Background:

Over the past 20 years there has been growing awareness and evidence that cancer is a family’s illness, and not just the patient’s diagnosis. This is reflected by the fact that about a third of patients, partner and children develop clinically relevant levels of psychological distress or behavioral problems. Several factors which mediate child and couple adjustment have been identified. Amongst others, mutual affective support, couple- and parent-child communication, the child’s appraisal of the parental illness, the availability of coping strategies, parenting skills, good parental psychological functioning, marital satisfaction and family functioning promote adjustment in family members. Yet, the availability of family-support in the case of parental cancer is especially in Switzerland still scarce and the majority of parent cancer patients report that they get little or no support from physicians for talking to their children about the illness.

Methods:

Aims and design: The present randomized-controlled study aims at the evaluation of the efficacy of a web-based counseling intervention during the first 5 months of treatment for the improvement of coping at the level of minor children, couples and the family.

Intervention: 90 families with minor children newly confronted with the cancer diagnosis of a parent will be randomized to either “Web-based counseling for families with parental cancer program” or to a control condition, which provides a reader for parents and children based on existing information booklets (treatment as usual). The intervention will consist of four modules (“Understanding what’s going on”, “Treatment management”, “Caring for myself and each other” and “Looking ahead”), parents have access to two and children and adolescents one session / module.  The program will contain separate sections for parents and children (4-7 years, 8-11 years, above 12 years) with teenagers working on their own and parents working with their younger children. Primary outcome is child adjustment (behavioral problems and quality of life), family adjustment (cohesion, flexibility and communication), couple adjustment (communication, intimacy and conflict) and parental mental health and coping.

Data assessment: Families will be informed about the study by the treating physician in the first month post diagnosis. After consenting to participation, families will receive login data and access to questionnaires on family, couple and individual functioning (T1). After randomization either to active treatment or control condition, families will start with the program, including the receipt of regular email contact by the study team and monthly assessments on treatment satisfaction and short evaluation of family coping and individual wellbeing. After completion of the intervention (T2) and 12 months postdiagnosis (T3), parents and teenagers will receive the same questionnaires as at T1.