Family cohesion predicts long-term health and well-being after losing a parent to cancer as a teenager: A nationwide population-based study

• Published in: PloS one 2023-04, Vol.18 (4), p.e0283327-e0283327
• Main Authors: Birgisdóttir, Dröfn, Grenklo, Tove Bylund, Kreicbergs, Ulrika, Steineck, Gunnar, Fürst, Carl Johan, Kristensson, Jimmie
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adults; Annan hälsovetenskap; Anxiety; Bereavement; Biology and Life Sciences; Cancer; Cancer and Oncology; Cancer och onkologi; Child; Children; Cohesion; Confounding (Statistics); Consent; Data collection; Demographic aspects; Depression; End-of-life; End-of-life care; Ethics; Families & family life; Family; Family cohesion; Family Relations; Grief; Health aspects; Health Sciences; Humans; Hälsovetenskap; Influence; Long-term effects; Loss (Psychology); Medical and Health Sciences; Medicin och hälsovetenskap; Medicine and Health Sciences; Mental depression; Mental health; Neoplasms - epidemiology; Neoplasms - psychology; Oncology; Other Health Sciences; Palliative care; Parental death; Parental Death - psychology; Parents; Parents & parenting; People and Places; Population studies; Population-based studies; Quality of life; Questionnaires; Review boards; Risk; Self report; Sleeping problems; Social Sciences; Statistical analysis; Teenagers; Variables; Well being; Young Adult; Young adults
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0283327

Parentally bereaved children are at increased risk of negative consequences, and the mediating factors most consistently identified are found to be related to family function after the loss, including cohesion. However, existing evidence is limited, especially with respect to children and youths' own perception of family cohesion and its long-term effects on health and well-being. Therefore, the aim of this study was to investigate self-reported family cohesion the first year after the loss of a parent to cancer and its association to long-term psychological health and well-being among young adults that were bereaved during their teenage years. In this nationwide population-based study, 622 of 851 (73%) young adults (aged 18-26) responded to a study-specific questionnaire six to nine years after losing a parent to cancer at the age of 13 to 16. Associations were assessed with modified Poisson regression. Bereaved youth that reported poor family cohesion the first year after losing a parent to cancer had a higher risk of reporting symptoms of moderate to severe depression six to nine years after the loss compared to those reporting good family cohesion. They also had a higher risk of reporting low levels of well-being, symptoms of anxiety, problematic sleeping and emotional numbness once a week or more at the time of the survey. These results remained statistically significant after adjusting for a variety of possible confounding factors. Self-reported poor family cohesion the first year after the loss of a parent to cancer was strongly associated with long-term negative psychological health-related outcomes among bereaved youth. To pay attention to family cohesion and, if needed, to provide support to strengthen family cohesion in families facing bereavement might prevent long-term suffering for their teenage children.