Mastery and social support moderate the effects of educational level on adjustment of Arab mothers of children diagnosed with cancer
Corresponding Author
Siwar Makhoul Khoury
Rambam Health Care Campus, Haifa, Israel
Correspondence
Siwar Makhoul Khoury, PhD, Rambam Health Care Campus, Haifa, Israel.
Emails: [email protected], [email protected]
Search for more papers by this authorCorresponding Author
Siwar Makhoul Khoury
Rambam Health Care Campus, Haifa, Israel
Correspondence
Siwar Makhoul Khoury, PhD, Rambam Health Care Campus, Haifa, Israel.
Emails: [email protected], [email protected]
Search for more papers by this authorAbstract
The study explored the adjustment of Arab mothers of children diagnosed with cancer, as shown by the mothers' distress and quality of life. The aim was twofold: to examine the associations between educational level, psychosocial resources and adjustment indices and to assess the moderating effects of psychosocial resources on the education and adjustment association. The sample consisted of 100 Arab mothers who completed questionnaires assessing demographic and illness variables, mastery, social support, psychological distress and quality of life. High levels of education and psychosocial resources contributed to low distress and high levels of quality of life. Mastery and social support moderated the effects of education on adjustment: Under low levels of education, higher mastery was related to lower distress and higher quality of life, and higher social support was related to lower distress. Education, mastery and social support are important resources in the context of adjustment to cancer. In addition, psychosocial resources are important factors for adjustment under low levels of education and should be taken into consideration when developing intervention programmes for Arab parents coping with their child's cancer.
REFERENCES
- Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.
- Al-Krenawi, A., & Graham, J. R. (2011). Mental health help-seeking among Arab university students in Israel, differentiated by religion. Mental Health, Religion & Culture, 14, 157–167. https://doi.org/10.1080/13674670903454229.
10.1080/13674670903454229 Google Scholar
- Arnberg, F. K., Hultman, C. M., Michel, P.-O., & Lundin, T. (2012). Social support moderates posttraumatic stress and general distress after disaster. Journal of Traumatic Stress, 25, 721–727. https://doi.org/10.1002/jts.21758.
- Azaiza, F., & Cohen, M. (2008). Between traditional and modern perceptions of breast and cervical cancer screenings: A qualitative study of Arab women in Israel. Psychooncology, 17, 34–41. https://doi.org/10.1002/pon.1180
- Bemis, H., Yarboi, J., Gerhardt, C. A., Vannatta, K., Desjardins, L., Murphy, L. K., … Compas, B. E. (2015). Childhood cancer in context: Sociodemographic factors, stress, and psychological distress among mothers and children. Journal of Pediatric Psychology, 40, 733–743. https://doi.org/10.1093/jpepsy/jsv024.
- Ben-Zur, H. (2008). Personal resources of mastery-optimism, and communal support beliefs, as predictors of posttraumatic stress in uprooted Israelis. Anxiety, Stress and Coping, 21, 295–307. https://doi.org/10.1080/10615800801956177.
- Ben-Zur, H., Gil, S., & Shamshins, Y. (2012). The relationship between exposure to terror through the media, coping strategies and resources, and distress and secondary traumatization. International Journal of Stress Management, 19, 132–150. https://doi.org/10.1037/a0027864.
- Brandao, T., Schulz, M. S., & Matos, P. M. (2017). Psychological adjustment after breast cancer: A systematic review of longitudinal studies. Psycho-Oncology, 26, 917–926. https://doi.org/10.1002/pon.4230.
- Central Bureau of Statistics (2018). https://www.cbs.gov.il/publications18/yarhon0318/pdf/b1.pdf. Retrieved 23 April 2018.
- Dagan, M., Sanderman, R., Schokker, M. C., Wiggers, T., Bass, P. C., van Haastert, M., & Hagedoorn, M. (2011). Spousal support in distress over time in couples coping with cancer: The role of personal control. Journal of Family Psychology, 25, 310–318. https://doi.org/10.1037/a0022887.
- Dalgard, O. S., Mykletun, A., Rognerud, M., Johansen, R., & Zahl, P. H. (2007). Education, sense of mastery and mental health: Results from a nation wide health monitoring study in Norway. BMC Psychiatry, 7, 20–29. https://doi.org/10.1186/1471-244X-7-20.
- Derogatis, L. R. (2001). Brief Symptom Inventory 18 (BSI 18): Administration, scoring and procedures manual. Minneapolis, MN: NCS Pearson Inc.
- Derogatis, L. R., & Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine, 13, 595–605. https://doi.org/10.1017/S0033291700048017
- Dwairy, M. (2004). Parenting style and mental health of Palestinian – Arab adolescents in Israel. Transcultural Psychiatry, 41, 233–252.
- Fayed, N., Klassen, A. F., Dix, D., Klaassen, R., & Sung, L. (2011). Exploring predictors of optimism among parents of children with cancer. Psycho-Oncology, 20, 411–418. https://doi.org/10.1002/pon.1743.
- Gage-Bouchard, E. A., Devine, K. A., & Heckler, C. E. (2013). The relationship between socio-demographic characteristics, family environment, and caregiver coping in families of children with cancer. Journal of Clinical Psychology in Medical Settings, 20, 478–487. https://doi.org/10.1007/s10880-013-9362-3.
- Gelkopf, M., Solomon, Z., Berger, R., & Bleich, A. (2008). The mental health impact of terrorism in Israel: A repeat cross-sectional study of Arabs and Jews. Acta Psychiatrica Scandinavica, 117, 369–380. https://doi.org/10.1111/j.1600-0447.2008.01164.x.
- Greenberger, E., Chen, C., Dmitrieva, J., & Farruggia, S. P. (2003). Item-wording and The dimensionality of the Rosenberg self-esteem scale: Do they matter? Personality and Individual Differences, 35, 1241–1254. S0191-8869(02)00331-8.
- Grzywacz, J. G., Almeida, D. M., Neupert, S. D., & Ettner, S. L. (2004). Socioeconomic status and health: A micro-level analysis of exposure and vulnerability to daily stressors. Journal of Health and Social Behavior, 45, 1–16.
- Helgeson, V., & Cohen, S. (1996). Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. Health Psychology, 15, 135–148. https://doi.org/10.1037/0278-6133.15.2.135
10.1002/1099-1611(200007/08)9:4<273::AID-PON463>3.0.CO;2-F CAS PubMed Web of Science® Google Scholar
- Henselmans, I., Helgeson, V. S., Seltman, H., de Vries, J., Sanderman, R., & Ranchor, A. V. (2010). Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis. Health Psychology, 29, 160–168. https://doi.org/10.1037/a0017806.
- Hobfoll, S. E. (2002). Social and psychological resources and adaptation. Review of General Psychology, 4, 307–324. https://doi.org/10.1037//1089-2680.6.4.307.
- Hobfoll, S. E., & Walfisch, S. (1984). Coping with a threat to life: A longitudinal study of self-concept, social support, and psychological distress. American Journal of Community Psychology, 12, 87–100. https://doi.org/10.1007/BF00896930.
- House, J. S. (1987). Social support and social structure. Sociological Forum, 2, 135–146. https://doi.org/10.1007/BF01107897
10.1007/BF01107897 Google Scholar
- Israel Cancer Association. (2016). https://en.cancer.org.il/. Retrieved 2 June 2016.
- Jose, P. E. (2013). ModGraph-I: A programme to compute cell means for the graphical display of moderational analyses: The internet version, Version 3.0. Wellington, New Zealand: Victoria University of Wellington. Retrieved [7 May 2018] from https://psychology.victoria.ac.nz/modgraph/
- Kaniasty, K. (2006). Sense of mastery as a moderator of longer-term effects of disaster impact on psychological distress. In J. Strelau, & K. Klonowicz (Eds.), People under extreme stress (pp. 131–147). New York, NY: Nova Science Publishers Inc.
- Kazak, A. E., Alderfer, M., Rourke, M. T., Simms, S., Streisand, R., & Grossman, J. R. (2004). Journal of Pediatric Psychology, 29, 211–219. https://doi.org/10.1093/jpepsy/jsh022.
- Khattab, N. (2005). Ethnicity, class and the earning inequality in Israel, 1983–1995. Sociological Research, 10, 1–17. https://doi.org/10.5153/sro.1069.
- Kim, H. S., Sherman, D. K., & Taylor, S. E. (2008). Culture and social support. American Psychologist, 63, 518–526. https://doi.org/10.1037/0003-066X.
- Klassen, A., Raina, P., Reineking, S., Dix, D., Pritchard, S., & O'Donnell, M. (2007). Developing a literature base to understand the caregiving experience of parents of children with cancer: A systematic review of factors related to parental health and well-being. Supportive Care in Cancer, 15, 807–818. https://doi.org/10.1007/s00520-007-0243-x.
- Kreitler, S., & Kreitler, M. M. (2006). Multidimensional quality of life: A new measure of quality of life in adults. Social Indicators Research, 76, 5–33. https://doi.org/10.1007/s11205-005-4854-7.
- Kreitler, S., Peleg, D., & Ehrenfeld, M. (2007). Stress, self-efficacy and quality of life in cancer patients. Psycho-Oncology, 16, 329–341. https://doi.org/10.1002/pon.1063.
- Kwok, C., Endrawes, G., & Lee, C. F. (2016). Cultural beliefs and attitudes about breast cancer and screening practices among Arabic women in Australia. Cancer Nursing, 39(5), 367–374. https://doi.org/10.1097/NCC.0000000000000325.
- Lazarus, R. S. (1999). Stress and emotion: A new synthesis. London, UK: Free Association Books.
- Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping. New York, NY: Springer-Verlag.
- Long, K. A., & Marsland, A. L. (2011). Family adjustment to childhood cancer: A systematic review. Clinical Child and Family Psychology Review, 14, 57–88. https://doi.org/10.1007/s10567-010-0082-z.
- McLeod, J. D., & Kessler, R. C. (1990). Socioeconomic status differences in vulnerability to undesirable life events. Journal of Health and Social Behavior, 31, 162–172. https://doi.org/10.2307/2137170.
- Mu, P.-F., Ma, F.-C., Ku, S.-M., Shu, H. Q., Hwang, B., & Kuo, B.-I.-T. (2001). Families of Chinese children with malignancy: The factors impact on mother's anxiety. International Pediatric Nursing, 16, 287–295. https://doi.org/10.1053/jpdn.2000.25325.
- NIH: National Cancer Institute. (2016). https://www.cancer.gov/about-cancer/understanding/statistics. Retrieved 2 June 2016.
- Norberg, A. L., Lindblad, F., & Boman, K. K. (2005). Coping strategies in parents of children with cancer. Social Science & Medicine, 60, 965–975. https://doi.org/10.1016/j.socscimed.2004.06.030.
- Onrust, S., Cuijpers, P., Smit, F., & Bohlmeijer, E. (2007). Predictors of psychological adjustment after bereavement. International Psychogeriatrics, 19, 921–934. https://doi.org/10.1017/S1041610206004248.
- Pearlin, L. I., Menaghan, E. G., Leiberman, M. A., & Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337–356. https://doi.org/10.2307/2136676
- Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2–21. https://doi.org/10.2307/2136319.
- Prati, G., & Pietrantoni, L. (2010). The relation of perceived and received social support to mental health among first responders: A meta-analytic review. Journal of Community Psychology, 38, 403–417. https://doi.org/10.1002/jcop.20371.
- Rodriguez, E. M., Murphy, I., Vannatta, K., Gerhardt, C. A., Young-Saleme, T., Saylor, M., … Compas, B. (2016). Maternal coping and depressive symptoms as Predictors of mother-child communication about a child's cancer. Journal of Pediatric Psychology, 41, 329–339. https://doi.org/10.1093/jpepsy/jsv106.
- Sales, J., Fivush, R., & Teague, G. W. (2008). The role of parental coping in children with asthma's psychological well-being and asthma-related quality of life. Journal of Pediatric Psychology, 33, 208–219. https://doi.org/10.1093/jpepsy/jsm068.
- Schafer, M. H., & Koltai, J. (2015). Cancer diagnosis and mental health among older white adults: Moderating role for social networks? Society and Mental Health, 5, 182–202. https://doi.org/10.1177/2156869315577631.
- Sharabi, M. (2014). The relative centrality of life domains among Jews and Arabs in Israel: The effect of culture, ethnicity, and demographic variables. Community, Work & Family, 17, 219–236. https://doi.org/10.1080/13668803.2014.889660.
10.1080/13668803.2014.889660 Google Scholar
- Siemsen, E., Roth, A., & Oliveira, P. (2010). Common method bias in regression models with linear, quadratic, and interaction effects. Organizational Research Method, 13, 456–476. https://doi.org/10.1177/1094428109351241
- Simon, A. E., Steptoe, A., & Wardle, J. (2005). Socioeconomic status differences in coping with a stressful medical procedure. Psychosomatic Medicine, 67, 270–276. https://doi.org/10.1097/01.psy.0000155665.55439.53.
- Streisand, R., Kazak, A. E., & Tercyak, K. P. (2003). Pediatric-specific parenting stress and family functioning in parents of children treated for cancer. Children's Health Care, 32, 245–256. https://doi.org/10.1207/S15326888CHC3204_1
- Sultan, S., Leclair, T., Rondeau, E., Burns, W., & Abate, C. (2016). A systematic review on factors and consequences of parental distress as related to childhood cancer. European Journal of Cancer Care, 25, 616–637. https://doi.org/10.1111/ecc.12361.
- Tremolada, M., Bonichini, S., Aloisio, D., Schiavo, S., Carli, M., & Pillon, M. (2013). Post-traumatic stress symptoms among mothers of children with leukemia undergoing treatment: A longitudinal study. Psycho-Oncology, 22, 1266–1272. https://doi.org/10.1002/pon.3132.
- Tremolada, M., Bonichini, S., Pillon, M., Schiavo, M. S., & Carli, M. (2011). Eliciting adaptive emotion in conversations with parents of children receiving therapy for leukemia. Journal of Psychosocial Oncology, 29, 327–346. https://doi.org/10.1080/07347332.2011.563341.
- Tremolada, M., Bonichini, S., Schiavo, S., & Pillon, M. (2012). Post-traumatic stress symptoms in mothers of children with leukaemia undergoing the first 12 months of therapy: Predictive models. Psychology & Health, 27, 1448–1462. https://doi.org/10.1080/08870446.2012.690414.
- Wagner, J. L., Chaney, J. M., Hommel, K. A., Page, M. C., Mullins, L. L., White, M. M., & Jarvis, J. N. (2003). The influence of parental distress on child depressive symptoms in juvenile rheumatic disease: The moderating effect of illness intrusiveness. Journal of Pediatric Psychology, 28, 453–462. https://doi.org/10.1093/jpepsy/jsg036.
- Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30–41. https://doi.org/10.1207/s15327752jpa5201_2.