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Self‐injury in youths who lost a parent to cancer: nationwide study of the impact of family‐related and health‐care‐related factors
Author(s) -
Bylund Grenklo Tove,
Kreicbergs Ulrika,
Valdimarsdóttir Unnur A.,
Nyberg Tommy,
Steineck Gunnar,
Fürst Carl Johan
Publication year - 2014
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.3515
Subject(s) - medicine , relative risk , distress , health care , population , confidence interval , cancer , distrust , psychiatry , clinical psychology , psychology , environmental health , economics , economic growth , psychotherapist
Background Self‐injury, a manifestation of severe psychological distress, is increased in cancer‐bereaved youths. Little is known about the potential influence on the risk for self‐injury of factors that could be clinically relevant to and modifiable by the health‐care professionals involved in the care of the dying parent. Methods In a nationwide population‐based anonymous study, 622 (73.1%) youths (aged 18–26) who, 6 to 9 years earlier at ages 13 to 16, had lost a parent to cancer answered study‐specific questions about self‐injury and factors related to the family and parental health care. Results Univariable analyses showed that the risk for self‐injury was increased among cancer‐bereaved youths who reported poor family cohesion the years before (relative risk [RR], 3.4, 95% confidence interval [CI], 2.5–4.6) and after the loss (RR, 3.3, 95% CI, 2.4–4.4), distrust in the health care provided to the dying parent (RR, 1.7, 95% CI, 1.2–2.4), perceiving poor health‐care efforts to cure the parent (RR 1.5, 95% CI, 1.1–2.1) and poor efforts to prevent suffering (RR, 1.6, 95% CI, 1.1–2.4), that at least one of their parents had been depressed or had troubles in life (RR, 1.5, CI, 1.1–2.1) and believing 3 days before the loss that the treatment would probably cure the parent (RR, 1.6, CI, 1.1–2.3). In the total multivariable models, only poor family cohesion before and after the loss remained statistically significantly associated with self‐injury. Conclusion Poor family cohesion before and after the loss of a parent to cancer is associated with an increased risk of self‐injury in teenage children. Copyright © 2014 John Wiley & Sons, Ltd.