problems. For most children, these problems are mild and do not
interfere with their daily life as well as their development. However, those
children with chronic illnesses may have to suffer from their condition
throughout their childhood.
Today, one of the major chronic illnesses among children is cancer
(Hayman et al., 2002). It strikes randomly, unexpectedly, sparing no age group,
socio-economic status, ethnic group or geographic region. Children as young as a
few months, barely able to talk and walk, can already have cancer (Philippine
Information Agency, 2009). However, despite the major advances in treatment
and supportive care, cancer is still considered to be the leading cause of death
among children aged 14 and below (Philippine Cancer Society, 2007). Childhood
cancer survival rate in developed countries is as high as 95%. However, in the
Philippines, sadly, it is only 10 to 30% (International
Union Against Cancer,
2005). Also, according to the Philippine Information Agency (2009), about 3,500
Filipino children fall victim to cancer every year, and every day, eight children
die; one in every three hours. Cases of children diagnosed with cancer continue
to increase annually in our country, and with the diagnosis, comes the long,
ARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently

Undergoing Cancer Treatment at the Philippine General Hospital
stressful, and painful medical journey that the patient, together with his or her
family, is about to go through.
A childs health concerns the parents as well as the other members of the
family (Warsh & Strong-Boag, 2005). That is why if a child is diagnosed to have
cancer, each member of the family becomes a part of one of the hardest battles
they will ever encounter. The childs parents, however, are the ones greatly
affected by their son or daughters cancer diagnosis and treatment. It is said to be
one of the worst news that a parent could ever receive. The emotional impact of
the diagnosis of cancer is intense and long lasting for them (Hashemi et al.,
2007). It is a psychological and an existential challenge for both of the parents
(Norberg, 2004). Also, with the gender difference between the parents, the effect
on the mother tends to differ with that of the father when confronted with
problems like this. Reactions, as well as adaptation, to the situation differ
between the mother and the father of the child (Magni et al., 1986). But as
parents, both of them try to provide all the support that they can give to their
children as they fight through cancer, and if these parents are not given or do not
receive the sufficient social and spiritual support from other people and if they
do not use the proper coping strategies, they may then experience and suffer
from psychological distress and maladjustments and emotional problems as well
(Hashemi et al., 2007).
For parents, coping with all the physical and emotional demands or
stressors that come along with their childs condition is not a very easy thing to

do. However, with the proper or appropriate coping strategies, dealing with the
situation might be a little easier for them (Hashemi et al., 2007).
In order to identify these appropriate coping techniques, it is essential to
assess the coping strategies used by the parents of children with cancer as well
as how good they have adapted to the situation using these strategies. It could
provide the coping strategies used by those parents who have already adapted
well and can therefore be used as reference by other parents. Thus, this study
was done to assess the adaptation as well as the coping strategies used by
mothers and fathers of children with cancer. And since the Philippine General
Hospital holds one of the leading cancer institutions in our country, this study
was carried out within its facilities.
Statement of the Problem

Children are the most valued and vulnerable members of a family, and if
one of them falls ill with a serious, life-threatening disease like cancer, the entire
family is thrown in a state of shock (Fromer, 1995).
Cancer is a disease that takes a child's strength, destroys organs and
bones, and weakens the body's defenses against other illnesses (Barrett et al.,
2005). According to Cancer.Net (2010), childhood cancer has become the second
leading cause of death among children, with Leukemia as the most common type
of childhood cancer. Also, the International Union Against Cancer (2005) showed
that about 160,000 children worldwide are diagnosed with cancer annually and
an estimated 90,000 will eventually die of their disease. In the Philippines,
children comprise 4050% of the population, and the proportion of childhood

cancer patients represents 310% of the total (International Union Against
Cancer, 2005). According to the Philippine Information Agency (2009), 8 kids die
every day because of cancer in the National Capital Region (NCR) alone. Also,
according to Dr. Mae Conception Dolendo (2009), a pediatric oncologist at the
Davao Medical Center (DMC), there are about 80-100% new cases of childhood
cancer at DMC every year. And lastly, the data provided by the Philippine
Information Agency (2009) showed that about 3,500 children fall victim to
cancer every year. These figures show how the incidence of children diagnosed
with cancer is rapidly increasing in the country, and for the family, especially the
parents, of these young children, this diagnosis is a devastating blow that creates
an instant crisis to their lives.
For parents, having a child diagnosed with cancer is not just a medical
journey. For them, it is a very difficult and heart-wrenching emotional
experience. It is learning to cope with seeing their child suffer from so much pain
and leaving them with feelings of helplessness and unable to provide any
solutions to make their child feel better. Also, childhood cancer changes the life
situation of the family and brings about stressors to the parents of varying
duration, predictability, and impact (Norberg, 2004). Normal daily life of the
family stops. The current situation implies demands and changes from the
parents everyday life. These demands include accepting intensity of ones own
reactions as well as handling with the reactions of other people, seeing the child
in pain as they undergo and suffer multiple hospitalizations, chemotherapy, etc.,
concerns about the childs future, the quality of care, aspects of the cancer
treatment itself, negative employment and financial consequences, and

supporting siblings of the ill child (Norberg, 2004). All these demands and
stressors become a part of the parents daily life starting from their childs cancer
diagnosis and all throughout his or her treatment. And for parents, this is a lot to
ask.
Most parents do have a hard time moving on with their life after their
child has been diagnosed with cancer. When a child has to stay in the hospital for
a long period of time for his or her treatment, the uncertainty and
unpredictability of the current situation keep both parents in a continuous state
of anxiety, expectation, and fear, making these emotions hard to control and face
in a well-balanced manner (Barrett et al., 2005). According to the study of Kazak
et al. (2005), most parents find their childs treatment traumatic. Results of the
study showed that Posttraumatic Stress Symptoms (PTSS) do seem to be
common among parents of children currently undergoing cancer treatment. Out
of the sample parents, only one parent was reported not to have PTSS. This
shows that most parents really are having a hard time handling this kind of
situation properly which then leads to psychological and emotional problems or
maladjustments. However, with the proper amount of social and spiritual
support as well as the use of the appropriate coping strategies, parents may cope
with the situation in a healthy way. It is then important to know the appropriate
coping strategies that these parents should use.
Also, it should not be forgotten that this kind of situation affects the
mother and the father of the child differently. The gender of both parents shows
differences as to how they adjust and adapt to their childs cancer diagnosis
(Magni et al., 1986). Furthermore, considering the different socio-demographic
statuses of these parents, which also influence the coping strategies that they
adapt, such as socio-economic status, educational attainment, etc., also seems
important to the study.
Objectives of the Study

The main objective of this study is to determine the different coping
strategies and resources that parents, i.e. the mother and father, of children with
cancer use in order to adapt or adjust to the situation in a healthy and wellbalanced manner.
The specific objectives of this study are:
to describe the socio-demographic profile of parents of children

diagnosed with cancer,
to identify the common problems and difficulties, i.e. economic,

psychological-emotional, social-relational, etc. experienced by
parents of children diagnosed with cancer,
to describe the coping strategies adapted by mothers and fathers

of children with cancer,
to determine the factors associated with the type of coping

strategies adapted by parents, and

to determine the effects of these coping strategies on them as

parents.
Hypothesis of the Study

The study has the following hypotheses:
Ha: Familiarity, as well as adequate and proper use, of the

appropriate coping strategies would help the parents cope or
adapt with their childs cancer in a healthy and well-balanced
manner.
H0: Familiarity, as well as adequate and proper use, of the

appropriate coping strategies will have no effect on the parents
adaptation or adjustment to the situation.
Significance of the Study

The main focus of this study is the parents, including both the mother and
the father, of children diagnosed with cancer and are currently undergoing
treatment. These parents together with their family are facing one of the hardest
challenges in their life. They may be having the toughest time of their life. Also, as
presented by the Department of Health as well as the Philippine Information
Agency (2009), the number of children diagnosed with cancer in the Philippines
increases every year, which means that without the proper coping strategies, the
number of parents that may suffer from psychological and emotional problems
may increase as well. With all this in mind, it seems vital or important to identify
and provide these parents with the proper coping strategies that could help them
deal and cope with the situation in a more positive way.
Also, during the cancer treatment of the child, the parents ability to
manage or balance his or her psychological distress is vital not only to his or her
own consolation or comfort, but it can also influence the childs well-being and
his or her long-term psychological adjustment (Norberg, 2004). Therefore, this
study is not only significant for the parents well-being but is also beneficial to
the children diagnosed with cancer as well as the rest of the family members.
Since the Philippines is a third-world country, having a child in your
family diagnosed with cancer would already mean a big problem financially.
Parents in the family suffering from psychological distress could not afford to go
to a psychiatrist or get any professional help anymore. With this, it seems that
this study is not just significant but it seems practical as well. This study could
provide these parents the information to handle the situation better so as to
lessen any psychological and emotional problems.
Furthermore, this study may also be beneficial to the cancer institution
itself in planning services not just for the patient but also for the parents of the
patient. It may also highlight the areas of practice and administration in which
improvements can be made. This study may also help the institutions create the
necessary facilities to implement these coping strategies. And since coping is one
major concept in nursing, this study may also be significant for the nurses in
helping the parents of the patient adapt in their current situation supporting and
providing them with the proper information about coping. Moreover, this study
may also serve as a future reference for other researchers on the subject of
coping strategies of both parents of children with cancer.

CHAPTER II
Research Frameworks
Theoretical Framework
The Family Stress and Coping Theory is used as the framework of this
study. This theoretical foundation provides a broad base from which questions
are presented and responses are analyzed. The Family Stress and Coping Theory
assumes that individuals and families adapt to stress, and that they view
stressors and resources according to their own perception (McCubbin &
Patterson, 1985). It also assumes that their adaptation is affected by the
supposed stressors, the way the situation is perceived, and the resources or
coping strategies available to help deal with the stress.
The Family Stress and Coping Theory uses two models: Hills ABCX Model
(Hill, 1949) and the Double ABCX Model of Family Adaptation and Adjustment
(McCubbin & Patterson, 1985). The ABCX Model, which was designed to explain
the families responses or reactions to war separation and reunion, uses the
interaction of three factors to determine if the family experiences a crisis. These
factors include the stressor, the familys available resources in dealing with the
crisis, and their definition of the stressor event.
On the other hand, the Double ABCX Model of Family Adaptation and
Adjustment assumes that factors, both inside and outside the family, affect or
influence how well families adapt to a chronic stressor, such as chronic illness in
10
a child, and in this case, cancer. It also states that in understanding a familys
response to a stressful life event, the coping process, both cognitive and
behavioral strategies, is a key aspect. Coping strategies that individuals use have
also been categorized as problem-focused or those that moderate or control the
problem, or emotion-focused or those that reduce the emotional distress.
Conceptual Framework
Figure 1. Conceptual Model of the Study
According to the related literature of this study, a childs cancer diagnosis

can bring about various emotional and psychological distresses to the parents
(Magni et al., 1986). This could include depression, anxiety, stress, as well as
insomnia, sleep disturbances, and other somatic symptoms. With all the various
emotional and psychological distresses together with the different demands of
the situation, both parents tend to use the available or preferred coping
11
strategies and resources in order to cope with the situation. However, as

illustrated on Figure 1 above, the dependent variable (DV) of this study or the
coping strategies that parents adapt in coping with the situation is influenced or
is dependent on several factors concerning the parents themselves, which make
up the independent variables (IV) of this study. These factors are basically some
of the socio-demographic information about the parents. One good example of
these is their sex. Since there is an existing gender dimension as to how their
childs cancer diagnosis affects them, mothers and fathers tend to adjust and
adapt differently to the situation, which results to the different coping strategies
used by each parent (Morrow et al., 1984). Other factors involving parents
include their age, attitude towards the disease of their child, educational
attainment, economic status or income, and their family support.
However, another set of variables that may affect the relationship
between the independent and dependent variables of the study have also been
observed by the researcher. These variables, such as sex, age, number of
hospitalizations, and duration of treatment of the child with cancer, are
considered to be the confounding variables (CV) of the study. These factors,
according to the related literature of this study, may also influence the behavior
of parents as they cope with the situation; that is why it is important for the
researcher to control or to minimize the effects of these variables in order to
obtain the proper relationship between the independent and dependent
variables.

12
Taking into account all these factors, the mother and the father now adapt
to the situation using coping strategies that may either help them adjust or adapt
positively, or lead them to a negative adjustment or adaptation. According to the
related literature, some coping strategies really help these parents cope with the
situation in a well-balanced manner thus, helping them adjust or adapt positively
to the situation. However, according to Wittrock et al. (1994), there are also
some coping strategies that instead of helping the parents cope positively with
the situation; they actually increase the parents depression and anxiety. Because
of the lack of proper emotional and social support, some parents tend to use
undesirable coping mechanisms, like alcohol abuse, thus leading them to a
maladjustment or maladaptation.
Operational Framework
Childs cancer diagnosis children, aged 1-14 years, presently diagnosed

with any type of cancer and is being treated at the Philippine General
Hospital (PGH)
Parents sex refers to the biological characteristics that determines the

parents reproductive role (e.g. male or female)
Parents (Mother/Father) age refers to the number of years that the

parent have existed or lived
Parents (Mother/Father) civil status refers to the current marital status

of the parents (e.g. single, married, divorced, etc.)

13
Parents (Mother/Father) socio-economic status refers to the

employment, income, as well as the social status in the community of the
parent
Parents (Mother/Father) educational attainment refers to the level of

education that the parent have achieved (e.g. primary, secondary, etc.)
Childs age refers to the number of years that the child diagnosed with
cancer have existed or lived
Childs sex refers to the biological characteristics that determines the

childs reproductive role
Number of hospitalizations refers to the number of times the child

diagnosed with cancer was hospitalized due to his/her illness
Duration of treatment refers to the length of time the child diagnosed

with cancer has been undergoing treatment
Coping strategies of parents refers to the different available or preferred

coping techniques or styles that the parents use as a response to their
childs cancer diagnosis
Positive adjustment a well-balanced psychological and emotional

adjustment or adaptation of parents to the demands and stress brought
about by the childs cancer diagnosis
Negative adjustment when parents engage in processes leading to poor

or negative adaptation or those that has become harmful than helpful

14
CHAPTER III
Review of Related Literature
Psychological Distress among Parents

In a family, the children are the most cherished and vulnerable, and when
cancer strikes among them, various emotional reactions from the family will take
place. According to the studies of Dahlquist et al. (1993), and Magni et al. (1986),
most parents of children diagnosed with cancer, or children who are in
treatment, showed increased signs of psychological and emotional distress as
compared to the normative data of the studies. Also, in some longitudinal studies
(Fife et al., 1987; Sawyer et al., 1993), results showed that even months after the
diagnosis, parents still suffer from psychological distress such as anxiety,
depression, insomnia, as well as somatic symptoms. Feelings of depression as
well as sleep disturbances were reported among parents even after 8 months
since the diagnosis of their children (Magni et al., 1986), and according to
Sawyers et al. (1993) study, depression and somatic symptoms are still higher
one year after the diagnosis. Lastly, Powazek et al. (1980) reported that families,
one year after the diagnosis, still suffer from high levels of stress.
Other studies concerning parents with children undergoing active cancer
treatment also reported psychological distress among the parents (Larson et al.,
1994; Brown et al., 1993). Psychiatric disorders were diagnosed among 34% of
the mothers of children with cancer during the different phases of their childs
treatment (Brown et al., 1993). Also, results of the Beck Depression Inventory
15
(BDI) showed that the mothers diagnosed with psychiatric disorder got higher
scores on depression than those who were not diagnosed with any psychiatric
disorder.
Studies by Morrow et al. (1984) and Brown et al. (1993), also analyzed
parents of those children that were off treatment. Morrow et al. (1984) reported
these parents having the lowest scores on a scale measuring the psychological
adjustment to the illness. Brown et al. (1993) also found out that mothers of
children who were off treatment had significantly lower depression scores
compared to the mothers of children newly diagnosed with cancer, and mothers
of children one year after diagnosis.
For those parents with children that have survived cancer, emotional
disturbances were lesser compared to the normative data (Kazak et al., 1994).
However, Kazak et al. (1994) also reported that if the illness-related concerns of
the children of these parents will be taken into consideration, these parents still
seem to experience posttraumatic symptoms, feelings of uncertainty, and fear for
relapses. Worries about infertility, and uncertainties about the future are also
very common (Leventhal-Belfer et al., 1993).
Socio-demographic Characteristics of Parents and Their Level of Distress
Some of the socio-demographic characteristics of those parents of
children with cancer have been observed as factors in the difference in the levels
of distress that they experience. One major example of this is the sex of the
parent. Difference between the psychological distress experienced by the
mothers and the fathers of children diagnosed with cancer have been recorded in
16
some studies; for example, in a study made by Sloper (1998), 51% of mothers
were observed with high levels of distress, while only around 40% of fathers
displayed the same levels of distress.
She also reported that predictors of
distress for mothers differ with that of the father. For mothers, their appraisal of
the strain of the illness, their own ability to deal with it, and family cohesion
were the significant predictors of distress while for the fathers, predictors of
distress included the risk factors of employment problems, and the number of
the child's hospital admissions (Sloper, 1998). Furthermore, a study by Brown et
al. (1993) showed that a year after the diagnosis, the emotional problems
experienced by mothers and fathers differ as well. Results of the study showed
that a high percentage of mothers were diagnosed as overanxious while fathers,
on the other hand, were diagnosed with major depression or increased feelings
of depression.
Another socio-demographic characteristic of parents that affects the
psychological distress that they experience is their socio-economic status (SES).
Parents with a low SES, or lower income, are said to have greater risks of having
psychological and emotional problems (Van Dongen-Melman et al., 1995).
Mothers with lower SES are also said to suffer from increased maladjustments
compared to those with higher SES.
Age and civil status are also considered to be factors affecting the parents
psychological distress. As Morrow et al. (1984) reported, younger parents had
significant greater psycho-social adjustment difficulties, while those parents that

17
were married tended to have moderately lower levels of depression and anxiety
than those who were currently not married.
Some Positive Responses by Parents
On another note, some positive responses are also reported by parents as
a result of their childs illness. These include their good support systems,
increased closeness within the family, strengthened marital relationships, and
new values and attitudes in life, as well as reports on how they value life more
(Peck et al., 1979). This shows that even this kind of event can still bring about
positive reactions in a family. Having said this, however, we cannot deny the
hardship brought about by the childs condition to their parents. This is where
appropriate coping strategies become significant and helpful.

Most of the studies related to this research have used similar scales or
questionnaires in measuring or assessing the coping strategies used in coping
with the cancer diagnosis among children. Three scales were used in more than
one study, and these are Social Support Questionnaire (SSQ), The Coping Health
Inventory for Parents (CHIP), and the Ways of Coping Scale and its adapted
version, the Coping Strategy Inventory (CSI). Different conceptualizations of
coping strategies such as positive and negative type of coping, disengagement
and engagement coping, and emotion and problem focused coping have been
identified from the different studies using these scales. Common coping
strategies observed in studies were social support (Morrow et al., 1984),
18
communication (Brown et al., 1993), and search for meaning (Bearison et al.,
1993).
Social Support
Social support refers to the emotional and physical comfort given to an
individual to help him or her cope with stress (Overholser and Fritz, 1990). A
study by Morrow et al. (1984) showed that support from family and friends of
parents have been very helpful to them. They reported that support from the
medical community as well as the other parents in the help group were
recognized by the parents as the most efficient sources of support. Also,
according to the study of Larson et al. (1994), among the parents, the mothers
are the ones that use social support more often. They reported that mothers of
children with cancer and even those of healthy controls receive more overall
informational as well as emotional support than did fathers. They also added that
mothers appeared to have more contact with their relatives and friends than
fathers do.
Communication
Communication also plays a vital role in the parents coping.
Communication here does not only refer to communication between the parents
and the child about the illness but it also refers to the communication between
the parents and their family and friends about their emotional experiences
(Leventhal-Belfer et al., 1993). Also, according to Brown et al. (1993),
understanding of the childs medical condition through communication with the
other parents going through the same situation as well as communication with
19
the medical staff that are a part or helps with the treatment of the child are also
seen by other parents as a good coping strategy. They reported that a good
relationship with the medical team is important for parents of children with
cancer. Parents try to build their trust on them as their childrens lives mostly
depend on their treatment.
Magnis et al. (1986) study also reported that
parents of children with cancer gave more importance to their relationship with
their childrens medical team than the parents of children with other conditions.
In addition, Shapiro and Shumaker (1987), found that compared to the
fathers, mothers of children with cancer tend to have more open and more
frequent communication with their sick child. They also found that those parents
who were less well-educated and those that use passive coping tend to have
better relationships with the medical staff. Because parents can acquire
information and get support with their communication with other parents and
the medical staff, communication and support were seen as related to one
another (Brown et al. 1993).
Search for Meaning
Another common coping mechanism observed on parents of children
with cancer was searching for meaning. Bearison et al., (1993) stated that in
times of traumatic events, people try to search for the reason on why and how
the event occurred in order to understand and make sense about it and thus,
cope with it emotionally and gain some sense of control. They, however, found
that most of the parents resort in internal types of attributions and especially
self-blame in their search for meaning of their childs condition. In the study, it
20
was observed that mothers blamed themselves for their childs illness more
often. Fathers, on the other hand, often tend to accept that there was no reason
for the childs illness (Bearison et al., 1993).
Other attributions such as
environmental factors as the cause of their childs illness were also observed in
their study.
Other Coping Strategies
Other coping strategies used more often by parents of children diagnosed
with cancer have also been mentioned or identified in some related literature.
This includes withdrawal (Fife et al., 1987), and wishful thinking, (Sawyer et al.,
1993). Petermann et al. (1986) also identified praying and religion as a coping
strategy. They found in their study that the fathers were the ones who most often
used praying as a coping strategy.
Other studies reported about coping strategies in terms of emotion or
problem-focused type of coping (Wittrock et al., 1994). Wittrock et al. (1994), for
example, identified five emotion-focused coping strategies, such as maintaining
emotional balance, relying on religion, being optimistic, denial and acceptance,
and three problem-focused coping strategies such as information seeking,
problem solving and help seeking. However, no correlations were found in using
these eight coping strategies.
Furthermore, Grootenhuis et al. (1996) also identified different types of
control strategies as the parents means of coping with childhood cancer. These
control strategies included predictive, vicarious, illusory and interpretative
control. Grootenhuis et al. (1996) reported that mothers tend to depend more on
21
interpretative and illusory control than fathers do. They also found that parents
of children in remission relied more on vicarious and predictive control than
those parents of children with a relapse.
Wishful thinking and attribution of special characteristics to the child
with cancer by their parents were also considered and investigated as a coping
strategy by Grootenhuis et al. (1996). This attribution of positive characteristics
to the child provides the parents with an image of their child as being special and
vital, which leads them to develop or create the illusion that fate will be kind to
them. Also, with the parents believing that their child is strong and can handle
the situation, their confidence that their child will survive increases (Grootenhuis
et al. 1996).
Factors Influencing Adjustment or Adaptation

These coping strategies may be helpful for some parents regarding their
adaptation and adjustment to the situation. However, there are still other factors
that may influence how well they adapt to their childs condition. According to
some studies, factors like the characteristics of the child with cancer (Van
Dongen-Melman et al., 1995), characteristics of the parents (Magni et al. 1986),
the kind of coping strategies these parents use (Morrow et al. 1984), and other
life events and stressors (Kalnins et al. 1980) all contribute or influence the
adjustment or coping of parents with children diagnosed with cancer.

22
Characteristics of Children
Some child-related factors have been reported to have affected the
parents adaptation and adjustment (Van Dongen-Melman et al., 1995). These
factors were reported to cause more emotional and psychological problems to
the parents. These include the number of hospitalizations of the child, and the
childs functional impairment. These factors are said to have caused more
depression among mothers as well as increased problems in both parents (Van
Dongen-Melman et al., 1995). Also, a lesser survival perspective of the child,
which is indicated by a relapse or second malignancy, was associated to more
emotional problems in both parents (Van Dongen-Melman et al., 1995).
Furthermore, the duration of the childs treatment was found to have a positive
correlation with maternal posttraumatic stress symptoms by Stuber et al.
(1994).
Other child-related factors like the age and sex of the child diagnosed with
cancer have also been reported to influence the parents adjustment. Kupst et al.
(1995), found that there is a relation between the parents adjustment to their
childrens age. According to the results of the study, parents with younger
children had difficulty coping than those parents with older children. Brown et
al. (1993), on the other hand, reported that parents, especially the mothers, with
male children diagnosed with cancer have shown higher levels of depression and
view their sons cancer diagnosis as having greater impact on them.
Lastly, Mulhern et al. (1992) also investigated the emotional reactions of
the children with cancer as a factor influencing the parents adaptation to the
23
situation. They reported that children showing higher levels of depression cause
depressive symptoms among mothers. They also found that the childrens
behavior problems as well as their difficulties in adjusting to their illness were
predictors for the mothers adjustment problems.
Characteristics of Parents
Factors involving the parents themselves were also seen to have
influenced their adjustment and adaptation. Of the parent-related factors, gender
is considered to be one of the most significant and has received the most
attention. According to the study of Magni et al. (1986), sex differences among
parents also show variances in adjustment and adaptation to the childs cancer
diagnosis. They reported that there is an increasing evidence of differences in the
levels of depression and anxiety for mothers and fathers. Also, according to their
study, fathers reactions to the situation differ in several ways. It was described
that fathers tend to have increased drinking and avoiding discussion of the
subject. Lastly, Magni et al. (1986) also reported that these differences may be
caused by the fathers tendency to deny or their failure to report the actual
distress that they are experiencing, and that this does not necessarily mean that
fathers experiences less distress.
Other factors affecting the parents adjustment to childhood cancer
include some of their socio-demographic background such as their age, civil
status, and socio-economic status. In a study made by Van Dongen-Melman et al.
(1995), the significance of the socio-economic status of the parents in their
adjustment to the situation was investigated. They have observed that parents
24
with lower income or low socio-economic status have higher risks of having
problems. They also found that those mothers with lower socio-economic status
adapted higher degrees of emotion-focused coping, which unfortunately was
associated with increased maladjustments. In addition to that, compared to those
parents in the study with higher socio-economic status, those parents with lower
socio-economic status were observed to have more self-criticism as well as selfblame (Van Dongen-Melman et al. 1995).
Furthermore, Morrow et al. (1984) reported in their study that younger
parents, or those below the age of 30, had more difficulty coping or adjusting
than those older parents. They also suggested in their study that being married is
another factor influencing parents adjustment. They reported that parents
currently married had lesser emotional or psychological distress than those who
were not married.
Coping Resources and Strategies
Also, as mentioned earlier, the coping resources and the kind of coping
strategies that the parents use also affect the parents coping with the situation.
Coping strategies play a vital role on the parents adjustment and parents use
different or various coping strategies. One of the coping resources that really
helped the parents was the social support that they received. According to
Morrow et al. (1984), support from friends and relatives are really helpful for
parents of children with cancer to cope better with their situation especially
after diagnosis and during treatment. Sex differences were also visible in the use
of social support as a coping strategy. According to study of Larson et al. (1994),
25
for both parents, social support was observed to be inversely related to anxiety
and depression, but it also appeared that mothers placed greater importance on
social support than the fathers.
Another example of coping strategy is communication. Brown et al.
(1993) reported that open and frequent disease-specific communication
between the parents and the medical staff, as well as communication between
the mother and the father were found to be positively correlated with good
adjustment as well as marital quality.
Other coping strategies that seem to be related to a positive adjustment
were also identified by Bearison et al., (1993). They included external types of
attributions and acceptance of the physicians advice that the cause was
unknown. These coping strategies are under the idea suggested by Bearison et
al., (1993) about searching for meaning in a traumatic event like this. They also
found that those parents who understand their childrens medical condition
better experience less distress. Furthermore, Petermann et al. (1986) have also
identified five coping techniques and reported that families tend to be more
stable and stress-resistant if they see their childs disease as a challenge.
According to their study, having a positive outlook about the childs disease will
bring about positive adjustment as well.
However, there are also some particular coping strategies which were
found to have caused maladjustments increasing the parents depression and
anxiety. These were found by Wittrock et al. (1994) to be disengaged coping and
emotion-focused coping styles.
26
In a study, however, made by Baskin et al. (1983), no relations between

coping strategies and adjustment or adaptation were reported. They stated that,
although parents experience high level of stress and say that they are coping
well, no correlations were found between coping strategies and adjustment.
They also reported that problem-focused coping and communication have no
relation whatsoever to adjustment.
Life Events and Other Stressors
The factors mentioned above all affect or contribute as to how well the
parents will cope with their childs condition. However, there are also other life
events or stressors that still continue to occur with the parents lives. As these
parents continue to face the demands brought about by their childrens
condition, most of them also continue dealing with other life events or
concurrent stressors. This was observed in the study made by Kalnins et al. in
1980. Kalnins et al. (1980) classified these problems as illness in other family
members, other major complications related to the childs illness, death of
another befriended child with cancer or other significant person, changes in their
occupation, and financial problems. According to Kalnins et al. (1980), financial
problems have the greatest impact on families. Overholser and Fritz (1990) also
found that financial problems experienced by parents were related to setbacks in
the mothers occupation or career. They also found that the mothers were the
ones who suffered setbacks in their occupation more often compared to the
fathers.

27
Furthermore, Brown et al. (1993) found that compared to those parents

with physically healthy children, parents of children with cancer encounter more
stressful life events. They also found that parents of children newly diagnosed
with cancer experience greater familial stressors. Moreover, it was found by
Kupst et al. (1995) that those parents who experience less additional life events
or stressors experience better adjustment or coping.

28
CHAPTER IV
Methodology
Research Design
In this study, the researcher decided to use both quantitative and
qualitative designs. The quantitative part of the study was covered or provided
by the data collected after letting the participants of the study answer two
questionnaires, one of which is the Kessler Psychological Distress Scale, also
known as K10, and the other is the Coping Strategies Questionnaire, a survey
questionnaire created by the researcher so as to obtain the specific and
necessary data needed for the study. The questionnaire created by the
researcher was used to determine the coping strategies that the participants use
in relation to their current situation. The K10, on the other hand, was used to
determine the levels of psychological distress that they experience as an effect of
the situation.
Socio-demographic information about the participants, such as age, sex,
educational attainment, etc., was also obtained by the researcher. Also, as
observed in the related literature of the study, some information regarding the
child, such as their age, sex, number of hospitalizations, duration of treatment,
etc., also affects the parents adjustment and adaptation; that is why the
researcher has also decided to obtain the necessary information about the child
diagnosed with cancer.

29
Furthermore, correlations between all the observed factors affecting the

adaptation and adjustment of the participants, and the observed type of coping
and adjustment that the participants display were also provided by the
researcher as part of the quantitative data. To determine whether there is a
statistically significant association (represented by the P-value) between the
variables, the researcher applied the statistical tests such as the Independent
Samples T-Test, and One-way ANOVA on the data. Furthermore, a P-value of less
than 0.05 was considered significant.
On the other hand, the qualitative part of this study included KeyInformant Interviews. These interviews were conducted in order to obtain other
information that may not have been covered by the quantitative part of the
study. They were also used to describe the quality of life of the parents after the
diagnosis of their childs cancer. Through these interviews the researcher has
obtained more candid and in-depth answers from the respondents regarding
their situation. Furthermore, with the help of the selected key-informants, the
researcher has assessed further the coping behavior of parents of children with
cancer.
The researcher has chosen both quantitative and qualitative designs in
order to have both the quantitative and qualitative data that are essential to this
study. The quantitative design is important in this study as it creates a statistical
model in an attempt to assess and explain the coping strategies used by the
participants. This design may also provide a precise measurement and analysis
of the levels of stress that the participants experience in relation to the coping
30
strategies that they adapt. The qualitative design, on the other hand, was also
chosen by the researcher so as to create a deeper analysis or understanding of
the participants current situation. Also, according to Gilgun (1992), the amount,
richness and depth of data acquired by the very nature of qualitative designs
help to fill in existing gaps in research through a focus on experiences within as
well as between families and outside systems.
Reference & Source Population

The participants of this study included the parents, both the mother and
father of children diagnosed with cancer who are currently being treated at the
Philippine General Hospital. The researcher also chose this specific setting where
the sample participants were obtained because of the fact that the PGH houses
one of the leading cancer institutions in the Philippines and also because PGH
offers a very cheap treatment, which means that people from different places
from the country tend to go here and get their treatment. Having said this, it
seems that the researcher has obtained or gathered respondents from a wide
range of participants, which somehow helped enrich the data of the research.
Sampling Design
The study employed a purposive sampling technique. Purposive sampling
is based on the assumption that one wants to discover, understand, gain insight;
therefore one needs to select a sample from which one can learn the most
(Merriam, 1988).
31
Purposive sampling is also criterion-based and the criteria used for the
selection of the participants are that their sons or daughters diagnosed with
cancer should be at the age of 18 years or below. Their son or daughter should
also be currently undergoing cancer treatment at the PGH and should be under
the supervision of an oncologist. No age limit was set for the participants.
With this, a total of 83 respondents participated in the study. This number
or sample size should be enough to represent the total population of parents of
children with cancer at the PGH.
With regard to the Key-Informant Interviews, the researcher decided to
have the couple with the highest monthly income, the couple with the lowest
monthly income, a single mother, and a single father among the respondents as
the key-informants of the study. Since according to the related literature, the
socio-economic status of parents is considered to be one of the major factors
influencing them as to what type of coping strategies they adapt with regard to
the situation, the researcher chose the couples with the highest and lowest
monthly income as key-informants. Also, the researcher chose a single mother
and father as key-informants because according again to the related literature,
marital status and sex also greatly affects the coping mechanisms of parents.
Furthermore, the researcher believed that these people are enough to represent
the respondents of the study and provide the necessary and significant
additional information about the topic.

32
Instrumentation
After getting the appropriate sample for the study, quantitative and
qualitative data was then gathered from the participants using the selected
instruments of the researcher. The instruments used in this study included
Coping Strategies Questionnaire, a questionnaire created by the researcher,
which covered the coping strategies used by the parents, the Kessler
Psychological Distress Scale (K10), a psychological screening tool which
determined the levels of psychological distress experienced by the parents in the
past month prior to taking the test, and an open-ended, semi-structured
interview guide, which was used by the researcher to further assess the coping
behavior of the participants in the Key-Informant Interviews conducted.
The researcher also provided a demographic sheet that the participants
filled out with socio-demographic information, as well as other information that
was needed for the study, about themselves and their child, who was diagnosed
with cancer. The socio-demographic information gathered included the parents
name, age, gender, religion, occupation, monthly family income, educational
attainment, civil status, and number of children, as well as the childs name, age,
gender, and birth order. Other information about the childs illness included the
hospitalization times, duration of stay in the hospital, and the duration when
their child was diagnosed with cancer. All these information were seen by the
researcher, as well as some of the related literature of this study, to be significant
variables affecting both the mother and the fathers coping mechanism.

33
After that, the participants proceed to the Kessler Psychological Distress

Scale (K10). The K10 is a brief, simple, valid, and reliable screening tool
developed in 1992 by Professors Ron Kessler and Dan Mroczek that measures
non-specific psychological distress in the anxiety-depression spectrum (Kessler
et al., 1994). It has been widely used in researches and in population health
surveys in United States, Australia, as well as in other countries. It has also been
included in the WHO World Mental Health surveys, which are being carried out
in 30 countries around the world. Also, several translated versions of the K10,
including Arabic, Chinese, German, Dutch, Italian, Japanese, and other languages,
have already been developed. For this study, the K10 will also be translated into
Filipino by the researcher in order to get more accurate results from the Filipino
participants.
The Kessler Psychological Distress Scale consists of 10 questions about
non-specific psychological distress that seeks to determine the level of current
symptoms of depression and anxiety that a person may have experienced in the
past four weeks prior to the interview (Kessler et al., 1994). Items of the scale
cover different emotional states like feeling nervous, hopeless, restless or fidgety,
depressed, and worthless. It is a self-administered tool wherein a person
responds using a five-level response scale based on the amount of time that the
person reports experiencing the particular problem in each item. The response
categories for each of the items include: none of the time, a little of the time,
some of the time, most of the time, and all of the time. Some examples of the
items in the K10 are: 1) In the past 4 weeks, about how often did you feel tired out
for no good reason; 2) In the past 4 weeks, about how often did you feel nervous;
34
and 3) In the past 4 weeks, about how often did you feel so nervous that nothing
could calm you down. Completing the questionnaire may only take about 2-3
minutes.
As stated, the main function of K10 is to determine the level of current
psychological distress experienced by an individual. With regard to the
objectives of this study, this instrument is a good tool in collecting data regarding
the severity of psychological distress that the parents of children with cancer
experience as a result of their childs illness. Also, reliability tests on the K10
resulted values of the kappa and weighted kappa scores that ranged from 0.42 to
0.74 which indicates that K10 is a moderately reliable instrument.
Upon completing the K10, participants proceed to the Coping Strategies
Questionnaire created by the researcher which gathered data about the coping
strategies that they use as they adapt to the situation of being the parents of
children diagnosed with cancer. The questionnaire consisted of 30 statements or
phrases that will describe their reaction, behavior, or attitude in response to
their childs cancer diagnosis. It is self-administered and may take the
respondents 5-10 minutes to complete. The prefix for all the statement or phrase
in each item is, When my child was diagnosed with cancer I started, and each
item is rated by the participants based on how well each statement or phrase
describes their reaction, behavior, or attitude. Using a five-point Likert scale, the
participants choose from a range of 1-5, where 1 is Strongly Disagree and 5
means Strongly Agree.

35
The aim of this questionnaire is to determine which coping strategies that

the sample participants use. The researcher used ten types of coping strategies
as the scales of this questionnaire, with each scale represented by three items.
The researcher chose the ten coping strategies based on the related literature of
this study, as well as on some of the questionnaires that were used in most of the
related studies such as the Social Support Questionnaire (SSQ), The Coping
Health Inventory for Parents (CHIP), and the Ways of Coping Scale and its
adapted version, the Coping Strategy Inventory (CSI). Some of the items in this
questionnaire are also just revised versions of the ones found on the
questionnaires mentioned, while some were created by the researcher himself.
The coping strategies used by the researcher included Communicating with
Medical Staff and Other Parents (items 9, 3, 26), Acquiring Social Support (items
29, 14, 4), Wishful Thinking (11, 17, 1), Seeking Spiritual Support (items 5, 24,
18), Being Optimistic about the Situation (items 10, 28, 15), Using Passive
Appraisal (items 8, 22, 30), Substance Use (items 19, 6, 27), Self-blame (16, 12,
23), Positive Reframing (items 20, 2, 13), and Self-isolation (Items 7, 21, 25).
Some example of the items in the questionnaire are: 1) Hoping a miracle will
happen; 2) Trying to see my childs illness in a different light, to make it seem more
positive; and 3) Talking with the medical staff (nurses, social worker, etc.) about
my childs illness when we visit the medical center. Furthermore, after pretesting
the questionnaire, reliability of the scales of the questionnaire ranged from 0.692
to 0.831, which basically indicates that the instrument was relatively reliable.

36
The last instrument used in this study was the in-depth, semi-structured
interview guide for the Key-Informant Interviews, which provided the
qualitative data needed in this research. This interview guide, which took about
20-30 minutes, was used to determine the quality of life of these parents and
their family (through the help of the selected key-informants) as they go through
their situation in life. It consists of 10 open-ended questions about how the
childs cancer diagnosis affected their lives, about the problems and difficulties
that they have experienced, and about how they manage to cope with their
situation. The first and second questions were about their initial reactions when
their child was diagnosed with cancer, and the difficulty of accepting the
diagnosis. The third, fourth, and fifth questions, however, tackled concerns about
how the childs cancer diagnosis changed or impacted their lives as parents, as
well as the different problems and difficulties it brought to them. The fourth
question determines the effects of childs cancer diagnosis on more specific
aspects of the parents lives like their psychological-emotional health,
economical status, social relationships, etc. The sixth, seventh, and eighth
questions, on the other hand, were about the coping behavior that they adapt in
relation to their current situation. The ninth question asked the parents to
describe their current condition in relation to their childs illness, and lastly, the
tenth question was about the positive effect that might have been brought about
by the situation. Furthermore this interview guide was used by the researcher to
strengthen or support, as well as to fill the gaps of the data gathered in the
quantitative part of the study.

37
Data Gathering Procedure

The following instruments that were used in this study as mentioned
above have all been administered at the Philippine General Hospital itself. The
administration of tests, as well as the Key-Informant Interviews, was done in
certain length of time so as to achieve the desired number of participants as the
parents of children with cancer come and go to the cancer institute for their
treatment.
The quantitative data was first gathered by providing self-administered
questionnaires to the selected participants. The participants were first asked to
read a letter asking for their consent to participate in the study. This letter also
contained information about the whole process of the study such as the tests that
they have to undergo. If they agree to take part in the study, the participants
were given a pen and a copy of the questionnaire. First, participants complete the
socio-demographic information asked from them; this is basically the first part of
the questionnaire. After that, they proceed to answering the Kessler
Psychological Distress Scale (K10), which makes up the second part of the
questionnaire. Lastly, the participants complete the Coping Strategies
Questionnaire created by the researcher. While the participants were answering
the questionnaires, the researcher leaves the participants alone so as not to
affect or influence their answers. After a few minutes or so, the researcher
returns to the participant to see if he/she has already finished answering the
questionnaire.

38
In scoring the K10, a mark or a score of 1 was given to any question

answered with none of the time, a mark of 2 was given to any question answered
with a little of the time, and so on up to 5 for questions answered with all of the
time. The researcher then got the sum of the scores given by the respondents in
all 10 items to get the total score, which may yield a minimum score of 10 and a
maximum score of 50.
Generally, low scores on K10 indicate low levels of psychological distress
and high scores indicate high levels of psychological distress. However, more
specific interpretations of scores were also done using a set of cut-off scores
provided by the instrument. People who got a score under 20 were likely to be
well, those who score 20-24 were likely to have a mild mental disorder, those
who score 25-29 were likely to have a moderate mental disorder, and people
who score over 30 were likely to have a severe mental disorder.
On the other hand, the questionnaire created by the researcher, which
took the participants about 5-10 minutes to complete, was scored by the
researcher by simply getting the sum of the item scores for each scale. High
scores on some certain scale indicate the more frequent use of that specific
coping strategy.
After gathering all the data from the quantitative part of the study, the
researcher then selected the key-informants for the Key-Informant Interviews
from the respondents. The researcher contacted these people and conducted the
interviews on the date and place agreed upon by the researcher and the key-

39
informant. Interviews were also taped or recorded for more accurate

transcription.
Ethical Consideration
Prior to participating in the study, the participants were asked to read a
letter asking for their informed consent. No participant was forced to partake in
the study. All necessary information about the study, as well as the questionnaire
that the participants have to complete, was also be discussed by the researcher
to the participant beforehand. Also, as mentioned on the letter, information that
were given out by the participants were handled with great confidentiality and
were only used to achieve the objectives of the study that the researcher hopes
to somehow benefit them in return.
Scope and Limitations

This study focused on the assessment of coping strategies of the parents
of children with cancer that are currently undergoing treatment at the Philippine
General Hospital including how well they have adapted or adjusted
psychologically and emotionally to the situation using these strategies. It covered
and provided information about the importance of the coping strategies in
dealing and coping with this kind of situation. The study, however, was only
limited to the parents of the patient. It did not include other members of the
family. It was also restricted to those parents of children diagnosed with cancer
and are currently undergoing treatment. It did not include those parents of
40
children who have already survived cancer. It did not also deal with the effects of
the childs illness on the marital relationship of the parents. Furthermore, the
data of the study were limited only to the information that the respondents from
the selected institution, which is the PGH, have provided based on the
questionnaire and interview, as well as the data and information from the
related literature that were cited and reviewed.

41
CHAPTER V
Presentation of Results
Socio-Demographic Profile of Respondents/Parents

A total of 83 parents participated in the study. As Table 1 below shows,
the sex distribution of the participants is closely even with 41 fathers (49%) and
42 mothers (50%). This is basically because most of the respondents are married
couples giving an even distribution of mothers and fathers. The age profile of the
parents showed that most of them are middle-aged adults. As presented, the
largest proportion of the respondents is in the 30-39 age category, which
comprises 37% of the respondents. Next to it is the 40-49 age category with 35%
of the respondents. Lastly, parents who belonged to the older age group of 50
and above only consisted of 9%.
Also, as mentioned earlier, majority of the parents who participated are
married couples. As presented below (Table 1), among the 83 parents who
participated, there were a total of 33 married couples, which comprises 80% of
the total respondents. The remaining parents were single, divorced, or widowed.
Overall, there were 33 couples, 5 single fathers, 2 widowed fathers, 1 divorced
father, 5 single mothers, 3 widowed mothers, and 1 divorced mother.
Regarding the parents educational background, as shown on the table,
only 41% of the participants have reached college or the tertiary level of
education, while more than half of the participants (52%) only reached the
42
secondary level (high school). The remaining 7%, on the other hand, have
reached only the primary or the elementary level. In addition, none of the
parents who participated was illiterate. Also, a total of 39 parents (47%) are
employed with only one parent (1%) unemployed. However, since majority of
the respondents are married couples, almost all of these employed parents are
fathers being the chief provider for the family. This explains the large number of
housewives in the respondents, which comprises 34% of the total respondents.
Occupations of those employed include government employee, police officer,
teacher, saleslady, driver, laborer, etc. Furthermore, as shown below, more than
half of the respondents (57%) are earning only about P5, 000-P9, 999 every
month. Only 26% of the respondents are earning P10, 000-P14, 999 monthly,
while 17% are earning less than P5, 000 every month. This just shows that most
of the families who go to PGH for the cancer treatment of a child in the family are
not really that well-off.
With regard to the parents religion, as presented below, a total of 86%
were Roman Catholic with the remaining 14% divided into Christian (1%),
Iglesia ni Cristo (6%), Muslim (1%), Ang Dating Daan (3%), Methodist (1%), and
Seventh-Day Adventist (2%). Obviously, large majority of the participants are
Roman Catholic since it is the dominant religion in the country.
Lastly, majority of the parents (37%) have three children, while about
23% have two children. Furthermore, 13% of the parents have only one child
and a total of 17% have five or more children.

43
Table 1. Socio-Demographic Profile of Parents (N=83)

Characteristics
Sex
Age
Marital Status
Educational Attainment
Occupational Status
Monthly Family Income

Religion
No. of Children
Male (Father)
Female (Mother)
20-29 Years
30-39 Years
40-49 Years
50 Years
Single
Married
Divorced
Widowed
Elementary Level
High School Level
College Level
Employed
Business
Housewife
Unemployed
< P5,000
P5,000-P9,999
P10,000-P14,999
Roman Catholic
Christian
Iglesia ni Cristo
Muslim
Ang Dating Daan
Methodist
Seventh-Day Adventist
1
2
3
4
5
NO.
41
42
16
31
29
7
6
66
5
6
6
43
34
39
15
28
1
14
48
21
71
1
5
1
2
1
2
11
19
31
8
14
49
51
19
37
35
9
7
80
6
7
7
52
41
47
18
34
1
17
57
26
86
1
6
1
3
1
2
13
23
37
10
17
Socio-Demographic Profile of Children with Cancer

Since there are 33 married couples, 9 single mothers, and 8 single fathers
who participated, a total of 50 children with cancer have been a part of the study.
As presented on the Table 2 below, 62% of these children are males and 38% are
females. Majority of them (40%) are aged 6 years or below, while about 26% are
44
aged 13-18 years. 34%, on the other hand, belonged to the 7-12 age category.
Furthermore, the youngest age among the children is 1 year old, while the oldest
age is 18 years old. Furthermore, as presented, 28% of these children are the
youngest child in the family, and about 34% are the eldest child. However,
majority of these children (38%) is the middle child of the family, meaning that
they were born as the second, third, etc. child in the family.
Table 2 below also shows the duration since when these children were
diagnosed with cancer. As shown below, 42% of these children have been
diagnosed with cancer for just less than a year, while only 20% were diagnosed
with cancer for more than 2 years already. This shows that majority of the
respondents of the study, which are the parents of these children, had just
started this medical journey with their children and might still be new to the
situation they are in. Furthermore, majority of these children (32%) have been
hospitalized for more than five times already, while 20% have been hospitalized
for only once. These hospitalizations may probably be because of the
chemotherapies that they undergo which also require them to stay in the
hospital for a couple of days or weeks.
Table 2. Socio-Demographic Profile of Children (N=50)
Characteristics
Sex
Age
Birth Order
Male
Female
6 Years
7-12 Years
13-18 Years
Eldest
Middle Child
Youngest
NO.
31
19
20
17
13
17
19
14
62
38
40
34
26
34
38
28

45
Duration of Diagnosis
Hospitalization Times
< 1 Year
1-2 Years
> 2 Years
1
2
3
4
5
21
19
10
10
11
9
4
16
42
38
20
20
22
18
8
32
Results of the Coping Strategies Questionnaire

Firstly, Table 3 below shows the scores given by the parents to the scale
Communicating with Medical Staff and Other Parents. As shown below, this
scale consisted of the items like Talking with the medical staff (nurses, social
worker, etc.) about my childs illness when we visit the medical center, or Talking
with other parents in the same type of situation and learning about their
experiences. The scale gained a total score of 1,065. Furthermore, the scale got
a mean score of x =12.83, which basically indicates that majority of the parents
do found talking with the medical staff and other parents regarding their childs
condition as helpful in coping with the situation.
Table 3. Communicating with Medical Staff and Other Parents
(3) Talking with
the medical staff
(nurses, social
worker, etc.)
about my childs
illness when we
visit the medical
center.
83
(9) Talking with

other parents in
the same type of
situation and
learning about
their
experiences.
(26) Talking
with the doctor
about my
concerns about
my child.
83
83
TOTAL
83
Score
368
340
357
1,065
Mean (x )
4.43
4.10
4.30
12.83

46
The next table below (Table 4) presents the data regarding the scores on
the scale Acquiring Social Support, which was represented by the items 4, 14,
and 29 in the questionnaire. The scale included items like Seeking advice and
assistance from relatives and friends, or Sharing our difficulties and concerns
with relatives and friends. As shown in the table, item 29 (i.e. Seeking
encouragement and support from relatives and friends.) got the attention of
most of the parents with a mean score of x =4.40. Overall, this scale got a
reasonably high mean score of x =12.58 with a total score of 1,044, which
generally means that majority of the parents started seeking the support from
their family and friends when their child was diagnosed with cancer.
Table 4. Acquiring Social Support
(4) Seeking
advice and
assistance from
relatives and
friends.
83
(14) Sharing our

difficulties and
concerns with
relatives and
friends.
83
(29) Seeking
encouragement
and support
from relatives
and friends.
83
TOTAL
83
Score
353
326
365
1,044
Mean (x )
4.25
3.93
4.40
12.58
Table 5 below, presents the score of the parents on the scale Selfisolation. Items 7, 21, and 25 represented this scale in the questionnaire and as
seen on the table below, all three items got a mean score below 3. With a small
total score of only about 538, the scales mean score (x =6.48), obviously, was
low as well. This indicates that majority of the parents did not prefer isolating
themselves from other people as a coping strategy. Furthermore, the data on

47
Table 5 also supports the data presented on Table 4, which states that most of
the parents choose to acquire support from their family and friends.
Table 5. Self-isolation
(7) Trying to
keep my feelings
and concerns
about my child to
myself.
N
83
(21) Keeping
others from
knowing how
bad I feel about
my childs
illness.
83
(25) Avoiding
being with
people in
general.
83
TOTAL
83
Score
177
187
174
538
Mean (x )
2.13
2.25
2.10
6.48
Table 6, reports the results of the scores given by the parents on the
Wishful Thinking scale. As shown on the table, the scale was represented by
items 1, 11, and 17 in the questionnaire. Item 1 (i.e. Hoping a miracle will
happen.) got the highest mean score of x =4.65, which says that most of the
parents believe and hope that a miracle will happen and their children will get
better from their illness. With fairly high mean scores on all of the items, the
scale consequently got a rather high mean score (x =12.66) as well. Basically, this
shows that majority of the parents use wishful thinking in coping with their
situation.
Table 6. Wishful Thinking
(1) Hoping a
miracle will
happen.
(11) Wishing
that I can change
what is
happening.
83
83
(17) Wishing
that my childs
illness would
simply go away
or somehow be
over with.
83
Score
386
331
334
1,051
Mean (x )
4.65
3.99
4.02
12.66

TOTAL
83
48
The scores given by respondents on the coping strategy Seeking Spiritual

Support is the one presented on the next table below (Table 7). Items 5, 18, and
24 represented this scale, which all got extremely high mean scores of x =4.82, x
=4.86, and x =4.84, respectively. This scale includes items like Praying more than
usual, or Having stronger faith in God. Apparently, with a mean score of x
=14.52, this scale got the highest mean score from the parents among all of the
coping strategies in the questionnaire. This indicates that, among other things,
almost all of the parents prayed, sought Gods help, and used their spiritual
beliefs as a source of strength in order for them to get through the situation that
they are currently in.
Table 7. Seeking Spiritual Support
(5) Praying more
than usual.
N
83
(18) Having
stronger faith in
God.
83
(24) Seeking
Gods help.
83
TOTAL
83
Score
400
403
402
1,205
Mean (x )
4.82
4.86
4.84
14.52
Table 8 below shows the scores of the Self-blame coping strategy as

given by the respondents. Items 12, 16, and 23 represented this scale in the
questionnaire and all of them got fairly low scores from the parents with the
mean score of x =2.53 as the highest among the three. Items like Criticizing or
blaming myself for my childs illness, or To realize that if I had taken care of my
child really well, he/she wouldnt be sick comprised the scale. A total score of
only about 564 and a rather low mean score of about x =6.79 shows that only a

49
few among the parents relies on Self-blame as a coping strategy in the situation
they are in.
Table 8. Self-blame
(12) To realize
that my childs
illness is
somehow my
fault.
(16) Criticizing
or blaming
myself for my
childs illness.
83
(23) To realize
that if I had
taken care of my
child really well,
he/she wouldnt
be sick.
83
TOTAL
83
83
Score
191
163
210
564
Mean (x )
2.30
1.96
2.53
6.79
The next table (Table 9) presents the data regarding the scores of the
scale Being Optimistic about the Situation, which as seen on the table, is
represented by items 10, 15, and 28 in the questionnaire. The scale includes
items like Believing that my child will get better no matter what, or Believing
that my child is getting the best medical care possible. As presented on the table,
all three items got fairly high mean scores resulting to a rather high mean score
(x =13.78) for the scale. Generally, this indicates that majority of the parents
continue to be optimistic about their situation.
Table 9. Being Optimistic About the Situation
(10) Believing
that my child will
get better no
matter what.
N
83
(15) Believing
that my child is
getting the best
medical care
possible.
83
(28) Believing
that things will
always work out.
83
TOTAL
83
Score
397
366
381
1,144
Mean (x )
4.78
4.41
4.59
13.78

50
Table 10 presents the scores given by the parents on the Using Passive
Appraisal scale. The scale, represented by items number 8, 22, and 30, included
items like Refusing to think about it too much, or Thinking that maybe we
should just leave my childs recovery to luck. As presented below, item 30 (i.e.
Believing that time will make a difference and the only thing left to do is to wait
for my child to get better.) got the highest mean score among the three, which is
x =3.87. Furthermore, the scale got a mean score of x =9.85 indicating a moderate
preference of passive appraisal as a coping strategy in the situation.
Table 10. Using Passive Appraisal
(8) Thinking that
maybe we should
just leave my
childs recovery
to luck.
(22) Refusing to
think about it too
much.
(30) Believing
that time will
make a
difference and
the only thing
left to do is to
wait for my child
to get better.
83
83
83
TOTAL
83
Score
194
303
321
818
Mean (x )
2.34
3.65
3.87
9.85
The scores for the scale Positive Reframing is shown on Table 11. The
scale included items 2, 13, and 20, with all getting high mean scores of x =4.24, x
=4.10, and x =4.02, respectively. As a result, a rather high mean score of x =12.36
was given to the scale indicating that majority of the parents try to look at their
childs illness in a more positive way.

51
Table 11. Positive Reframing

(2) Trying to see
my childs illness
in a different
light, to make it
seem more
positive.
83
(13) Looking for

something good
in what is
happening.
Score
Mean (x )
83
(20) Defining my
childs illness in a
more positive
way so that I do
not become too
discouraged.
83
TOTAL
83
352
340
334
1,026
4.24
4.10
4.02
12.36
Finally, Table 12 below presents the scores given the scale Substance
Use as answered by the parents. As shown below, items 6, 19, and 27 with
statements like Drinking alcohol in order to think about it less even just for a
while, or Using drugs or other medication to make myself feel better were used
to represent the scale in the questionnaire. However, all three items got
extremely low mean scores that are below 2. With the scales mean score of x
=5.42, which is apparently the lowest mean score among all the coping
strategies, the researcher can imply that although drinking alcohol, or taking
medication may help to make them feel better despite the situation, majority of
the parents still avoid Substance Use as a coping mechanism in their current
situation.
Table 12. Substance Use
(6) Drinking
alcohol in order
to think about it
less even just for
a while.
N
Score
Mean (x )
83
155
1.87
(19) Using drugs

or other
medication to
make myself feel
better.
83
140
1.69
(27) Eating,
drinking,
smoking, using
drugs or
medication, etc.,
to help me get
through the
situation.
83
155
1.87

TOTAL
83
450
5.42
52
Coping Strategies of Parents in Relation to their Socio-Demographic Profile

Firstly, the researcher tested out the relationship between the type of
coping strategies adapted and the sex of the parent, which can be seen on Table
13 below. Here, the researcher used the Independent Samples T-Test as the
statistical test in determining the significance of the association between the
variables. As presented below, coping strategies such as Communicating with
Medical Staff and Other Parents, Acquiring Social Support, Self-Isolation, and
Substance Use were found to have statistically significant associations with the
sex of the parent with P-values of p=0.000 (this doesn't mean that it is zero; since
SPSS tend to round off, it only means that it is lower than .001), p=0.037, p=0.31,
p=001, respectively. With a mean score of x =13.74, mothers tend to
communicate more with the medical staff and other parents than fathers do.
Also, mothers tend to acquire or seek the support of her family and friends more
than the fathers, as shown by the 1-point lead of mothers on fathers in their
mean scores. On the other hand, with a mean score of x =7.17 and x =6.61 on
Self-Isolation and Substance Use, fathers tend to keep their feelings and concerns
about their child to their selves, and they also seem to drink, smoke, or use
medication to help them feel better and get through the situation. Regarding the
other coping strategies like Wishful Thinking, Seeking Spiritual Support, Selfblame, Being Optimistic about the Situation, Using Passive Appraisal, and Positive
Reframing, although no significant associations have been found between them
and the sex of the parent, it has still been reported on the table below that
mothers tend to seek spiritual support, try to be optimistic about the situation,
use passive appraisal and positive reframing more, compared to the fathers.
53
Fathers, on the other hand, are reported to use Wishful Thinking, and Self-blame
more than mothers. The results, however, on these scales are simply based on
the mean scores of the mother and the father and, again, no significant
association were found between them and the sex of the parent after applying
the Independent Samples T-Test.
Table 13. Coping Strategies in Relation to Sex
Coping Strategies
Male
(Father)
Mean (x )
11.90
Female
(Mother)
Mean (x )
13.74
Statistical
Test
P-value
.000
Acquiring Social Support
12.07
13.07
.037
Self-Isolation
7.17
5.81
.031
Wishful Thinking
12.90
12.43
.334
Seeking Spiritual Support
14.46
14.57
.609
Self-blame
7.17
6.43
.312
Being Optimistic about the Situation
13.76
13.83
.775
Using Passive Appraisal
9.83
9.88
.925
Positive Reframing
12.24
12.48
.624
Substance Use
6.61
4.26
.001
No. of Cases
N=41
N=42
Communicating with Medical Staff and

Other Parents
The next socio-demographic information that the researcher used to

relate with the coping strategies is age. Since there are 4 subgroups or categories
of age, the researcher seemed it more appropriate to use the One-way ANOVA in
testing for the significant association between the variables (same statistical test
54
is used with the rest of the socio-demographic information). As presented on the

table below (Table 14), only the Wishful Thinking coping strategy was found to
have a statistically significant association with the age of the parent with a Pvalue of p=.030. As seen on the table, parents that belonged to the 40-49 age
category (x =12.63) tend to use this coping strategy more often compared to
older parents (x =10.57), as well as the other age groups. The other scales, on the
other hand, regardless of whether they have a significant association with the
age of the parent, found that parents under the 30-39 age category communicate
more with the medical staff and other parents (x =13.32), acquire more social
support (x =12.94), and seek more spiritual support (x =14.61) compared to the
other age groups. Those parents under the 40-49 age category, on the other
hand, seemed to isolate themselves more (x =7.21), use wishful thinking more (x
=13.31), and use substances more (x =6.17) as their coping strategies compared
to the other age categories. Older parents or those aged 50 years or more, on the
other hand, were reported to use the coping strategies such as Self-blame, Being
Optimistic about the Situation, Using Passive Appraisal, and Positive Reframing
more often compared to the other parents with the mean scores of x =7.75, x
=14.14, x =10.14, and x =13.14, respectively.
Table 14. Coping Strategies in Relation to Age
Coping Strategies
Communicating with
Medical Staff and Other
Parents
20-29
Years
Mean(x )
12.56
30-39
Years
Mean(x )
13.32
40-49
Years
Mean(x )
12.76
50
Years
Mean(x )
11.57
Stat.
Test
P-value
.328
11.81
12.94
12.72
12.14
.368

55
Self-Isolation
5.88
6.03
7.21
6.86
.337
Wishful Thinking
12.63
12.55
13.31
10.57
.030
14.56
14.61
14.45
14.29
.828
Self-blame
6.56
6.55
7.00
7.75
.868
Being Optimistic about the

Situation
14.06
13.94
13.41
14.14
.204
10.13
9.42
10.10
10.14
.687
Positive Reframing
12.00
12.58
12.14
13.14
.573
Substance Use
4.94
5.03
6.17
5.14
.478
N=16
N=31
N=29
N=7
No. of Cases
The next table below (Table 15), presents the coping strategies adapted
by parents in relation to their marital status. As presented, two coping strategies
were found to have a statistically significant association with the marital status
of the parent. These include Acquiring Social Support and Substance Use. In
Acquiring Social Support, widowed parents got the highest mean score of x
=14.33, with those that are married with the lowest with x =12.35. Widowed
parents also got the highest mean scores in the following coping strategies:
Communicating with Medical Staff and Other Parents (x =14.00), Seeking Spiritual
Support (x =14.83), Being Optimistic about the Situation (x =14.17), and Positive
Reframing (x =13.17). Those parents that are divorced, however, got the highest
mean score on those coping strategies that might seem to be negative. These
include Self-Isolation, Self-blame, and Substance Use with mean score of x =8.20, x
=9.20, and x =7.40, respectively.

56
Table 15. Coping Strategies in Relation to Marital Status

Coping Strategies
Single
Married
Divorced
Widowed
Mean(x )
12.50
Mean(x )
12.82
Mean(x )
12.00
Mean(x )
14.00
Stat.
Test
P-value
.549
13.00
12.35
13.00
14.33
.028
Self-Isolation
7.00
6.39
8.20
5.50
.443
Wishful Thinking
12.33
12.76
11.80
12.67
.806
14.33
14.58
13.60
14.83
.324
Self-blame
5.83
6.89
9.20
4.67
.130

Situation
13.67
13.85
12.80
14.17
.254
11.00
9.74
10.00
9.83
.709
Positive Reframing
12.50
12.35
11.40
13.17
.604
Substance Use
5.67
5.45
7.40
3.17
.001
No. of Cases
N=6
N=66
N=5
N=6
Communicating with
Medical Staff and Other
Parents
Table 16 presents the coping strategies used by parents in relation to

their educational attainment. Three coping strategies, here, were found to have
statistically significant associations with the level of education of the parents.
These are Communicating with the Medical Staff and Other Parents, Wishful
Thinking, an Substance Use with the P-values of p=0.001, p=0.034, and p=0.10,
respectively. As presented on the table below, those parents who have reached
college level of education (x =13.15) significantly used Communicating with the
Medical Staff and Other Parents compared to those parents who have only
reached the elementary level (x =9.50). In Substance Use, however, it was those
57
parents with an elementary level of education who used drinking, smoking, or

taking medications to make them feel better significantly with a mean score of x
=9.00 compared to those parents with a college level of education who got a
mean score of only x =4.79. In the coping strategy, Wishful Thinking, it was those
parents with high school level of education who got the highest mean score of x
=13.28, and those parents with college level of education with the lowest mean
score of x =11.85. On the other hand, the rest of the coping strategies did not
have statistically significant relationships with the level of education of the
parents. However, it was still reported that parents with college level of
education got the highest mean scores on Acquiring Social Support, Self-Isolation,
and Positive Reframing with a mean score of x =12.94, x =6.74, and x =12.65,
respectively. Self-blame (x =8.17) and Passive Appraisal (x =10.83), on the other
hand, were observed to be used more often by those parents with only an
elementary level of education compare to the other parents with higher level of
education.
Table 16. Coping Strategies in Relation to Educational Attainment
Coping Strategies
College
Level
Stat.
Test
Mean (x )
9.50
High
School
Level
Mean (x )
13.05
Mean (x )
13.15
P-value
.001
12.00
12.37
12.94
.425
Self-Isolation
6.00
6.35
6.74
.775
Wishful Thinking
12.83
13.28
11.85
.034
13.67
14.72
14.41
.100

Other Parents
Elem.
Level

58
Self-blame
8.17
6.79
6.56
.557
13.50
13.88
13.74
.723
10.83
9.91
9.62
.541
Positive Reframing
11.50
12.26
12.65
.436
Substance Use
9.00
5.42
4.79
.010
No. of Cases
N=6
N=43
N=34
Finally, the last socio-demographic information about the parents that the
researcher used to associate with the type of coping strategies they adapt is their
monthly family income. As presented on the table below (Table 17), coping
strategies such as Acquiring Social Support and Being Optimistic about the
Situation were the ones that have been found to have statistically significant
relationship with the monthly family income of the parents. Also, as shown,
parents with lower monthly income of those that earn less than P5, 000 a month
try to acquire the help and support of their family and friends more, as shown by
the mean score of x =13.29, compared to those with higher monthly income or
those that earn P10, 000-P14, 000 monthly, who got a mean score of x =12.08.
The same goes for the coping strategy Being Optimistic about the Situation, where
those parents with lower monthly income got the highest mean score of x =14.36.
Furthermore, for those coping strategies where no statistically significant
associations with monthly family income were found such as Wishful Thinking,
Seeking Spiritual Support, Self-blame, and Using Passive Appraisal, it was those
parents earning less than P5, 000 a month who got the highest mean scores with
x =13.26, x =14.71, x =7.43, and x =10.14, respectively. Lastly, Positive Reframing

59
was reported to be used more by those who earn P10, 000-P 14, 999 monthly
with the mean score of x =13.05, although no statistically significant association
was found between the two.
Table 17. Coping Strategies in Relation to Monthly Family Income
Coping Strategies
Mean (x )
12.79
P5,000P9,999
Mean (x )
12.58
P10,000P14,999
Mean (x )
13.43
Stat.
Test
P-value
.406
13.29
13.24
12.08
.042
Self-Isolation
5.86
6.75
6.29
.563
Wishful Thinking
13.26
12.69
12.14
.286
14.71
14.56
14.29
.384
Self-blame
7.43
6.69
6.62
.739
14.36
13.48
14.14
.017
10.14
9.94
9.48
.702
Positive Reframing
12.86
11.92
13.05
.081
Substance Use
5.36
5.79
4.62
.371
N=14
N=48
N=21

Other Parents
No. of Cases
< P5,000
Results of Kessler Psychological Distress Scale (K10)

Table 18 below presents the scores of the parents in each item of them
Kessler Psychological Distress Scale (K10). As presented on the table, item
number 2 (i.e. In the past 4 weeks, about how often did you feel nervous?) got the
highest score from the parents with a mean score of x =3.14. As shown, almost
half (42%) of the parents answered most of the time, which basically means
that large majority of the respondents have been experiencing nervousness most
60
of the time for the past 4 weeks prior to answering the questionnaire.
Furthermore, only about 9% of the parents answered none of the time.
Item 2 is then followed by Item 1 (i.e. In the past 4 weeks, about how often
did you feel tired out for no good reason?) with a mean score of x =2.90. As
presented on the table below, majority of the parents (35%) answered some of
the time and only about 4% answered all of the time. Also, another 25% of the
parents answered most of the time. With this we can say that majority of the
parents do experience the feeling of exhaustion without them knowing the
reason why.
It was also observed that majority of the parents did feel depressed and
restless for the past four weeks prior to answering the questionnaire as shown
by the high mean scores on items 7 (x =2.89) and 5 (x =2.86). With the majority
of the parents (28%) responding with some of the time and another 27%
responding with most of the time on item number 7 (i.e. In the past 4 weeks,
about how often did you feel depressed?), we can imply that more than half of the
parents have been experiencing depression in the past month prior to answering
the questionnaire. Furthermore, 7% of the parents did say that they experienced
depression all of the time. In item number 5 (i.e. In the past 4 weeks, about how
often did you feel restless or fidgety?), on the other hand, majority of the parents
(31%) answered some of the time, and another 22% of the parents answered
most of the time, while only about 14% of the parents responded with none of
the time.

61
Next are items number 8 (i.e. In the past 4 weeks, about how often did you
feel that everything was an effort?) and 4 (i.e. In the past 4 weeks, about how often
did you feel hopeless?) with means scores of x =2.41 and x =2.23, respectively. As
presented on the table below, the results in item 8 are somehow evenly
distributed, with 28% of the parents responding with some of the time, 27%
responding with a little of the time, 26% with none of the time, and 18% with
most of the time. Only 1 parent, however, responded with all of the time. In
item 4, majority of the parents (38%) responded with none of the time. This
obviously indicates that the parents, in the past 4 weeks prior to answering the
questionnaire, have still been hopeful about the situation or about their childs
condition. Furthermore, only about 13% of the parents responded with most of
the time and 5% responded with all of the time.
Next are items number 3 (i.e. In the past 4 weeks, about how often did you
feel so nervous that nothing could calm you down?), 9 (i.e. In the past 4 weeks,
about how often did you feel so sad that nothing could cheer you up?), and, 6 (i.e. In
the past 4 weeks, about how often did you feel so restless you could not sit still?)
with mean scores of x =2.18, x =2.12, and x =2.08, respectively. As presented, in
item 3, almost half of the parents (43%) experienced too much nervousness that
nothing could calm them down for only a little of the time. Also, in item 9, 35%
of the parents responded with a little of the time, and another 32% responded
with none of the time. Finally, again in item number 6, a large majority of the
parents (40%) and another 33% of the parents say that in the past month prior
to answering the questionnaire, they have only experienced too much

62
restlessness that they could not sit still a little of the time and none of the
time, respectively.
Lastly, as presented on the table below, item number 10 (i.e. In the past 4
weeks, about how often did you feel worthless?) got the lowest mean score of x
=1.88. As shown below, almost half of the parents (47%) did not feel that they
are worthless in the past month prior to answering the questionnaire. Another
29% said that they only felt worthless a little of the time. Furthermore, only
about 3% and 4% responded with most of the time and none of the time,
respectively, to this item.
Table 18. Item Scores on Kessler Psychological Distress Scale (N=83)
Items
1. In the past 4 weeks, about
how often did you feel tired
out for no good reason?
how often did you feel
nervous?
how often did you feel so
nervous that nothing could
calm you down?
hopeless?
restless or fidgety?
None of the time

A little of the time
Some of the time
Most of the time
All of the time
None of the time
Some of the time
Most of the time
All of the time
None of the time
Some of the time
Most of the time
All of the time
None of the time
Some of the time
Most of the time
All of the time
None of the time
Some of the time
Most of the time
All of the time
NO.
5
25
29
21
3
7
18
19
34
5
23
36
13
8
3
31
21
16
11
4
12
18
26
24
3
6
30
35
25
4
9
22
23
42
4
28
43
16
10
3
38
25
19
13
5
14
22
31
29
4

Mean
(x )
2.90
3.14
2.18
2.23
2.86
63

how often did you feel so
restless you could not sit
still?
depressed?
how often did you feel that
everything was an effort?
how often did you feel so sad
that nothing could cheer you
up?
10. In the past 4 weeks,
about how often did you feel
worthless?
None of the time

Some of the time
Most of the time
All of the time
None of the time
Some of the time
Most of the time
All of the time
None of the time
Some of the time
Most of the time
All of the time
None of the time
Some of the time
Most of the time
All of the time
None of the time
Some of the time
Most of the time
All of the time
27
33
14
7
2
11
21
23
22
6
22
22
23
15
1
27
29
20
4
3
39
24
14
3
3
33
40
17
8
2
13
25
28
27
7
26
27
28
18
1
32
35
24
5
4
47
29
17
3
4
2.08
2.89
2.41
2.12
1.88
Figure 2 below illustrates the total scores of the parents on K10. As

illustrated, about 33% of the parents got a total score that is less than 20, which
indicates that they are likely to be well. However, a significant percentage of the
parents got scores that may indicate that they are likely to have a moderate or
severe mental disorder. As shown in the figure, about 28% of the parents got a
score of 25-29, and about 25% got a score of 30 or even higher. With these
values, the researcher can imply that more than half of the parents (53%) may be
suffering from moderate to severe mental disorders probably caused by the
emotional and psychological demands of the situation.

64
Figure 2. Total Scores of Parents on K10
Results of K10 in Relation to the Coping Strategies Adapted

Table 19 below presents the scores of the respondents on the K10
Questionnaire in relation to the different types of coping strategies that they
have adapted. As presented on the table, differences between the mean scores in
K10 of those parents who got a lower score (3-8) and those who got a higher
score (9-15) in each of the coping strategies can be observed. These differences
were observed in coping strategies like Communicating with Medical Staff and
Other Parents, Acquiring Social Support, Self-Isolation, Self-blame,
Positive Reframing, and Substance Use. However, in coping strategies such as
Wishful Thinking and Using Passive Appraisal, not much difference between
the two groups were observed. Also, in coping strategies such as Seeking
Spiritual Support and Being Optimistic about the Situation, no comparisons
were made since all 83 respondents got a score of 9-15 in each scale.

65
As shown on the table below, those parents who got a higher score (9-15)
in the coping strategy Communicating with Medical Staff and Other Parents, got
a low mean score (x =17.86) in K10, while those parents who got a lower score
(3-8), got a higher mean score (x =25.30) in K10. This trend goes the same for
Acquiring Social Support and Positive Reframing. As explained, higher scores
in K10 indicates higher levels of psychological distress experienced, while lower
scores indicate lower levels of psychological distress. This shows that those
parents who chose to adapt Communicating with Medical Staff and Other
Parents, Acquiring Social Support, and Positive Reframing as their coping
strategies, may actually have a healthier adaptation as shown by their lower
mean scores in K10.
On the other hand, those parents who got high scores in the coping
strategies such as Self-Isolation, Self-blame, and Substance Use got high
mean scores as well in the K10 questionnaire, and those who got low scores got
low mean scores in K10 as well. This shows that these people, after adapting
such coping strategies may have experienced higher levels of psychological
distress compared to those who got lower scores on each scale. Exact values of
mean scores can be seen on the table above (Table 19).
Table 19. K10 Scores in Relation to Coping Strategies
Coping Strategies
Communicating with Medical Staff

and Other Parents
NO.
Score
3-8
9-15
7
76
8
91
K10
Score
Mean (x )
25.30
17.86
3-8
9-15
4
79
5
95
25.14
16.40

66
Self-Isolation
3-8
9-15
65
18
78
22
20.44
24.77
Wishful Thinking
3-8
9-15
7
76
8
91
24.81
23.43
3-8
9-15
0
83
0
100
0
18.70
Self-blame
3-8
9-15
59
24
71
29
24.17
26.00

Situation
3-8
9-15
0
83
0
100
0
19.17
3-8
9-15
21
62
25
75
24.48
26.77
Positive reframing
3-8
9-15
7
76
8
91
26.85
22.50
Substance Use
3-8
9-15
68
15
82
18
20.40
24.98
Key-Informant Interviews
As discussed in the methodology, the researcher conducted keyinformant interviews in order to obtain other information that have not been
covered in the quantitative part of the study. The purpose of these interviews is
to gather more candid and in-depth answers from the respondents regarding
their situation. The researcher believes that these key-informant interviews will
help fill the gaps in the study, as well as in satisfying some of the objectives of the
study that have not been covered by the quantitative part. With this, the
researcher conducted four key-informant interviews and chose the following
people from his respondents as the key-informants for the interview: the couple
with the highest monthly income, the couple with the lowest monthly income, a
single mother, and a single father. The researcher chose the couples with the

67
highest and lowest monthly income since socio-economic status, according to the
related literature, is considered as one of the major factors affecting the type of
coping strategies that parents adapt. Also, for the single mother and father, the
researcher believed that they can provide deeper information regarding their
situation while being single. Furthermore, the researcher believed that these
people are enough to represent the respondents of the study and provide the
necessary and significant additional information about the topic. And so, in this
section, the researcher will now try to present the results of the interviews.
Names of the interviewees will not be mentioned for ethical reasons.
Couple with the Highest Monthly Family Income
The first key-informant interview that the researcher conducted was with
the couple that had the highest monthly family income among his respondents.
The father, who works as a marketing agent, is earning about P14, 000 a month,
while the mother stays as a housewife. The father graduated in college and is
now 31 years old, while the mother, aged 27 years old, reached college but was
not able to graduate. Also, both of the parents are Roman Catholics. Their son,
who is now 4 years old, has been diagnosed with cancer for almost 6 months
already. He is the couples only child and ever since he was diagnosed with
cancer, he has been hospitalized only once. However, during the time of the
interview, according to the parents, the child was already recovering really well
from his illness.
When the couple found out about their childs illness after a checkup from
a doctor, their first reaction, according to them, was that they were shocked. The
68
mother even said that she couldnt believe what the doctor was saying at first.
She also started wondering how it happened. She said, Nagulat talaga ako noon
kasi hindi ko ine-expect na magkakaroon siya ng ganun kasi nung pinanganak ko
siya, malusog siya tapos normal naman. These were somehow the same reaction
of the father. When asked what his first reactions were, he said, Syempre, bakit?
Tanong ka kagad, bakit? Saan niya nakuha yun? Both parents also said that after
finding out about the news, they immediately shared it to some of their family
and friends. As the father said, Nung malaman namin, syempre pinagsabi mo sa
mga kamag-anak mo, sa mga kung sino yung makakatulong sayo para at least
meron kang pagsimulan. The mother, who asked advice from their parents, said,
Sinabi ko sa mga magulang namin tapos sinabi nila na walang dapat sayangin na
oras, dalhin na kagad sa ospital. And so, the parents did bring their son to the
hospital, which, according to them, was one of the immediate actions that they
did.
When the couple was asked about how they manage to accept the news
they said that it was indeed hard for both of them. The mother said that at first,
she would always ask, Totoo ba yun? O baka mali lang yung doktor, ganun. She
also said, Sobrang hirap talaga tanggapin. Galit na galit nga ako sa doktor eh.
Kasi parang puro negative yung sinabi niya, kaya parang galit na galit ka, hindi
mo talaga matanggap. Iniisip ko palagi, mali lang siya. The father, on the other
hand, said that it was hard to accept that his child had cancer but he also added
that in spite of the situation, it is still important for them to focus on their childs
condition. As he have said, Mahirap, but at the same time, kelangan maging
positive ka pa rin, maging focused ka dun sa solusyon na kaya mong gawin. When
69
asked about whether they have already fully accepted their childs condition,
both parents said yes, since their child has already recovered really well from his
illness.
According to the couple, several things have changed in their lives since
their child was diagnosed with cancer. The mother said, Dati sobrang hirap kasi
inaalagaan mo siya, tapos kailangan punta kayo nang punta ng ospital. Halos
araw-araw nandito kami, pipila kami, nagpapagod kami sa ganun. She even
added that she actually lost weight as a result. The father, on the other hand,
reported that it was indeed stressful. He said, Sobrang nakakastress, kasi arawaraw nag-iisip ka. The father also, however, reported that his childs illness did
affect his job performance. He said, Oo, kasi yung trabaho kailangan ng
matinding planning, pag-iisip, so nakakadagdag yung iniisip mo outside work
tulad nung pamilya mo. Regarding the effects of the childs illness on their
economic status, the father reported that there are times that they do have
problems regarding money but he also said that this is easily resolved because of
the people (i.e. family and friends) that supports them financially. However,
despite all these effects, the father still said, Kaakibat yan ng pagpapagaling niya
eh. Di naman lahat ng bagay madali eh, so kailangan paghihirapan mo din.
When the couple was asked about how they manage to cope with all the
demands of the situation, the mother answered right away with, nagdadasal.
After that the mother then added, Syempre, unang-una yung Diyos talaga eh.
Parang siya na lang yung kakapitan mo, diba? The father then added, Humihingi
din kami ng tulong sa mga kamag-anak. Katulong namin palagi sila. He also said
70
that their relatives helped them a lot in giving them advice, support and
encouragement all the time. When the researcher asked them on whether they
drink, smoke, or take medication to make them feel better, the father answered
with, Ah, hindi. Para samin, sapat na yung pagdadasal, yung presence ng mga
kamag-anak. Tsaka, imbes uminom, tinututukan na lang namin yung anak namin.
Binubuhos na lang namin lahat sa kanya. Furthermore, the couple also reported
how other parents of children with cancer helped them. The mother said,
Nakatulong din sila, nagbibigay ng mga advice, mga ganun. Dito, marami akong
nakilalang mga magulang, ayun nag-uusap-usap kami, lahat naman nagpapalakas
ng loob. She even added, Kinakausap ko talaga silang lahat. When asked
whether they try to avoid sharing their feelings or concerns for their child or
whether they isolate themselves from other people so they can have some time
alone, the father answered, Samin mas lalo pa naming inilalabas kasi mas
nakakabawas yun ng bigat ng loob and at the same time naishe-share mo yung
kalagayan mo ngayon, yung burden nababawasan.
According to the couple, as of now, everything is okay. Their child has
been recovering really well and almost everything is somehow back to normal.
When asked about the positive effects of their childs sickness on them, the father
answered with, Siyempre, mas lalo kayo naging close, lalo mong minahal yung
anak mo, kasi hindi mo alam na anytime baka pwede siyang kunin ni Lord. He
also added that their experience gave them awareness on the illness and that it
taught them to be more aware of their health.

71
Couple with the Lowest Monthly Family Income

The next key-informant interview conducted by the researcher was the
couple that had the smallest monthly family income among the respondents. The
father, about 34 years old, works as a family driver and earns about P4,000 a
month. The mother, on the other hand, is about 30 years old and just like in the
first couple, she is also a housewife. Both of them graduated only from high
school and both were also Roman Catholics. The couple has two children and the
youngest of which, a 3-year old girl, was diagnosed with cancer for about a year
already. Since the diagnosis, she has been hospitalized once where she stayed in
the hospital for more than a month. During the time of the interview, the couple
said that their daughter is now slowly recovering from her illness.
According to the couple, when they were told by the doctor that their
daughter has cancer, both of them got really surprised. The mother said, Nung
una, di ko alam gagawin ko. Nagulat talaga ako tapos parang di ako mapakali,
ganun. She even added that she was crying when the doctor was telling them
the news. The father also said that he was surprised about the news, and that one
of his first reactions was that he got angry about what happened. He said, Yung
reaksyon ko, syempre nagagalit ako. Parang di ko matanggap. Pero yun nga, wala
na din naman magagawa eh, gumawa na lang kami ng paraan para mapagamot
siya. When the researcher asked them about what their immediate actions were,
the mother answered with, Ayun, lumapit talaga ako sa Panginoon. Humingi ako
ng tulong sa kanya. Tapos sama-sama rin kaming nagdasal para sa ikakagagaling
nga niya. The father, on the other hand, said, Humingi rin kami ng tulong sa mga
72
dapat hingan ng tulong, kasi hindi ko naman kayang ipagamot ang anak ko sa
kinikita kong maliit.
Acceptance, for both parents, had been really hard as well. According to
the mother, it was one of the worst news she had ever received and accepting it
was not easy. She said, Sobrang hirap talaga. Di ako makapaniwala tapos parang
ayokong tanggapin. Syempre, anak mo yan eh. The father said the same thing;
Syempre, hindi mo basta-basta matatanggap yung ganong klaseng balita eh.
Nung una nga parang gusto kong magwala. However, according to the father, as
their daughter gradually recovers, his anger was also gradually replaced with
happiness.
According to the couple, the childs illness has brought several changes to
their lives. It has affected their family in so many ways. As the mother said, Ah,
maraming pagbabago. Sa pag-iintindi lang sa mga bata. Dobleng pag-iintindi
ginagawa mo kasi dalawa yung anak mo, tapos yung isa may sakit pa. She even
added that it was indeed somehow exhausting. She said, Sobrang nakakapagod
dati. Pero syempre para yan sa aak mo, kaya okay lang. Regarding the fathers
job, he said, Sa trabaho, syempre family driver ako palagi akong kailangan ng
amo ko, eh kaso kalimitan na-aabsent ako sa pagdadrive dahil sa anak ko.
Another thing that they said was that even their relationship as a couple was
affected. The mother said, Sa pagsasama namin, medyo hindi kami
nagkakaintindihan. Minsan, may mga beses na medyo mainit yung ulo ng isa.
Halimbawa kapag may isang bagay na kailangan gawin tapos di nagawa, lalonglalo na pag tungkol sa bata. Minsan problema sa pera. Ayun, di naman nawawala
73
yung away sa mag-asawa eh. With all these effects brought about by the childs
illness, according to them, it was still their economic status that was greatly
affected and the one that made it really hard for them. As the mother said,
Sobrang napakagastos. Halos palagi kaming kapos. Hindi lang sa araw-araw na
gastusin, pati yung mga gamot nakadagdag. Sobrang mamahal ng mga gamot.
The father also said that because of their financial problem, he had to sell his
tricycle. Also, the father reported that sometimes, he even finds himself thinking
of doing bad things just to get money to buy medicine or his daughter. He said,
Minsan kapag kailangan ng gamot ng anak mo, tapos wala kang pera, minsan
kung anu-ano naiisip mo. Pero sa awa ng Diyos, hindi naman nakakagawa ng
masama, nakakapag-isip lang talaga. However, the couple did say that
somehow, these financial problems were solved with the help of their families
and other people that helps and supports them financially.
Despite all those difficulties brought by their childs illness, they still
manage to get through the situation. When the researcher asked them how they
did it, the couple said that it was the support of their family and friends that
really helped them a lot in coping with the situation, financially and emotionally.
As the mother reported, Napakalaki talagang tulong yung nagawa ng mga
kamag-anak namin. Sa pag-aalaga sa bata, sa pinansyal, halos palagi silang
nandyan para tulungan ka. Pinapahiram kami ng pera, ganun. The father also
added, Yung mga tao din, kahit hindi kamag-anak, nakakatuwa din, kasi kahit
hindi kami binibigyan ng tulong pinansyal, nandiyan pa rin sila para magpalakas
ng loob, nakakapagpatatag. The couple said that family and friends encouraged
and supported them all the way, and that without them, they didnt know how
74
they would manage all those demands of the situation. As the mother said, Hindi
ko talaga alam kung ano ang gagawin namin kung wala yung mga kamag-anak
namin, mga kaibigan namin. Also, the father added, Napakalaking bagay yung
marami kang tao sa paligid mo talaga kasi pag dating sa mga ganitong problema,
tutulangan ka nila. Furthermore, the couple also reported that the doctors and
nurses also helped in making the situation a little bit lighter. The mother said,
Nakatulong din yung mga doktor kasi minsan pinapagaan din nila yung loob mo.
Tapos sinasabi naman nila na gagawin nila lahat para gumaling yung anak mo,
ayun nakakapagpagaan din ng loob. The father also added that the doctors also
helped them by giving them advice on where they could buy medicine on a lower
price which, according to him, really helped a lot. Another thing that they said
that also helped them is the parents of other children with cancer. The mother
said that other parents, somehow make them feel better because, they are able to
share the same sentiments with them. She said, Palagi ako nakikipag-usap dito
kapag nagpapa-ckeckup kami. Nagkakaroon kami ng bonding, yung mga
problema, mga hinanakit. Nandodon din yung mga iyakan, pati biruan. Kaya kahit
papano nakakapagaan din ng loob. The father then added, Dito kasi, hindi ka
nagsosolo, sama-sama kayo. Para bang may kakampi ka sa mga problema mo, kasi
syempre pare-parehas naman yung pinagdadaanan ninyo. Regarding the help of
spiritual support, the mother said, Oh, syempre naman. Number one yan, hindi
pwedeng mawala ang Panginoon syempre. Bago ang lahat, sa Panginoon ka muna
lalapit. Siya ang may hawak ng buhay ng anak ko eh. The father then added that
he believes that God will not abandon his daughter. He said, Wala talaga akong
pag-aalinlangan sa paniniwala sa Panginoon na gagaling ang anak ko. Basta
75
100% talaga paniniwala ko sa Panginoon, kaya pinagdadasal ko palagi anak ko sa

Kanya. When asked whether they drink, smoke, or take medication to feel
better, the mother immediately answered no saying that she has no time or
money for such things. The father, however, admitted that he drinks occasionally
but he also said that even though he drinks, his attention is still on the problem
and his child.
Despite all of these things that they have been through, the couple
believes that somehow it has also brought positive things like as the mother said,
Lalong naging maganda yung bonding namin ng anak ko, pati silang mag-ama.
Tapos lalo din gumanda yung pagsasama sa pamilya. Kumbaga parang yung anak
namin yung nagpatatag sa pamilya namin. The father also added that because of
what happened, he became closer to God and his faith became stronger.
Single Father
After with the couples, the researcher also conducted key-informant
interviews with single parents. And so, in this section, the researcher will now
discuss the results of the interview with a 32-year old single father. He is a
Roman Catholic as well and has graduated only in high school. He has 2 children,
the youngest of which was diagnosed with cancer for more than a year already.
His child with cancer is a 5-year old boy and since the diagnosis, he has been
hospitalized twice already. His family actually lives in Visayas. However, since
there is no chemotherapy there, according to the father, he and his son went to
Manila and lived with his brother leaving his other son to his parents in Visayas.

76
According to the father, during the time of the interview, his son had a relapse
and is now back to undergoing chemotherapies.
According to the father, upon hearing the news that his youngest son has
a cancer, he felt really devastated. He said, Sobrang sakit talaga marinig yung
ganong klaseng balita. Para bang gugunaw yung mundo ko nun eh. He also added
that somehow, he felt some grudge against the fact that out of all the people, this
happened to him, a poor, single father. He said, Syempre hindi mo maiwasang
sumama ang loob mo kasi kug sino pang mahirap, siya pa yung nagkaroon ng
ganung klaseng sakit. Also, according to the father, when he got the news, he
told it right away to his parents asking for some help. He said, Nung nalaman ko,
humingi ako kagad ng tulong sa mga magulang ko, mga kapatid ko, kasi mag-isa
nga lang naman ako. Ayun, binigyan naman nila ako ng pamasahe papuntang
Maynila. When asked about how he managed to accept his sons illness, he said,
Nung una parang hindi mo talaga matatanggap kasi siyempre anak ko yan eh.
Hindi mo talaga sukat akalain magkakaganyan siya eh. He also added that
during that time, one big question in his head was how it happened. He said,
Lahat naman ng sinasabi ng doktor nang mabuntis yung asawa ko dati, sinusunod
naman namin eh. Kaya hindi ko talaga lubos na maisip kung pano nangyari yan
eh. In the end he said that as time went by, he just learned to accept his sons
illness. He said, Syempre, sa tagal ng ano, tanggap na rin kahit papano kasi wala
na rin naman akong magagawa diyan eh.
According to the father, since the diagnosis, their lives have changed very
much, and for him, one of these major changes includes their migration from
77
Visayas to Manila. He said, Ayun, isang napakalaking pagbabago yung paglipat

namin ng anak ko dito sa Maynila. Halos mag-iisang taon ko na rig hindi nakikita
yung isa kong anak. Another major change in his life is his job. He said that
because of his childs illness, he had to quit his job in Visayas. He said, Iniwan ko
na din yung trabaho ko sa probinsya. Sa ngayon, wala na akong trabaho. Yung isa
kong anak inaasa ko na lang sa mama ko. He also added that since he is single,
he is the only one taking care of the child, which makes it hard for him to find a
job in Manila. It was a good thing, according to him, that his brother in Manila
continues to help them by providing financial support for his sons medication.
He said, Hindi na ako makapagtrabaho kasi walang mag-aalaga sa pasyente. Buti
nandyan yung kapatid ko tumutulong sa pagpapagamot ng anak ko kahit papano.
Bale nasa anak ko na lahat yung focus ng araw-araw ko kasi wala na rin naman
ng ibang gumagawa, ako lang. When asked about the effects of his sons illness
on his emotional and psychological health, he said, Syempre naging madalas na
nalulungkot ako sa sitwasyon namin. Napapaisip ng mga bagay-bagay. Halos
araw-araw nag-iisip ako kung pano ko maipapatuloy yung pagpapagamot niya.
He also added that he often finds himself just staring blankly into space or even
sometimes finds himself crying. He said, Madalas talaga akong tulala. Madalas
naiiyak na lang ako bigla sa sitwasyon namin ba. Madalas ding puyat.
When the researcher asked him about how he is able to go through with
this kind of situation, he said that the only thing that he does is pray. He said,
Ipinapasa-Diyos ko na lang talaga eh. Siyempre sa kanya ka na lang talaga
humuhugot ng lakas ng loob eh. Para bang siya na ang bahala sa anak ko, sa amin.
Wala naman kasing imposible talaga sa Panginoon. He also added that his faith
78
with God somehow became much stronger since his son had cancer. He also
added that since he is new in town, he doesnt have many friends in Manila that
can actually help him. He said, Ayun, dahil di naman ako taga-dito, kakaunti mga
kilala ko, mga kaibigan ko nasa probinsya din kaya wala din akong masyadong
malapitan dito. However, he also reported that whenever he is in PGH for
checkup and while waiting for his turn, he also tries to communicate with the
other parents. He said, Nakikipag-usap din ako sa mga magulang dito. Humihingi
ng payo, kumbaga dun sa mga naunang magpagamot. Kwentuhan din, ayun,
nakakatulong din yun sa pagpagaan ba ng loob. The father also reported that
despite the situation, he still tries to remain positive and continue believing that
his son will get better in the end. He also reported that there are times that he
finds being alone much better than being with or talking with people. He said,
Kung minsan kasi talaga pag nasa problema ka, ayaw mo na may kausap ka.
Minsan gusto mo talaga makapagsarili, para ba makapag-isip ka ng maayos.
When the researcher asked him whether he use substances (i.e. alcohol, drugs)
to make him feel better, he said, Ah, hindi. Dati nung wala pa siyang sakit
umiinom talaga ako, pero ngayon hindi na din kasi halos lahat na nga ng atensyon
ko nasa kanya na. tsaka delikado din kasi walang nagbabantay sa kanya.
When asked about their current condition, the father reported that as of
that moment, his son seems to be okay. He also said that although his son had a
relapse, he still feels very hopeful for his recovery. However, he did say that he
misses his other son and hopes that everything will be back to normal. He said,
Sana matapos na din to lahat. Nagdadasal na lang talaga ako sa Panginoon.
Naniniwala talaga kasi ako na di niya kami pababayaan eh.
79
Single Mother
The last key-informant the researcher interviewed is a single mother. She
is a 35- year old college graduate who works as a government employee where
she earns about P8, 000 a month. Also, like all other key-informants, she is a
Roman Catholic. She only has a 7-year old daughter who was diagnosed with
cancer for aout 8 months already. Since the diagnosis, her daughter was
hospitalized twice where she stayed in the hospital for weeks.
When the mother found out about her daughters illness, her first
reaction was just like the other parents who got surprised by the news. She said
Syempre po nabigla talaga ako. Hindi mo matanggap yun kasi inisip ko mag-isa
lang ako. Masakit, masakit po talaga. She also added that upon hearing the news,
the mother felt really devastated and that for the few days since her daughter
was diagnosed, she felt really heavy inside. She said, Nung sa unang linggo, hindi
ako komportable, parang problematic palagi. Tapos mabigat yung loob ko lagi.
Furthermore, she said that when she found out, she immediately told it to her
parents and her siblings. She said, Pinaalam ko din kagad sa mga magulang ko,
mga kapatid ko yung problema ko, na ayun nga, may sakit yung anak ko. Kasi
parang yung mga panahon na yon, nangailangan ako ng moral support. When
asked about whether she has already accepted her daughters illness, she replied
with, Oo, tanggap ko na. pero pine-pray ko naman kay Lord na gumaling na siya.
Para bang ipinapasa-Diyos ko na lang yung kalagayan niya. She did add,
however, that accepting it was really hard. She said that at first she couldnt
imagine why it had to be her daughter. She said, Mahirap na mahirap, lalo na sa
80
tulad ko na isang ina, wala akong kadamay, mag-isa lang ako, wala akong asawa,
tapos siya ang kaisa-isa kong anak na kung mawawala siya sa akin parang hindi
ko kayang tanggapin.
According to the mother, her daughters illness did have some effects on
their lives. It affected them in so many ways. She said that before, she didnt
really spend much time with her daughter because she was busy, but now, she
said that she makes sure of it that she really has her full attention on her child.
She also added that her work has been greatly affected as well. She said,
Syempre pati yung trabaho sobrang apektado. Madalas na akong absent. Kasi
kahit papano, gusto ko ako yung nagbabantay sa anak ko. Pero buti na lang din
nandyan yung mga magulang ko, na tumutulong sa pag-alaga sa kanya paminsanminsan. She also added that it was a good thing that her bosses understand her
situation and that they even support and assist her. Regarding their financial
status, the mother reported that her childs illness somehow made life harder for
them. Although, she did say that she is thankful for her siblings that supports her
financially. When the researcher asked her about how hard it was to have a
daughter with cancer, she replied, Mahirap na mahirap talaga. In the real sense
of the word na mahirap. Kasi parang ang lahat ng bagay para sayo ay hindi na
normal. Lalo na para sakin na mag-isa lang. She also reported that as a result,
she felt like she was stressed all the time. She said, Syempre yung stress nandyan.
Para bang buong araw sa trabaho, stress na stress ka, iniisip mo yung anak mo.
Tapos laging parang wala ka sa sarili, nag-iisip ng malalim kung ano yung mga
mangayayari sa darating na araw, ano yung pagdadaanan ng anak ko. She also
added that since the diagnosis, there are always these feelings of fear and
81
nervousness about what will happen to her daughter. She said that it was really
hard to focus on work with all that is happening.
When the researcher asked the mother about how she survives the
situation, she said that it was all because of her faith in God. She said,
Pinalalakas ko na lang talaga loob ko sa tulong ni God. Yung faith ko sa Kanya
parang nagpapagaan talaga ng pakiramdam ko. Para bang Siya talaga yung
hinuhugutan ko ng lakas ng loob. She also added that she believes that nothing is
impossible with God and that God is the one that really gives her hope that
everything will be okay. Furthermore, she also reported that the support of her
family and friends did help her a lot to get through the situation. She said, Yung
mga kapatid ko, mga magulang ko, pati mga kaibigan ko rin, mga katrabaho ko,
lahat sila pinaparamdam nila sakin na hindi ako nag-iisa sa problemang ito.
Palagi nila akong ine-encourage, pinapalakas yung loob. She also added that
these people assist her financially, as well as in taking care of the child. She said,
Sa financial naman, konti lang naman kasi talaga kinikita ko, kaya pasalamat din
ako ng sobra sa mga kapatid ko pati na din yung mga taong nagpapahiram samin
ng pera, pambili ng gamot, mga ganun. Moreover, she said that parents of other
children in the hospital also help her feel better as they make her feel that she is
not the only one with this kind of problem. She said, Kung minsan, yung mga
magulang dito, may time kami na nag-uusap-usap kami, kwentuhan ng mga
experience namin sa mga anak namin. Parang nakakagaan din yun ng loob. She
also added that hearing the stories of other parents somehow encourages and
strengthens her as well. She said, Syempre nakikita ko na kung sila nga nakikita
kong parang kaya nilang malagpasan ang lahat bakit hindi ako, bakit hindi ko
82
kakayanin? She also reported that being positive or being optimistic about the
situation also helps. She said that being positive makes it a bit easier for her to
handle the situation, which, according to her, she needs to do for her daughter.
However, when asked whether she blames herself for her daughters illness, she
said, Oo, minsan naiisip ko rin yan. Kasi gaya nga ng sabi ko, dati hindi ko siya
napagtutuunan ng pansin, ng oras. Naisip ko na baka nagkulang ako sa pagaalaga, ganun. Furthermore, when asked about drinking, smoking, or taking
medication to feel better, she replied with no, and said that she doesnt really
have any vices and that she really tries to focus her attention on her daughter
instead of doing stuff like that. She said, Ah, hindi. Wala naman talaga kasi akong
mga ganyang vices. Tapos instead na gumanyan ako binabalin ko na lang talaga
ng oras, at atensyon ko sa anak ko tsaka sa problema namin.
Finally, when asked for a positive outcome of the situation, the mother
replied, Meron kasi gaya nga ngayon, yung oras na hindi nabigay sa kanya dati,
ngayon sobrang bumabawi na talaga ako sa kanya. Inaalagaan ko na siya ng
buong-buo at kahit papano mas napalapit ako sa kanya.

83
CHAPTER VI
Discussion of Results
Socio-Demographic Profile of Parents

As presented in Chapter V, a total of 83 parents participated in the study,
with 41 fathers and 42 mothers. One of the reasons why the numbers of mothers
and fathers who participated in the study are almost the same is because
majority of the parents who participated were married couples. Another reason
is because the researcher tried to even out the number between both parents
since it was stated in the related literature of this study that sex of the parent
does play a very important role in the type of coping strategies that a parent
adapts. It is considered in most of the related studies, as well as in the present
study, as one of the major factors that influence parents in their coping behavior.
So, with an almost even number of fathers and mothers, the researcher can make
a more accurate comparison between the two in terms of the type of coping
strategies that they adapt. This comparison will be discussed and elaborated
more, later in this chapter.
The large number of married couples that participated in the study did
not only affect the number of fathers and mothers but also the data regarding the
occupational status of the parents. As presented on Table 1 in Chapter V, a total
of 34% of the parents was comprised by housewives. This is basically because of
the gender roles attributed to parents that is very common in our society, where
fathers work and provide for the family, while mothers stay at home as
84
housewives, doing all the household responsibilities including taking care of the
rest of the family. Since majority are married couples, a large number of
housewives were observed.
With regard to the parents educational attainment, Table 1 in Chapter V
showed that more than half of the parents only reached secondary or high school
level. This data somehow is reflected on the data regarding the type of
occupation these parents have. Although a high percentage of the parents are
employed, their jobs are not really those highly-specialized and high-paying jobs.
Most of these jobs include saleslady, clerk, driver, laborer, construction worker,
fish vendor, etc. These jobs are not really the type of jobs that require high levels
of education. Furthermore, these data can be further reflected on the monthly
family income of the respondents. As reported, only about 26% of the
respondents earn P10, 000-P14, 999 a month, while about 74% earn below P9,
999. With these data, the researcher can tell the socio-economic status about the
parents, which shows that parents who actually choose PGH for their childs
cancer treatment belonged to the middle-lower classes of the society. These data
regarding the socio-economic status of the parents are believed to be major
factors influencing what type of coping strategies parents adapt. This will be
more elaborated later in this chapter.
Regarding the age of the parents, it is notable that majority of them are
middle-aged adults with more than half of them belonging in the age category of
30-49 years, and only a very small percentage of them were aged 50 years or
older. Furthermore, since our country is dominated by Roman Catholic, 86% of
85
respondents were Roman Catholics with the remaining 14% divided to different
religions like Christian, Iglesia ni Cristo, Muslim, Ang Dating Daan, Methodist, and
Seventh-Day Adventist. Finally, the number of children of the respondents
showed that most of the respondents have small families with 37% of the
parents having only 3 children, and another 23% having only 2 children.
Common Problems/Difficulties Experienced by Parents

When a child in a family is diagnosed with cancer, the life of the whole
family is greatly affected with all the major changes, problems and difficulties
that come along with the childs illness. In most cases it is the parents that
confront and try to solve these problems and difficulties. These problems may
include financial, psychological and emotional, occupational, social-relational,
and other demands that come along with the childs illness. Basically, these
problems commonly encountered by parents of children diagnosed with cancer
are the ones that require parents to use or adapt coping strategies in the first
place.
Financial Problems
According to Kalnins et al. (1980), financial problems have an enormous
impact on families dealing with childhood cancer. For a third-world country like
ours, this seems to be very likely. With PGH as a public hospital it is
understandable that most of the people that go here for medication are not really
well-off. As observed in the socio-demographic profile of the respondents of the
study, about 74% of them reported to earn below P9, 999 a month and almost all
86
of them are employed in a blue-collar job. This indicates that a large majority of
the respondents belonged to the middle-lower economic classes, which means
that money is indeed a problem.
As observed in the key-informant interviews conducted by the
researcher, most of the parents reported difficulties regarding their economic
status. According to them, life was already hard, financially, even before their
child was diagnosed with cancer. So, with an additional burden of paying for the
childs
medication
and
treatment,
including
all
the
medicines
and
chemotherapies that the child needs, most of these parents do suffer from a great
financial problem.
As reported by the key-informants, sometimes they really do not know
where they would get the money that they need for their child. The couple with
the lowest monthly family income even stated that with all the other effects of
their childs illness on their lives, they still consider their economic status as the
one that is greatly affected and the one that made it really hard for them as
parents. The mother kept complaining about how expensive her childs
medication is, while the father, on the other hand, reported about how
sometimes, when he cannot provide money for his family, he always feels like
flying into a rage. Furthermore, he even reported that sometimes he even finds
himself thinking of doing bad things just to get the money that they need. This
shows that parents can get really desperate because of their economic issues.
The father even reported that he had to sell his tricycle to get some money for his

87
child. In addition, financial problems also affect the couples relationship. The
couple reported that sometimes, they fight because of their financial problems.
Furthermore, the parents would usually complain about why, out of all
the people, this had to happen to people like them who do not have a lot of
money. Most of the parents also tend to rely on their relatives and friends who
help them financially. Even the couple with the highest monthly income with a
salary of P14, 000 a month, reported about having financial problems as well and
that it is with the help of their parents that they get through this type of problem.
However, they also report that they usually end up having a lot of debt to a lot of
people in the end.
Occupational Problems
Another aspect of the lives of the parents that is affected by their childs
illness is their occupation. Since most of these parents are employed, having a
child with cancer may greatly affect their job performance. Overholser and Fritz
(1990) reported that families dealing with childhood cancer results to career
setbacks of mothers. This, however, is somehow different from what the data of
this study say. Since, as the researcher mentioned earlier, it is common in our
society that men work and provide for the family, while women stay as
housewives, most of the setbacks in career happen to the fathers. Single mothers
who work for their children, however, may also experience these occupational
problems. As reported in the key-informant interviews, fathers working often
find themselves not focused on their jobs. As the father in the couple with the
highest family income reported, it is hard to concentrate on his job as a
88
marketing agent, which requires complete focus, since he keeps on thinking

about other problems outside work such as his family or his child with cancer.
This goes the same for the father in the couple with the lowest monthly family
income who works as a family driver. He reported that he find it really hard not
to think about his family while at work. Another thing is that, since, as parents,
they want to be the one taking care of their child as much as possible, their
absences from work become very frequent. This is what the single mother
reported. However, the best example of the effect of the childs illness on the
parents occupation would be the single father from the key-informant
interviews. As reported by the father, since his family lives in a province in
Visayas, where according to him does not offer chemotherapy treatments, he and
his child had to live in Manila for his sons cancer treatment. As a result, he lost
his job as clerk back in his province. All these examples show how occupational
problems can be caused by the childs cancer diagnosis.
Social-Relational Problems
Another set of problems commonly experienced by parents of children
with cancer can be observed from the social relations that the parents have. As
stated in the related literature of this study, some parents, mostly the father,
isolate themselves from other people as a coping strategy to their childs illness
(Larson et al. 1994). This has also been observed in the results of this study. As
presented in Table 5 in Chapter V, a mean score of x =6.48 was given to the
coping strategy Self-Isolation. This shows that, although it is significantly low
compared to the other coping strategies, parents still adapt self-isolation as a
89
coping strategy, which may affect their social relationships with the people
around them. This can also be observed from the key-informant interviews. As
reported by the parents, they do indeed sometimes feel like isolating themselves
from people to, according to them, think better.
Another social-relational problem that may have been caused by the
childs cancer diagnosis is the marital relationship between the parents (Brown
et al. 1993). Although no specific instrument was used to determine this, the
couples in the key-informant interview did report that sometimes they fight
either because of their financial problems regarding the childs medication, or
because of the other parents neglect over the child with cancer. They also
reported that because of the stress that they experience, most of the time either
one of them is in a bad mood which results into a fight.
Emotional and Psychological Problems

Finally, the most significant problem encountered by the parents is the
emotional and psychological difficulties that come along with the childs cancer
diagnosis. This is where all the other problems mentioned above boil down. It is
very common that when a child in a family is diagnosed with cancer, various
emotional reactions take place among the family. Parents, however, are once
again the ones that are greatly affected emotionally and psychologically by this
kind of event. Its emotional and psychological impact of the diagnosis of cancer
is intense and long lasting for them (Hashemi et al., 2007). According to the
studies of Dahlquist et al. (1993), and Magni et al. (1986), most parents of
children diagnosed with cancer, or children who are in treatment, showed
90
increased signs of psychological and emotional distress as compared to the

normative data of their studies. Feelings of depression, anxiety, stress and some
somatic symptoms have been very commonly reported among parents (Brown et
al., 1993). Similarly, this study shares the same results with its related literature
regarding the emotional and psychological problems encountered by parents.
The data regarding the emotional and psychological distress experienced
by the respondents of the study have been determined by the Kesller
Psychological Distress Scale (K10). It measures the psychological distress along
the axes of anxiety and depression that an individual experienced in the past 4
weeks prior to taking the test. Results of the questionnaire (refer to Figure 2)
showed that although 33% of the parents did get a low score of less than 20,
which indicates that they are likely to be well, there is still a significant
percentage of parents (28%) that were believed to have a moderate mental
disorder, and another 25% that are likely to have a severe mental disorder. This
just supports the results of other related studies that parents do suffer from
psychological distress when confronted by their childs cancer diagnosis.
Furthermore, majority of the parents reported of feeling nervous most of
the time during the past month prior to answering the questionnaire. This is
probably because most of the parents are afraid of what may happen to their
child in any moment. Most of the parents also reported in the questionnaire
about feeling tired for no reason, feeling depressed, felling restless or fidgety,
and feeling that everything that they do is an effort. All these negative feelings
experienced by these parents indicate that they, like those parents in other
91
related literature of this study, experienced feelings of depression, anxiety, stress

and some somatic symptoms.
These data from the K10 questionnaire is further supported by the
results of the key-informant interviews conducted by the researcher. Based on
the interviews, most of the reactions of the parents upon finding out about their
childs illness were pretty much the same. They reported being shocked,
surprised, getting mad at the doctor, and feeling enraged. Some of them used
denial as a defense mechanism to the news, thinking that maybe the doctors
were wrong about their diagnosis. Another issue for the parents was acceptance.
According to Eiser et al. (1992), parents undergo the same stages that people go
through when they lose a loved one before they can accept their childs cancer
diagnosis. All of the parents that were interviewed find it really hard to accept
their childs illness. Mostly it is time that actually helps them learn to accept it.
However, at the beginning, accepting this kind of news for parents is not a very
easy job. Parents would usually describe it as mahirap or masakit. After the
acceptance phase, parents reported that they start to feel depressed and anxious
about the situation. The single father did report that he often finds himself just
staring blankly into space or even sometimes finds himself crying. Parents also
find themselves thinking very much about their problems regarding their childs
illness. They feel that they have this obligation to focus and occupy themselves
with thoughts about how to solve these problems. The parents also reported that
they also often feel anxious about what may happen to their child, that in any
moment their child could die.

92
Apart from the fact that having a child diagnosed with cancer can really
cause emotional and psychological problems to parents, another possible reason
that may contribute to these results of high levels of psychological distress
among parents is the fact that there are still other life events and concurrent
stressors that occurs in their lives (Kalnins et al., 1980). Well, one very common
example of these concurrent stressors would be the ones that were discussed
above, financial, occupational, and social-relational problems. All these things,
together with the fact that your child is suffering from cancer and that there is
this possibility that he or she may die because of it, contribute to the emotional
and psychological stress that these parents experience.

With the use of the Coping Strategy Questionnaire created by the
researcher, different coping strategies used by parents were identified. As have
been reported in the previous chapter, the leading coping strategy adapted by
parents is Seeking Spiritual Support. This result is similar to the findings of
Hashemi et al. (2007), who showed that parents adapt Seeking Spiritual
Support more often compared to the other coping strategies. This indicates that
upon all other things, Filipino parents still choose to seek the spiritual support
from God. It also shows that the religious conviction that Filipino people have is
in accord with the results of the present study. It is indeed very common that
among Filipino families, no matter what the religion is (although Roman
Catholics were greatly represented in the study), seek help from God among

93
other things in times of adversities. Also, according to Yeh (2001), while caring
for a child with cancer, expanding on the meaning of life and illness from the
perspective of spiritual belief would actually help the parents cope. He stated
that parents began to reconsider the meaning and the purpose of life through
religious beliefs, which is probably the reason for these kinds of results in the
study. Furthermore, these results are further supported by the key-informant
interviews conducted, where all of the key-informants reporting that God, or
their religion, do play a major role on their coping. All parents reported how
praying and having a strong faith with God make them feel a lot better or as they
say it, nakakapagpagaan ng loob. Parents also reported that believing that
there is a God who has control on everything that is happening around us makes
them feel more hopeful, knowing that God will not abandon them and their child.
Next to the Seeking Spiritual Support is the coping strategy, Being
Optimistic about the Situation. With items in the questionnaire like Believing
that my child will get better no matter what, Believing that my child is getting the
best medical care possible, and Believing that things will always work out, the
significant use of the coping strategy basically indicates that large majority of
parents prefer to be optimistic despite their situation. According to a study made
by Petermann et al. (1986) optimism was found to be positively correlated with
positive adjustment. They reported that parents who are more optimistic about
the situation tend to have better psychological well-being. Optimism basically
means the global expectation that good things will happen (Scheier & Carver,
1992). This characteristic again seems to be another common feature of
Filipinos. In a third-world country like the Philippines, where a lot of tragedies,
94
natural disasters, etc. have happened, Filipinos have remained resilient hoping
that things will always be better and turn out for the good. Also, according to the
joint study made by Axa Asia Life and research company Taylor Nelson Sofres
(2007), Filipinos still are the second happiest and most optimistic people in Asia.
This study also showed that Filipinos are relatively happy about their careers
and their families but are most optimistic about their health, which is probably
the reason why parents gave high scores for this coping strategy. Furthermore,
this result has also been supported by the key-informant interviews where
parents reported that although it was hard to be optimistic with all the problems
and difficulties that came along the childs diagnosis of cancer, they still try to
remain positive about the situation. They believed that it is important to remain
hopeful and focus on the childs recovery.
Following Being Optimistic about the Situation are the coping
strategies such as Communicating with Medical Staff and Other Parents,
Wishful Thinking, Acquiring Social Support, and Positive Reframing with
mean scores of (x =12.83), (x =12.66), (x =12.58), and (x =12.36), respectively. As
presented, the mean scores of these four coping strategies are significantly high.
However, no significant differences can be seen between their mean scores.
Communication may have different meanings. This include the
communication between the parent and the child about the illness, the
communication between the parents and the medical staff about the childs
condition, and the communication between the parents and other parents of
children with cancer about their emotional experiences (Leventhal-Belfer et al.,
95
1993). In the present study, the questionnaire focused more on the

communication between the parents and the medical staff and the one between
the parents and other parents. It is probable that the reason why the
respondents chose Communicating with Medical Staff and Other Parents
significantly is because parents still believed that the medical staff treating their
children is still the ones that have direct control on their childs treatment, in
which the childs recovery depends on (Brown et al., 1993). Also, since they are
the ones that are really knowledgeable about their childs illness parents still
have strong trust on them regarding their child. Communicating with them gives
the parents the idea that something is being done to cure their child. It also
provides them with information about the childs illness, which makes them
become more aware of it (Brown et al., 1993). Communicating with the other
parents going through the same situation also helps the parents to feel at ease
knowing that they are not alone and that there are other people who go through
the same things that they are going through. This has been reported in the keyinformant interviews conducted, where the parents said that with all the parents
sharing the same sentiments, they feel more encouraged and relaxed.
Acquiring Social Support, on the other hand, was used significantly by
parents because of the fact that the availability of the family and friends helps a
person to cope with stress (Morrow et al., 1984). Morrow et al. (1984) reported
that next to the spouse, the medical community and other parents in the mutual
help group were the most helpful sources of support as perceived by the parents.
Another probable reason, regarding the respondents of the present study, is the
fact that Filipinos have this trait known as the Pakikipagkapwa-tao and Family
96
Orientation (Garcia et al., 1984). According to Garcia et al. (1984), this

indigenous Filipino trait is the regard for the dignity of others and being with
them. It consists of all levels of interaction with one's fellowman in times of
crisis, like illness and death. With this, it seems understandable why majority of
the respondents adapt this coping strategy. Filipinos are indeed known for
helping each other out in times of problems like this. Furthermore, according to
the key-informant interviews, social support helps parents to make them feel
better knowing that there are family and friends who support them in their
endeavors. It also supports them financially, which they consider as a big thing
since most of the parents do not have a high socio-economic status. One
statement that will probably sum up the importance of social support for parents
was stated by the mother of the couple with the lowest family income. She said,
Hindi ko talaga alam kung ano ang gagawin namin kung wala yung mga kamaganak namin, mga kaibigan namin.
For the coping strategies such as Wishful Thinking and Positive
Reframing, respondents have significantly adapted them probably because of
the same reason why they have adapted Being Optimistic about the Situation
significantly. Both wishful thinking and positive reframing require some
optimism to be done, and as the researcher mentioned earlier, optimism is one
trait that is very characteristic of Filipinos.
Following those coping strategies above are Using Passive Appraisal,
Self-blame, Self-Isolation, and Substance Use. Basically, these coping
strategies are the ones that are not significantly adapted by the respondents. As
97
reported, parents do not use passive appraisal that much. This is probably
because, as much as possible, parents would like to do something about their
childs illness that would result to a faster recovery rather than not do anything
about it (Fife et al., 1987).
Regarding the coping strategy Self-blame, parents probably did not
adapt this coping strategy significantly because it was probably hard for them to
admit to themselves that they may be the reason why their child is suffering from
cancer. It is indeed a hard thing to accept that you have caused your own childs
illness. Also, according to one of the related literature of the study, self-blame is
usually associated with negative adjustment (Bearison et al., 1993). On the other
hand, the coping strategy Self-Isolation may not have been adapted by parents
significantly because of the same reason why most of the parents choose to adapt
Acquiring Social Support. As the researcher mentioned earlier, the Filipinos
would rather acquire the help of other people than choose to isolate themselves
from others and be alone. Although some parents from the key-informant
interviews did report of spending some time alone and away from people to
think better, majority of the parents still prefer to have the company of family
and friends most of the time. Based on the key-informant interviews, the effect of
having family and friends around you in times of crisis like this is a lot better
compared to isolating yourself from people.
Finally, the least adapted coping strategy among all is the Substance
Use. According to the study by Fife et al. (1987), increased substance use as a
way of coping is actually a sign that the individual is experiencing anxiety,
98
depression, or trauma. Furthermore, as reported in the key-informant

interviews, parents would rather give their full attention on their childs illness
as well as the other problems that come along with it instead of drinking,
smoking or taking medication. It is probable that parents do not see it right for
them to enjoy alcohol, cigarettes, etc. while their child is suffering from cancer.
Also, as the father from the couple with the lowest monthly family income
reported, no matter how much you drink, smoke, etc., your child would still be
sick and your problems would still be there. However, it is also possible that the
parents, because of shame, did not answer honestly on this scale, since it shows
irresponsibility on their side.
Factors Associated with Type of Coping Strategies Adapted by Parents

As discussed in the Theoretical Framework as well as in the related
literature of the present study, several factors influence the type of coping
strategies adapted by parents. Most of these factors are basically the sociodemographic information of the parents themselves such as their sex, age,
marital status, educational attainment, and socio-economic status.
Sex of the Parent

According to the related literature of the study, the sex of the parent
plays a major role in terms of the coping behavior of the parent (Magni et al.,
1986). A study made by Magni et al. (1986) reported that sex differences showed
differences in the type of coping strategies adapted, which results to differences
in the levels of depression and anxiety for mothers and fathers. The same results
99
were observed in the present study. As presented on Table 13 in the previous

chapter, statistically significant associations were found between the sex of the
parent and coping strategies they adapt such as Communicating with Medical
Staff and Other Parents, Acquiring Social Support, Self-Isolation, and
Substance Use. Among all the other variables, the sex of the parent had the
most number of statistically significant associations with the coping strategies.
As reported in the earlier chapter, mothers used communication more
often than fathers. This result is the same with Shapiro and Shumakers study
(1987) who showed that mothers communicate with the childs medical staff as
well as other parents more often than fathers. It is probable that since majority
of the mothers are housewives and since they are the ones actually taking care of
the child, they communicate more often than fathers do with the medical staff so
that they can be more well-informed about the childs illness. The same results
were observed in the coping strategy, Acquiring Social Support. It was reported
that mothers tend mothers tend to acquire social support more than fathers do.
This result is similar with Larson et al. (1994) who also showed that mothers use
social support more than fathers. The probable reason for this is the fact that
wives are usually the ones that have larger everyday kin networks and more
frequent contact with relatives than fathers (Larson et al. 1994). Furthermore,
communication and support are seen to be related to one another, because it is
believed that with communication parents can search for information or get
support (Shapiro and Shumaker, 1987).

100
On the other hand, regarding the association between the sex of the
parent and self-isolation, it was observed that fathers tend to isolate themselves
more from people than mothers. This data basically supports the result above
that mothers tend to acquire social support more than fathers. This, again, was
also observed by the study made by Larson et al. (1994). According to their
study, fathers tend to avoid discussion of the subject as well as to avoid the
company of other people at certain times. They believed that this is because
fathers, as much as possible, try to hide their emotions from other people and so
in these kinds of situation, they tend to isolate themselves from people and be
free to express how they feel (Larson et al. 1994).
It was also reported that fathers, compared to mothers, tend to use
Substance Use more. Same results were found in the study of Magni et al.
(1986), where, as they have reported, fathers tend to drink more as a way of
coping with the situation. They reported that increased drinking after the
diagnosis of their childs cancer is a common reaction from fathers. According to
their study, since men usually have more vices like drinking and smoking, they
tend to rely on these vices more when faced with problems like this, which,
according to them, helps them get through it (Magni et al. 1986).
Finally, although no statistically significant association was found
between the sex of the parent and the use of Self-blame, it has still been
reported that fathers tend to criticize and blame themselves for their childs
illness than mothers. This is probably because since majority of the fathers are
employed, they do not get the chance to take care of their children all the time,
101
which probably is the reason that they attribute to the childs illness (Ruccione et
al., 1994). This is supported by the high mean score that the item To realize that
if I had taken care of my child really well, he/she would not be sick got. Also,
according to the study made by Ruccione et al. (1994), since fathers are
considered as the head of the family, they always tend to feel responsible for
whatever happens to any member of the family. They either attribute it to the
low financial support that they provide for the family, or their lack of care for
their child (Ruccione et al. 1994).
Age of the Parent

Age of the parent is another factor that influences the coping mechanism
of parents of children with cancer. It was reported in a study by Morrow et al.,

(1984) that differences in the psychosocial adjustment difficulties experienced
were observed between younger parents, or those below 30 years, and older
parents. In the present study, the age of the parent was only found to have
statistically significant association with the use of Wishful Thinking. It was
reported that older parents (40-49 years) use wishful thinking more compared
to the other age groups. One probable reason is that older adults tend to employ
more emotion-focused coping strategies, one of which is wishful thinking, when
faced with these kinds of problems (Folkman and Lazarus, 1984).
Although no statistically significant differences were observed between
the different age groups regarding their use of the other coping strategies, it was
still reported that older parents tend to isolate themselves from people more
compared to the other age groups. A study made by Folkman and Lazarus (1984)
102
reported that older parents try to keep their feelings about their childs condition
to themselves because, as much as possible, they want people to think that they
are okay and that they can handle the situation, with their older age and greater
experience.
Marital Status of the Parent

Another factor that may influence the parental adjustment with their
childs cancer is their marital status. Speechley and Noh (1992) reported that
married subjects tended to have moderately lower levels of depression and
anxiety than those who are single, divorced or widowed. Regarding the type of
coping strategies they adapt, it was reported in the present study, as presented
in Table 15, that marital status of the parent have statistically significant
associations with the use of coping strategies like Acquiring Social Support, and
Substance Use. It was observed that those parents who are single, divorced,
and widowed seek or acquired social support more than the married parents.
This is probably because since single parents are alone and do not have partners
in raising their child/children, they rely more on the help of their social support
including their family and friends. According to Speechley and Noh (1992), those
parents who are currently not married tend to feel helpless and alone in times of
crisis, which is why they seek the help and support of other people that they
know.
With regard to the association between the marital status of the parent
and the use of Substance Use, it was reported in the previous chapter that
divorced parents use substances more in coping with the situation. This is
103
because divorced parents perceive their childs illness differently compared to

those married subjects (Speechley and Noh, 1992). Somehow, for them, their
childs illness seems more devastating since they got out of a failed marriage and
now they do not have the support that a spouse could provide them. They tend to
be more depressed about the situation, which results to increased drinking and
use of substances, which according to them is their source of comfort (Speechley
and Noh, 1992).
Lastly, although no statistically significant association was found, it was
also observed that the divorced parents used Self-blame more compared to the
other parents. This is probably because, since they are now alone in terms of
raising their family, they feel more responsible for what happens to their child,
and so they attribute their childs illness to themselves.
Educational Attainment of the Parent

Educational background of the parents is considered another factor that
affects the type of coping strategies applied by parents. As reported on Table 16

from the previous chapter, parents with lower educational level tend to
communicate more with the medical staff and other parents with the same
situation. Same results were observed in one of the related literature of the
present study. According to the study, parents with lower educational level tend
to have better relationships with the medical staff because since they do not have
much knowledge about their childs illness, they, as much as possible, try to
understand their childs illness through communicating more with the medical

104
staff, which according to them, makes them feel a part of the medical situation
(Shapiro and Shumaker, 1987).
It was also reported that those parents with lower level of education
adapted Substance Use as a way of coping significantly compared to the other
parents. The use of Self-blame was also observed among parents with lower
education. One probable reason for this is that since these parents do not have
higher educational background, they tend to resort to the only thing they know
that can somehow make them feel better despite the situation, which is drinking
or using other substances. Another is that it is probable that these parents may
feel that they cannot really do anything about their childs condition, so they
prefer to drink, smoke, etc. for them to not think about the situation too much.
On the other hand, it was also reported that those more educated
parents adapted Positive Reframing significantly. Same results were observed
from a study by Hashemi et al. (2007). This basically demonstrates the more
positive attitude from more educated parents. According to Hashemi et al.
(2007), parents with higher educational attainment, has more ability to redefine
their current situation into something positive, which helps them cope with the
situation better, compared to those with lower education.
Monthly Family Income

Finally, the socio-economic status of parents is considered as another
factor that greatly affects the coping behavior of parents. In one of the related
literature of the study, it was observed that parents with lower income had
higher risks of having problems in coping with the situation (Van DongenARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently
105
Melman et al., 1995). In the present study, it was reported on Table 17 that
parents with lower monthly income significantly seek the help and support of
family and friends compared to those with higher monthly income. This is
probably because these parents are not capable, with their low income, to
support financially their childs medication and so they seek financial support
from their family and friends.
It has also been reported, although no significant associations were
actually found, that those parents with monthly income below P5, 000 blamed
their selves more compared to those with higher monthly income. According to
the study by Van Dongen-Melman et al. (1995), this is probably because these
parents believe that it is because of their low socio-economic status that they
could or have not provided their child with the proper nutrition and medical care
that might have been the reason why their child got cancer. With this, parents
criticized themselves for not being able to provide proper medical care for their
children and believed that it was their fault why their child has cancer (Van
Dongen-Melman et al., 1995). Furthermore, it was also reported that those
parents with low monthly income used passive appraisal more compared to
those with higher income. This is probably because since they do not have
enough resources, which makes them feel like they cannot do much about their
childs condition, they tend to behave passively about the situation leaving their
childs recovery on luck, time, etc. (Van Dongen-Melman et al., 1995).

106
Effects of the Coping Strategies on the Parents

As discussed in the Conceptual Framework as well as in the review of
related literature of the study in Chapter III, the type of coping strategies adapted
by parents have a great effect on the adjustment or adaptation of the parents to
the situation. The coping strategies that parents adapt may either lead them to a
healthy and positive adjustment or to a negative or maladjustment.
As presented on Table 19 in Chapter V, which shows the scores of the
parents on the Kessler Psychological Stress Scale (K10) in relation to the coping
strategies that they have adapted, those parents who got high scores (9-15) in
the coping strategies such as Communicating with Medical Staff and Other
Parents, Acquiring Social Support, Wishful Thinking, and Positive
Reframing got lower mean scores in K10 compared to those with low scores (38) in the mentioned coping strategies. Basically, those parents who got low mean
scores in the K10 questionnaire indicate that they experience lesser
psychological distress, which means that they are adapting to the situation pretty
well. On the other hand, for those who got high mean scores in the K10, their
levels of psychological distress may be higher indicating that they are not coping
to the situation well. With this, the results mentioned above indicates that those
parents who chose to adapt those four coping strategies are more likely to be
well compared to those who did not significantly adapt those coping strategies.
Furthermore, for coping strategies such as Seeking Spiritual Support, and
Being Optimistic about the Situation, which are the two most adapted coping
strategies by the parents, no comparisons were made since no parent got a score
107
below 8 and all parents got a score from 9-15 on both scales. However, based on
the low mean scores (refer to Table 19) of the parents in the K10 questionnaire,
the researcher can imply that these parents may likely to be well as well.
These results are very much the same with the results of other related
literature of the study. Morrow et al. (1984) showed the same results with social
support from family and friends considered as really helpful for parents to cope
better with their situation. The same goes with communication, which showed
the same results with Brown et al. (1993), who reported also that open and
frequent disease-specific communication between the parents and the medical
staff, as well as communication between the mother and the father were found to
be positively correlated with good adjustment. Ferrandis et al. (2008), showed
the same results with positive reframing reporting that parents adapting positive
reframing, just like in this study, showed less depressive symptomatology. Sloper
(1998) also reported the same results that wishful thinking was associated with
less distress. Furthermore, results on the present study about the association of
the use of Seeking Spiritual Support and Being Optimistic about the Situation
with the levels of stress experienced is also supported by the results of the
studies made by Hashemi et al. (2007), and Petermann et al. (1986). According to
Hashemi et al. (2007), parents who seek spiritual support cope much better
while caring for the child with cancer since it provides them hope and faith in a
supernatural being that has the control on everything, even the lives of their
child. Finally, according to the study of Petermann et al. (1986), having a positive
outlook or being optimistic has been described and confirmed as one of the

108
major predictors of positive adjustment, which is the basically the same with
what the present study shows.
On the other hand, those parents who got high scores on coping
strategies such as Self-Isolation, Self-blame, Using Passive Appraisal, and
Substance Use as presented on Table 19, also got high mean scores in the K10
questionnaire, which indicates that parents adapting these coping strategies may
actually experience higher levels of psychological distress and result to
maladjustments. A study made by Fife et al. (1987) did report that coping
strategies like Using Passive Appraisal and Substance Use are usually
associated with increased depression, anxiety, etc. The same goes for the study
made by Bearison et al. (1993) who found the use of Self-blame positively
correlated with negative adjustment.
Furthermore, according to the Theoretical Framework of the present
study, adaptation of parents is generally depends on how people perceive
stressors (McCubbin & Patterson, 1985). As presented, the way parents perceive
their childs illness reflects on the type of coping strategies that they adapt.
However, as shown above, not all coping strategies may result to positive
adjustment. Thus, with the following results of the study, the researcher can
now accept the hypothesis of the study that states that familiarity of parents, as
well as their adequate use of the appropriate coping strategies may actually lead
them to cope with the situation in a healthy and well-balanced manner.

109
CHAPTER VII
Summary, Conclusion, and Recommendations
Summary
The study is essentially a look into the lives of the caring parents (i.e. the
mother and father) of children currently undergoing cancer treatment at the
Philippine General Hospital as they cope with their situation. A total of 83
parents were asked to participate in the study after employing a purposive
sampling method. With a quantitative and qualitative study design, the
respondents were asked to answer Kessler Psychological Distress Scale (K10)
and the Coping Strategies Questionnaire, which is a survey questionnaire created
by the researcher to determine the coping strategies that they adapted. Six out of
the 83 respondents were then selected by the researcher to participate in KeyInformant Interviews.
The questionnaire included the socio-demographic information of the
respondents. With regard to the respondents sex, a total of 41 fathers and 42
mothers participated. The respondents age ranged from 23-54 years old
wherein 37% (N=31) of the respondents fell into the age category of 30-39. A
total of 33 married couples participated with 8 single fathers and 9 single
mothers. Majority of the respondents (52%) have only reached secondary level
of education and about 47% are employed. Among the respondents, 57% (N=48)
earns P5, 000 - P9, 999 a month. Furthermore, almost all of the respondents
were Roman Catholics and majority of them (37%) had only 3 children.
110
The second part of the questionnaire consisted of the K10, which

determines the psychological distress experienced by the respondents in the
past 4 weeks prior to taking the test. Results showed that 33% of the
respondents were likely to be well. However, it was still reported by the
researcher that a total of 28% and another 25% of the respondents were likely
to have a moderate mental disorder, and likely to have a severe mental
disorder, respectively.
The third part of the questionnaire consisted of the Coping Strategies
Questionnaire. Here, the respondents choose from a five-point scale as to how
much they agree or disagree with 30 statements about how they cope with their
childs cancer diagnosis. The results showed that parents significantly used
Seeking Spiritual Support among the other coping strategies. This is followed
by Being Optimistic about the Situation, Communicating with Medical Staff
and Other Parents, Wishful Thinking, Acquiring Social Support, Positive
Reframing, Using Passive Appraisal, Self-blame, and Self-Isolation. The
least adapted coping strategy was Substance Use.
Correlations between the socio-demographic profile of the respondents
and the coping strategies they adapted were also done by the researcher. Results
showed that mothers tend to use Communicating with Medical Staff and Other
Parents and Acquiring Social Support, while fathers use Self-Isolation and
Substance Use more. Older parents were also observed to use Wishful
Thinking more. Regarding the parents marital status, it was observed that
single, divorced, and widowed parents used Acquiring Social Support more
111
than the married subjects. Divorced parents specifically, however, were reported
to use substances more compared to other parents. On the other hand, those
parents with lower educational background were reported to communicate
more with the medical staff and other parents. They were also reported to use
Substance Use more as a way of coping. Lastly, those parents with low monthly
income were reported to acquire more social support and are more optimistic
compared to those parents with higher monthly income.
Correlations regarding the K10 results in relation to the type of coping
strategies adapted were also presented by the researcher. Results showed that
those parents who adapted Communicating with Medical Staff and Other
Parents, Acquiring Social Support, Wishful Thinking, Positive Reframing
Seeking Spiritual Support, and Being Optimistic about the Situation, were
reported to have experienced lesser psychological distress compared to those
who adapted Self-Isolation, Self-blame, Using Passive Appraisal, and
Substance Use.
Finally, the Key-Informant Interviews conducted did not simply reveal
how the parents coped with their situation but also how difficult it was to have a
child with cancer as well as its effect on their lives. As reported by the
interviewees, accepting the diagnosis was one of the hardest parts of having a
child with cancer. After that, however, they have reported several problems or
difficulties that they have faced with regard to their childs illness. These
included financial, occupational, social-relational, emotional, and psychological
problems.
112
Conclusion
Cancer is considered as one of the major chronic illness among children
today. It is also considered to be the leading cause of death among children aged
14 and below in the country. Which is why for parents, having a child diagnosed
with cancer is a very hard thing to cope with.
Parents must perceive the
situation in a proper way for them to adapt the appropriate coping strategies,
which will help them cope with the situation in a healthy and well-balanced
manner.
Based on the data gathered and the analysis conducted, it was observed
that parents of children with cancer currently undergoing cancer treatment at
the PGH rely more on coping strategies that helps them cope with the situation in
a more positive way. Although, most of them, having low socio-economic status,
expressed problems and difficulties that they encountered since their childs
diagnosis, they still have learned to deal and adapt well with their situation. The
parents cope well with their current situation through seeking spiritual support,
communicating with the medical staff of the child, acquiring the support of
family and friends, being optimistic, redefining the situation into a more positive
idea, and even wishful thinking. Although some parents did report of using
negative coping strategies like isolating themselves from people, blaming or
criticizing themselves for their childs illness, behaving passively to the situation,
or using substances, these, however, were not used significantly.
Thus, based on all the information gathered, it can be deduced that the
familiarity, as well as the adequate use, of the appropriate coping strategies may
113
actually help parents of children with cancer cope with their situation in a
healthy and well-balanced manner.
Recommendations
In light of all the findings and conclusions of the study, the researcher
offers several recommendations to the parents of children with cancer, the
cancer institutions, and to the future researchers who would like to deal with the
same topic.
Recommendations to Parents
Based on all the information gathered in the present study, the researcher
suggests that the parents of children afflicted with cancer should be encouraged
to make use of and learn more about the appropriate coping strategies as
identified in the study. Parents should be well-informed about how to perceive
their situation properly and how they should react to it. Parents also should be
guided to avoid those negative coping strategies identified in the study. Finally,
parents should be encouraged to do all they can to cope well with their situation
because their childs recovery may somehow be affected by their coping
behavior.
Recommendations to Cancer Institutions
The cancer institutions with their facilities and services should not only
play a vital role on the treatment of the child but also to the coping of the families
of their patients, especially the parents. With this the researcher suggests
114
institutions should plan and create services that would help parents of children
with cancer cope well with their situation. They should start programs, seminars,
etc. that would educate or inform parents as to how they should deal with their
situation using the appropriate coping strategies. The researcher recommends
establishing the necessary facilities needed for the implementation of the
positive coping strategies identified. Furthermore, medical staff, i.e. doctors,
nurses, etc., should be properly informed about what these parents are going
through and how they can support the family by respecting them and serving as
a support by making referrals, providing information about the childs illness or
its management, allowing emotional expression by the parents, and by
responding to the emotions when expressed.
Recommendations to Future Researchers
For the future researchers who plan to make further studies that are in
line with the topic, the researcher suggests that other cancer institutions in the
country should also be included so as to have a wider population. Also, since not
many studies have been made regarding the topic in the country, the researcher
suggests that other aspects like the marital relationship, family functioning, etc.
of families with a child diagnosed with cancer should also be studied. Finally,
further assessment of other coping strategies that might not have been identified
in the present study should also be included in future studies.

115
Bibliography
Barrett, A., Voute, P. A., Stevens, M., Caron, H. (2005) Cancer in Children: Clinical
Management. New York: Ozford University Press.
Baskin, C. H., Forehand, R., & Saylor. C. (1985). Predictors of psychological
adjustment in mothers of children with cancer. J Psychosoc Oncol, 3, 4354.
Bearison, D. J., Sadow, A. J., Granowetter, L., & Winkel, G. (1993). Patients and
parents causal attributions for childhood cancer. J Psychosoc Oncol, 11, 47
61.
Brown, R. T., Kaslow, N. J., Madan-Swain, A., Doepke, K. J., Sexson, S. B., & Hill, L. J.
(1993). Parental psychopathology and childrens adjustment to leukemia. J
Am Acad Child Psychiatry, 32, 554561.
Cancer.Net. (2010, June). Childhood Cancer. Retrieved January 17, 2011, from
http://www.cancer.net/patient/Cancer+Types/Childhood+Cancer
Dahlquist, L. M., Czyzewski, D. I., Copeland, K. G., Jones, C. L., Taub, E., & Vaughan,
J. K. (1993). Parents of children newly diagnosed with cancer: anxiety,
coping, and marital distress. J Pediatr Psychol, 18, 365376.
Eiser, C., & Havermans, T. (1992). Mothers and fathers coping with chronic
childhood disease. Psychol Health, 7, 249257.
Ferrandis, E., Vaillo, Y., Garrido, M. J., Lopez, S., & Soler, C. (2008). General
distress, posttraumatic stress symptoms, and coping strategies in parents of
children with cancer. Temas em Psicologia, 16, 47-61.
Fife, B., Norton, J., & Groom, G. (1987). The familys adaptation to childhood
leukemia. Soc Sci Med, 24, 159168.
Folkman, S., & Lazarus, R. S. (1984). Stress, appraisal, and coping. Springer, New
York.
116
Fromer, M. J. (1995). Surviving Childhood Cancer. Washington, D.C.: American

Psychiatric Press, Inc.
Garcia, M., Zulueta F., & Caritativo, C. (1984). Sociology: Focus on Filipino Society
and Culture. Manila: National Book Store.
Gilgun, J. (1992). Definitions, methodologies, and methods in qualitative family
research. In J. Gilgun, K. Daly, & G. Handel (Eds.), Qualitative methods in
family research (pp. 2240). Newbury Park, CA: Sage Publications.
Grootenhuis, M. A., Last, B. F., De Graaf- Nijkerk, J. H., & Van Der Wel, M. (1996).
Secondary control strategies used by parents of children with cancer.
Psycho- Oncology, 5,91102.
Hashemi, F., Razavil, Sh., Sharif, F., & Shahriari, M. (2007). Coping strategies used
by parents of children with cancer in Shiraz, Southern Iran. Iranian Red
Crescent Medical Journal, 124-128.
Hayman, L., Mahon, M., & Turner J, (2002). Chronic Illness in Children: An
Evidence-Based Approach. New York: Springer Publishing Compan, Inc.
Hill, R. (1949). Families under stress: Adjustments to the crises of war, separation,
and reunion. New York: Harper
International Union Against Cancer (2005). Global Action Against Cancer.
Retrieved January 17, 2011, from http://cancer.iaea.org/documents/WHO_
Global_Action_Cancer_Engl_2005.pdf
Kalnins, I. V., Churchill, M. P., & Terry, G. E. (1980). Concurrent stresses in
families with a leukemic child. J Pediatr Psychol, 5, 8192.
Kazak, A., Boeving, A., Alderfer M., Hwang, W., & Reilly, A. (2005). Posttraumatic
Stress Symptoms During Treatment in Parents of Children With Cancer.
Journal of Clinical Oncology, 23, 7405-7410.
117
Kazak, A., Christakis, D., Alderfer, M., & Coiro, M. J. (1994). Young adolescent
cancer survivors and their parents: adjustment, learning problems, and
gender. J Fam Psychol, 8, 7484.
Kessler, R., & Mroczek, D. (1994). Final Versions of our Non-Specific Psychological
Distress Scale. Ann Arbor (MI), Survey Research Center of the Institute for
Social Research, University of Michigan.
Kupst, M. J., Natta, M. B., Richardson, C. C., Schulman, J. L., Lavigne, J. V., & Das, L.
(1995). Family coping with pediatric leukemia: ten years after treatment. J
Pediatr Psychol, 20, 601617.
Larson, L. S., Wittrock, D. A., & Sandgren, A. K. (1994). When a child is diagnosed
with cancer. I. Sex differences in parental adjustment. J Psychosoc Oncol, 12,
123142.
Lavee, Y., McCubbin, H., & Patterson J. (1985). The double ABCX model of family
stress and adaptation: An empirical test by analysis of structural equations
and latent variables. Journal of Marriage and the Family. 42, 811-825.
Leventhal-Belfer, L., Bakker, A. M., & Russo, C. L. (1993). Parents of childhood
cancer survivors: a descriptive look at their concerns and needs. J Psychosoc
Oncol. 11, 1941.
Magni, G., Carli, M., De Leo, D., Tshilolo, M., Zanesco, L. (1986). Longitudinal
evaluations of psychological distress in parents of children with
malignancies. Acta Paediatr Scand, 75, 283288.
Merriam, S. (1988). Case studv research in education. San Francisco: Jossey-Bass.
Morrow, G. R., Carpenter, P. J., & Hoagland, A. C. (1984). The role of social support
in parental adjustment to pediatric cancer. J Pediatr Psychol, 9, 317329.
Mulhern, R. K., Fairclough, D. L., Smith, B., & Douglas, S. M. (1992). Maternal
depression, assessment methods, and physical symptoms affect estimates of
depressive symptomatology among children with cancer. J Pediatr Psychol,
17, 313326.
118
Norberg, A. (2004). Stress and Coping in Parents of Children with Cancer. KI

Publications.
Overholser, J. C., & Fritz, G. K. (1990). The impact of childhood cancer on the
family. J Psychosoc Oncol, 8, 7185.
Peck, B. (1979). Effects of childhood cancer on long-term survivors and their
families. Br Med J, 1, 13271329.
Petermann, F., & Bode, U. (1986). Five coping styles in families of children with
cancer: a retrospective study in thirty families. Pediatr Hematol Oncol, 3,
299309.
Philippine Cancer Society (2007). April: Cancer in Children Awareness Month.
Retrieved January 17, 2011 http://www.philcancer.org.ph/index.php/learnmore-about-cancer/various-articles/95-what-is-cancer-in-children.html
Philippine Information Agency. (2009, April 5). Kids should not fight cancer alone.
Retrieved January 17, 2011, from http://www.pia.gov.ph/?m=12&sec=read
er&rp=1&fi=p090405.htm&no=5&date=04/05/2009
Powazek, D. M., Schyving Payne, J., Goff, J. R., Paulson, M. A., & Stagner, S. (1980).
Psychosocial ramifications of childhood leukemia: one year post-diagnosis.
In: Schulman JL, Kupst MJ (eds) The child with cancer. Thomas, Springfield,
pp 143155.
Ruccione, K. S., Waskerwitz, M., Buckley, J., Perin, G., & Hammond, G. D. (1994).
What caused my childs cancer? Parents responses to an epidemiology study
of childhood cancer. J Pediatr Oncol Nurs, 11, 7184.
Sawyer, M. G., Antoniou, G., Toogood, I., Rice, M., & Baghurst, P. A. (1993). A
prospective study of the psychological adjustment of parents and families of
children with cancer. J Pediatr Child Health, 29, 352356.
Scheier, M. F., & CARVER, C. S. (1992). Effects of optimism on psychological and
physical well-being: Theoretical overview and empirical update. Cognitive
Therapy and Research, 16, 201-228.
119
Shapiro, J., & Shumaker, S. (1987). Differences in emotional well-being and

communication styles between mothers and fathers of pediatric cancer
patients. J Psychosoc Oncol, 5, 121131.
Sloper, P. (1998). Predictors of distress in parents of children with cancer: a
prospective study. Journal of Pediatric Psychology, 25, 75-91.
Speechley, K. N., & Noh, S. (1992). Surviving childhood cancer, social support, and
parents psychological adjustment. J Pediatr Psychol, 17, 1531.
Stuber, M. L., Gonzales, S., Meeske, K., Guthrie, D., Houskamp, B. M., Pynoos, R., &
Kazak, A. (1994). Post-traumatic stress after childhood cancer. II. A family
model. Psycho-Oncology, 3, 313319.
Van Dongen-Melman, J. E. W. M., Pruyn, J. F. A., De Groot, A., Koot, H. M., Hhlen,
K., & Verhulst, F. C. (1995). Late psychosocial consequences for parents of
children who survived cancer. J Pediatr Psychol, 20, 567586.
Warsh, C. K., Strong-Boag, V. (2005). Childrens Health Issues in Historical
Perspective. Canada: Wilfrid Laurier University Press.
Wittrock, D. A., Larson, L. S., & Sandgren, A. K. (1994) When a child is diagnosed
with cancer. II. Parental coping, psychological adjustment, and relationships
with medical personnel. J Psychosoc Oncol, 12, 1732.
Yeh, C. (2001). Development and testing of the parental coping strategy
inventory (PCSI) with children with cancer in Taiwan. J Advanced Nurs, 36,
78-88.
120
Appendices
121
Appendix A: Grammarian Letter of Certification

COLLEGE OF ARTS AND SCIENCES
Padre Faura, Ermita, Manila
GRAMMARIAN LETTER OF CERTIFICATION
Date:
To whom this may concern,
This is to certify that this manuscript had undergone professional

grammar check and proof reading. This document is produced for whatever
purpose it may serve.
CHECKED AND VALIDATED BY:

Name: ______________________________________
Signature: _________________________
Occupation: ________________________________
Date Validated: ___________________
Institution of Practice: ____________________

____________________________________________
122
Appendix B: English Cover Letter and Informed Consent Form


Greetings!
I am Steve R. Arcilla, a student from the University of the Philippines Manila. I
am currently taking up Behavioral Sciences, and as a part of our requirements for
graduation, I am doing a study about the coping strategies adapted by parents of
children with cancer with regard to the stress, as well as the emotional and
psychological distress brought about by the situation. This study aims to determine the
effective ways that parents adapt in order for them to have a healthy and well-balanced
emotional and psychological being despite their situation.
I hope that you will help me fulfill the objectives of this study by answering this
brief survey questionnaire honestly and properly. All information given will be kept
confidential and will only be used for the purposes of this study. Thank you or your
cooperation and may God bless you!
Sincerely,
Steve R. Arcilla
BA Behavioral Sciences
2007-68603
_____________________________________________________________________________________________________
PROOF OF CONSENT
I agree and support the said aims of the study. All information regarding the
study, which will be used for the students thesis, was discussed and explained to me
really well by the researcher. I trust that all information that I will give will be kept
confidential between me and the researcher. As a part of this study, I will answer with
all honesty the said questionnaire and other questions asked.
I will now sign below as a proof of my consent in pariticipating in this study.
Signature: __________________________________________
Date: ________________________________________________
123
Appendix C: English Questionnaire
Part 1
Directions: Answer the following honestly.
A. (Demographic Information about the
parent of the child.)
B. (Demographic Information about the

child.)
Name: _______________________________
Name: _______________________________
Age: _____________
Age: _____________
Sex: __________
Sex: __________
Religion: _______________________________
Birth Order: _________________
Occupation:
_______________________________
Duration of Diagnosis:
_______________________________
Monthly Family Income:
Hospitalization Times: ____________
Duration of Stay in the Hospital:

_____________________________________
Below P10, 000

P10, 000 Below P25, 000
P25, 000 Below P40, 000
P40, 000 Below P55, 000
Above P55, 000
Educational Attainment (place an X

on the box):
Illiterate
Elementary Level
High School Level
College Level
Marital Status (place an X on the

box):
Single
Married
Divorced
Widowed
Number of Children: _______
124
Part 2
Kessler Psychological Distress Scale (K10)
Please tick the answer that is correct
for you:
All of
the
time
Most
of the
time
Some
of the
time
A little
of the
time
None
of the
time
1. In the past 4 weeks, about how

often did you feel tired out for
no good reason?
often did you feel nervous?
often did you feel so nervous
that nothing could calm you
down?
often did you feel hopeless?
often did you feel restless or
fidgety?
often did you feel so restless you
could not sit still?
often did you feel depressed?
often did you feel that
everything was an effort?
often did you feel so sad that
nothing could cheer you up?
often did you feel worthless?
Source: Kessler, R.C., Barker, P.R., Colpe, L.J., Epstein, J.F., Gfroerer, J.C., Hiripi, E., Howes, M.J, Normand, S-L.T.,
Manderscheid, R.W., Walters, E.E., Zaslavsky, A.M. (2003). Screening for serious mental illness in the general
population Archives of General Psychiatry. 60(2), 184-189.
125
STRONGLY
DISAGREE
DISAGREE
NIETHER
AGREE NOR
DISAGREE
AGREE
STRONGLY
AGREE
Part 3
Directions: With the prefix statement of When my child was diagnosed with cancer I
started, read each statement/phrase carefully, and then decide how well each
statement describes your reaction, behavior, or attitude in response to your childs
cancer diagnosis. If the statement describes your response very well, then circle the
number 5 indicating you STRONGLY AGREE; if the statement does not describe your
response at all, then circle the number 1 indicating that you STRONGLY DISAGREE; if the
statement describes your response to some degree, then select a number 2, 3, or 4, to
indicate how much you agree or disagree with the statement about your response.
1. Hoping a miracle will happen.

2. Trying to see my childs illness in a
different light, to make it seem more
positive.
3. Talking with the medical staff (nurses,
social worker, etc.) about my childs
illness when we visit the medical center.
4. Seeking advice and assistance from
relatives and friends.
5. Praying more than usual.
1
1
2
2
3
3
4
4
5
5
6. Drinking alcohol in order to think about

it less even just for a while.
7. Trying to keep my feelings and concerns
about my child to myself.
8. Thinking that maybe we should just
leave my childs recovery to luck.
9. Talking with other parents in the same
type of situation and learning about their
experiences.
10. Believing that my child will get better no
matter what.
11. Wishing that I can change what is
happening.
12. To realize that my childs illness is
somehow my fault.
13. Looking for something good in what is
happening.
When my child was diagnosed with cancer I

started:
126
14. Sharing our difficulties and concerns

with relatives and friends.
15. Believing that my child is getting the best
medical care possible.
16. Criticizing or blaming myself for my
childs illness.
17. Wishing that my childs illness would
simply go away or somehow be over
with.
18. Having stronger faith in God.
19. Using drugs or other medication to make

myself feel better.
20. Defining my childs illness in a more
positive way so that I do not become too
discouraged.
21. Keeping others from knowing how bad I
feel about my childs illness.
22. Refusing to think about it too much.
23. To realize that if I had taken care of my

child really well, he/she wouldnt be sick.
24. Seeking Gods help.
25. Avoiding being with people in general.
26. Talking with the doctor about my

concerns about my child.
27. Eating, drinking, smoking, using drugs or
medication, etc., to help me get through
the situation.
28. Believing that things will always work
out.
29. Seeking encouragement and support
from relatives and friends.
30. Believing that time will make a
difference and the only thing left to do is
to wait for my child to get better.
127
Appendix D: Filipino Cover Letter and Informed Consent Form to

Participate in the Survey

Magandang Araw!
Ako po si Steve R. Arcilla, isang mag-aaral ng Unibersidad ng Pilipinas Maynila at
kasalukuyang kumukuha ng kursong Behavioral Sciences. Bilang bahagi ng mga
kinakailangang gawin upang ako ay makapagtapos, ako po ay gumagawa ng isang pagaaral tungkol sa mga paraan na kadalasang ginagamit ng mga magulang ng mga batang
may sakit na kanser upang madala at maharap nila nang maayos ang sitwasyon, kasabay
ang istres, maging ang emosyonal at sikolohikal na epekto o dulot nito. Nais ko pong
malaman kung ano ang mas epektibong paraan para sa mga magulang na nabanggit
upang manatiling malusog at balanse ang kanilang sikolohikal na pag-iisip at emosyonal
na damdamin sa gitna ng sitwasyong hinaharap ng kanilang anak at ng kanilang pamilya.
Sana po ako ay inyong matulungan sa pamamagitan ng pagsagot nang matapat at
maayos sa maikling kwestsoneyr na ito. Asahan po ninyong ang ibibigay niyong
impormasyon ay mananatiling kompidensyal at gagamitin lamang para makamit ang
mga layunin ng pag-aaral na ito. Maraming salamat po sa inyong kooperasyon at
patnubayan po sana kayo ng Maykapal!
Sumasainyo,
Steve R. Arcilla
BA Behavioral Sciences
2007-68603
_____________________________________________________________________________________________________
PATUNAY NG PAGPAYAG
Ang paglagda ko sa patlang sa ibaba ng pahinang ito ay nagpapatunay ng aking
taos-pusong pagpayag sa mga adhikain ng pagsusuring ito. Naipaliwanag nang mabuti sa
akin ang paggagamitan ng pag-aaral na ito, at yoon ay para sa pagpasa ng isang tisis para
sa kursong kinukuha ng mananaliksik. Lahat ng impormasyong makakalap ukol sa akin
ay mananatiling pribado sa pagitan namin ng tagapagsaliksik. Bilang bahagi ng pag-aaral
na ito, ako ay sasagot ng buong katapatan sa lahat ng katanungnang kailangan sagutin.
Ako ay lalagda bilang patunay nang aking pagpayag sa aking partisipasyon sa
pagsasaliksik na ito.
Lagda: ___________________________________
Petsa: ___________________________________
128
Appendix E: Filipino Questionnaire
Part 1
Panuto: Pakisagutan nang matapat ang mga sumusond.
A. (Demograpikong Impormasyon tungkol
sa magulang ng bata)
B. (Demograpikong Impormasyon tungkol

sa bata)
Inisyals/Mga unang titik ng pangalan:
_______________________________
Inisyals/Mga unang titik ng pangalan:

_______________________________
Edad: _____________
Edad: _____________
Kasarian: __________
Kasarian: __________
Relihiyon:
_______________________________
Hanapbuhay:
_______________________________
Birth Order (hal. bunso, panganay,

pangalawang anak):
_________________
Buwanang Kita ng Pamilya (Monthly

Family Income):
Durasyon/Panahong nakalipas ng
magkaroon ng kanser:
_______________________________
Bilang/Beses ng pagkakaospital:
____________
Durasyon/Panahong itinagal sa loob

ng ospital:
______________________________
Mababa sa P10, 000

P10, 000 Mababa sa P25, 000
P25, 000 Mababa sa P40, 000
P40, 000 Mababa sa P55, 000
Mahigit sa P55, 000
Edukasyong Naabot (lagyan ng tsek

ang kahon):
Hindi Nakapag-aral
Pangunahin/Mababang Paaralan
(Elementary)
Paaralang Sekondarya (High
School)
Kolehiyo (College)
Estado Sibil (lagyan ng tsek ang

kahon):
Walang Asawa (Single)
May Asawa (Married)
Hiwalay sa Asawa (Divorced)
Biyudo/Biyuda
Bilang ng Anak: _______
129
NAPAKADALANG
MADALANG
PAMINSANMINSAN
MADALAS
Panuto: Pakilagyan ng ekis (X) ang kahon na

tumutugma sa inyong kasagutan sa bawat
tanong.
NAPAKADALAS
Part 2
Kessler Psychological Distress Scale (K10)
1. Sa nakaraang 4 na linggo, gaano ka kadalas

nakaramdam ng sobrang pagkapagod nang
walang dahilan?
nakaramdam ng kaba o nerbyos?
nakaramdam ng sobrang pagkakaba o
pagkanerbyos
na
tilay
walang
makapagpakalma saiyo?
4. Sa nakaraang 4 na linggo, gaano mo kadalas
naramdaman na tila bay wala ka ng pag-asa?
nakaramdam ng pagkabalisa o yaong hindi ka
mapakali o mapalagay?
nakaramdam ng sobrang pagkabalisa na hindi
mo magawang umupo sa isang upuan nang
maayos o kalmado?
nakaramdam ng depresyon o pagkalumbay?
8. Sa nakaraang 4 na linggo, gaano mo kadalas
naramdaman na para bang ang lahat ng bagay
ay napakahirap gawin at ikaw ay sadyang
walang gana para gawin ang mga ito?
nakaramdam ng sobrang pagkalungkot na
walang nakakapagpasaya sayo?
10.
Sa nakaraang 4 na linggo, gaano mo
kadalas naramdaman na para bang wala ng
halaga ang iyong sarili?
Source: Kessler, R.C., Barker, P.R., Colpe, L.J., Epstein, J.F., Gfroerer, J.C., Hiripi, E., Howes, M.J, Normand, S-L.T.,
Manderscheid, R.W., Walters, E.E., Zaslavsky, A.M. (2003). Screening for serious mental illness in the general
population Archives of General Psychiatry. 60(2), 184-189.
130
SANG-AYON
LUBOS NA
SUMASANGAYON
LUBOS NA HINDI
SUMASANGAYON
HINDI SANGAYON
WALANG
PAGSANG-AYON
O HINDI
PAGSANG-AYON
Part 3
Panuto: Basahin nang maayos ang bawat pangungusap o salaysay. Pagkatapos ay
magpasya kung gaano ito katugma o kaparehas sa inyong naging reaksyon,
naramdaman, o ginawa noong nalaman niyong may kanser ang inyong anak. Kung ang
salaysay ay sadyang tumutugma sa inyong reaksyon, naramdaman, o ginawang aksyon,
bilugan lamang ang numerong 5 na nagsasabing kayo ay LUBOS NA SUMASANG-AYON.
Kung ang salaysay naman ay sadyang mali o hindi tugma sa inyong reaksyon,
naramdaman, o ginawang aksyon, bilugan lamang ang numerong 1 na nagsasabing kayo
ay LUBOS NA HINDI SUMASANG-AYON. Kapag ang salaysay naman ay naglalarawan sa
inyong reaksyon, naramdaman, o ginawang aksyon sa ilang antas, pumili at bilugan
lamang ang isang numero sa 2, 3, o 4 na nagsasabi kung gaano kayo sumasang-ayon o
hindi sumsang-ayon sa salaysay.
1. Umasa na may mangyayaring himala at

gagaling bigla ang aking anak.
2. Subukang bigyan ng mas positibong
pakiramdam ang pagkakaroon ng sakit ng
aking anak.
3. Makipag-usap sa mga doktor at mga nars na
gumagamot sa aking anak tungkol sa kanyang
kalagayan.
4. Humingi ng payo at tulong mula sa aking mga
kamag-anak at mga kaibigan.
5. Magdasal nang mas madalas.
6. Uminom ng alak/alkohol paminsan-minsan

upang mawala sa aking isipan ang kalagayan
ng aking anak kahit saglit lamang.
7. I-sarili o itago mula sa ibang tao ang aking mga
nararamdaman na pag-aalala sa kalagayan ng
aking anak.
8. Ipabahala na lamang sa swerte ang paggaling
ng aking anak.
9. Makipag-usap sa ibang mga magulang na may
anak din na may kanser tungkol sa kanilang
mga naging karanasan.
10. Manalig na gagaling ang aking anak kahit
anong mangyari.
11. Mangarap na sana ay may kapagyarihan ako
na baguhin ang mga nangyayari.
Nang masuri na mayroong kanser ang aking anak,

ako ay nagsimulang:
131
12. Napagtanto na ang pagkakaroon ng kanser ng

aking anak ay aking kasalanan.
13. Maghanap ng positibong bagay sa mga
nangyayari.
14. Mamahagi ng aming pinagdadaaanan sa aking
mga kamag-anak at mga kaibigan.
15. Magtiwala na hindi pinapabayaan at ginagawa
ng ospital/doktor/nars ang lahat ng kanilang
makakaya upang gumaling ang aking anak.
16. Sisihin ang aking sarili sa pagkakaroon ng
sakit ng aking anak.
17. Mangarap na bigla na lamang mawawala ang
sakit ng aking anak.
18. Magkaroon ng mas malakas na pananalig sa
Panginoon.
19. Gumamit ng kung anumang medikasyon
upang maging maayos ang aking pakiramdam
sa kabila ng aming pinagdadaanan.
20. Tignan ang pagkakaroon ng sakit ng aking
anak sa mas positibong paraan o pag-iisip.
1
1
2
2
3
3
4
4
5
5
1
1
2
2
3
3
4
4
5
5
25. Umiwas o lumayo sa mga tao upang

makapagsarili.
26. Makipag-usap sa doktor ng aking anak
tungkol sa sakit ng aking anak.
27. Uminom/manigarilyo/gumamit ng droga o
anumang medikasyon upang maging mabuti
ang aking pakiramdam.
28. Manalig na ang lahat ng ito ay maayos din.
29. Humingi o naghanap ng suporta upang akoy

mabigyan ng lakas at pag-asa mula sa aking
mga kamag-anak at kaibigan
30. Naniwala na ang tanging kailangang gawin ay
maghintay dahil darating din ang panahon at
gagaling din ang aming anak.
21. Itago sa ibang tao ang aking mga pangamba

tungkol sa kalagayan ng aking anak.
22. Subukang huwag masyadong pag-isipan ang
aming pinagdadaanan.
23. Mag-isip na kung inalagaan ko lamang nang
mabuti ang aking anak, hindi siya
magkakasakit ng ganito.
24. Humingi ng tulong sa Panginoon.
132
Appendix F: English Interview Guide
1.
What was your fisrt reaction when you found out that your child has cancer?
What did you feel and what were your immediate actions after finding out?
2. Have you accepted your childs condition already?
3. What are the changes that happened in your life since your childs cancer
diagnosis?
4. How does your childs illness affect your:
a. daily life?
b. health (emotional and psychological)?
c. occupation?
d. financial status?
e. social-relationships (with spouse, other children, friends, etc.)?
5. What are the problems or difficulties that you have encountered with regard
to your childs illness?
6. Despite your current situation, how do you manage:
a. to continue with your daily life?
b. to Take care of the sick child?
c. to deal with the emotional and psychological effects of the
situation?
d. to deal or handle your financial problems?
7. How helpful or effective do you think ________________ are/is in making the
situation seem lighter?
a. Your relatives and friends
b. The medical staff treating your child
c. Other parents who also have children with cancer
d. Your religion
e. Your optimism
f. Blaming yourself
g. Isolating yourself from people
h. Using substances
8. In general, how do you think do you manage to deal or handle the situation
you and your family are currently in?
9. How can you describe your current situation now?
10. Despite all these things that you are currently going through, what do you
think are the positive effects (if you think that there are any) that might have
been brought about by your childs illness?
133
Appendix G: Filipino Interview Guide
1.
Ano po ang iyong naging unang reaksyon noong nalaman niyo na may
kanser ang inyong anak? Ano-ano ang inyong naramdaman at ginawa sa mga
unang araw matapos niyong malaman ang malungkot na balitang ito tungkol
sa inyong anak?
2. Sa ngayon, tanggap niyo na po ba ang kalagayan ng inyong anak?
3. Ano-ano ang mga naging pagbabago sa inyong buhay simula noong malaman
niyong may kanser ang inyong anak?
4. Ano-ano ang mga naging epekto ng pagkakaroon ng kanser ng inyong anak
sa inyong:
a. araw-araw na buhay?
b. kalusugan (emosyonal at sikolohikal)?
c. trabaho?
d. kalagayang pang-ekonomiko?
e. pakikitungo sa mga tao (sa inyong asawa, iba pang anak, mga
kamag-anank, kaibigan)?
5. Ano-ano po ba ang mga problemang inyong nakaharap kaugnay ng lagayan
ng inyong anak?
6. Sa kabila po ng inyong pinagdadaaanan, paano niyo po ba nagagawang
kayanin ang mga bagay tulad ng:
a. araw-araw na buhay?
b. pag-aalaga sa bata?
c. emosyonal at sikolohikal na epekto sainyo?
d. kalagayang pang-ekonomiko?
7. Para sa inyo, gaano po kalaki ang ginagampanang tulong ng __________ sa
pagpapagaan ng sitwasyong inyong pinagdadaanan?
a. mga kamag-anak at kaibigan
b. mga kawani ng ospital na tumutulong sa paggamot ng inyong anak
c. mga magulang na may anak din na may kanser
d. relihiyon
e. pagiging positibo
f. pagsisi sa sarili
g. pagsasarili o pag-iwas sa mga tao
h. pag-inom, pagsigarilyo, o paggamit ng droga o kung anumang
medikasyon
8. Sa kabuuan, paano niyo po nagagawang kayanin ang lahat ng inyong
pinagdadaanan? Ano-ano po ba ang inyong mga ginagawa upang maging
madali ang pagharap ninyo sa inyong sitwasyong pinagdadaanan?
9. Sa maikling pahayag, paano niyo po mailalarawan sa akin ang inyong
kalgayan ngayon?
10. Sa kabila po ng lahat ng ito, ano po sa tingin niyo ang mga positibong bagay
(kung mayroon man) ang maaaring naidulot ng karamdamang ito ng inyong
anak sa inyong sarili at sa inyong pamilya?
134
Biodata
STEVE R. ARCILLA
Block 7 Lot 2 Siena Villas, Brgy. Habay II

Bacoor, Cavite
Mobile Phone No. 09052729018
Email Address: stevrojanoarcilla@yahoo.com
EDUCATION:
Course: BA in Behavioral Science
2007 2011
Catanduanes National High School

Virac, Catanduanes
2003 2007
Virac Pilot Elementary School

Virac, Catanduanes
(Graduated with Honors)
1997 2003
SKILLS:
Very good communication in both Filipino and English.
Technically proficient in Microsoft Office (Word, PowerPoint, and Excel)
and Internet.
Has experience in field and community work.
Knowledgeable in Recruitment, Selection, Hiring, Training, Career
Development, HRIS, and other HR tasks.
Able to construct test batteries for hiring.
Has knowledge in conducting interviews (Behavior-based & STAR
interviews).
Knows how to administer and score the following tests:
Slosson Intelligence Test-Revised (SIT- R3)
Test of Nonverbal Intelligence (TONI- 3)
IPAT Culture Fair Intelligence Test
16 PF
NEO Personality Inventory Revised (NEO PI-R)
Manchester Personality Questionnaire (MPQ)
Gordon Personality Profile Inventory (GPP-I)
Panukat ng Pagkataong Pilipino (PPP)
Human Figure Drawing Test (HFDT)
ix
Sacks Sentence Completion Test (SSCT)

Edwards Personal Preference Schedule (EPPS)
Management Development Questionnaire (MDQ)
AFFILIATIONS:
UP Behavioral Studies Society
Member Externals Committee
UP Musicians Organization
Member Events committee
SEMINARS AND TRAINING ATTENDED:

Katutubo sa Makabagong Kamalayan: A Forum on the Rights of Various
Indigenous Peoples in the Philippines, College of Arts and Sciences,
University of the Philippines Manila (August 12, 2009)
Bata Batuta: A Forum on the Current Situation of the Filipino Children,

College of Arts and Sciences, University of the Philippines Manila (August
8, 2009)
Ang Kahirapan sa Mata ng Iskolar ng Bayan: The situation of urban poor

in the face of global financial crisis, College of Arts and Sciences,
University of the Philippines Manila (July 9, 2009)
Eto Kami Ngayon, Career Symposium, College of Arts and Sciences,

University of the Philippines Manila (A.Y. 2007-2009)
Childformers Protect or Destroy, A symposium on child labor, children in

conflict with the law, and child abuse (August 2008)
Wanna be on top? Level up!, A seminar on establishing effective habits for

college students, NTTC auditorium, University of the Philippines Manila
(September 2007)
INTERESTS:
Interests at high school included joining the Supreme Student
Government, becoming a member of the staff of the school paper, joining
quiz bees as well as district and regional science and math competitions.
General interests include reading, surfing the net, writing, playing the
guitar, learning, text messaging, and hanging out with friends.
AWARDS RECEIVED:
Awards received included the 6th Honors Award in elementary, 2nd Place
in Mathematics Individual Quiz, and 1st Place in Science-Math Team
Competition in high School.

Coping Strategies Used by Both Parents of Children Currently Undergoing Cancer Treatment at The Philippine General Hospital

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Coping Strategies Used by Both Parents of Children Currently Undergoing Cancer Treatment at The Philippine General Hospital

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University of the Philippines Manila

College of Arts and Sciences

Coping Strategies Used by Both Parents

In Partial Fulfillment of the Requirements

UNIVERSITY OF THE PHILIPPINES MANILA

This thesis entitled Coping Strategies Used by Both Parents of Children

Professor Nymia P. Simbulan

This undergraduate thesis has been accepted as partial fulfillment of the

Professor Leonardo R. Estacio, Jr.

To my family and friends

Prof. Nymia P. Simbulan;

List of Tables and Figures

Chapter II Research Frameworks

Chapter III Review of Related Literature

Chapter V Presentation of Results

Chapter VI Discussion of Results

Chapter VII Summary, Conclusion, and Recommendations

List of Tables and Figures

Today, cancer continues to be one of the major chronic illnesses among

identified. Likewise, the researcher conducted Key-Informant Interviews with six

General State of the Topic

Union Against Cancer,

ARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently

ARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently

Statement of the Problem

children comprise 4050% of the population, and the proportion of childhood

treatment itself, negative employment and financial consequences, and

Objectives of the Study

to describe the socio-demographic profile of parents of children

to identify the common problems and difficulties, i.e. economic,

to describe the coping strategies adapted by mothers and fathers

to determine the factors associated with the type of coping

ARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently

to determine the effects of these coping strategies on them as

Hypothesis of the Study

Ha: Familiarity, as well as adequate and proper use, of the

H0: Familiarity, as well as adequate and proper use, of the

Significance of the Study

ARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently

According to the related literature of this study, a childs cancer diagnosis

strategies and resources in order to cope with the situation. However, as

ARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently

Childs cancer diagnosis children, aged 1-14 years, presently diagnosed

Parents sex refers to the biological characteristics that determines the

Parents (Mother/Father) age refers to the number of years that the

Parents (Mother/Father) civil status refers to the current marital status

ARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently

Parents (Mother/Father) socio-economic status refers to the

Parents (Mother/Father) educational attainment refers to the level of

Childs sex refers to the biological characteristics that determines the

Number of hospitalizations refers to the number of times the child

Duration of treatment refers to the length of time the child diagnosed

Coping strategies of parents refers to the different available or preferred

Positive adjustment a well-balanced psychological and emotional

Negative adjustment when parents engage in processes leading to poor

ARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently

Psychological Distress among Parents

She also reported that predictors of

ARCILLA (2011) | Coping Strategies Used by Both Parents of Children Currently

Coping Strategies Adapted by Parents

Magnis et al. (1986) study also reported that

Other attributions such as

Factors Influencing Adjustment or Adaptation