Parenting stress is generally associated with poorer psychological adjustment in caregivers and children with chronic illness. Although parenting stress in pediatric cancer has been previously demonstrated, few studies have investigated this problem when treatments end. The present study aimed to describe disease-related parenting stress in the post-treatment phase of pediatric cancer, and to analyze the role of parents' age and education, family functioning, and perceived child vulnerability in predicting disease-related parenting stress. The study comprised 56 parents of children with cancer, in the post-treatment phase, who completed a clinical and demographic questionnaire, as well as the Pediatric Inventory for Parents, assessing parenting stress, the Child Perceived Vulnerability Scale, and the Family Adaptability and Cohesion Evaluation Scale-Version N. Results revealed that the level of disease-related parenting stress in the post-treatment phase was still significant. Emotional stress scores were especially high, further showing that parents' concerns in this phase focus mainly on the long-term impact of the disease and treatments, involving intense feelings of fear and uncertainty. A model with four predictors was tested using regression analysis, which explained 57% of parenting stress variance. More specifically, findings indicated that parental age and education significantly predicted parenting stress, accounting for over one-third of the variance in this outcome. Family functioning and perceived child vulnerability explained an additional 18% of parenting stress. Findings of this study suggest that even when treatment ends, there is still the need for continued support in order to assist parents' ability to deal with the implications of having a child who had cancer. Importantly, special attention should be given in clinical practice to the family functioning and to parents' beliefs about their child's vulnerability.

Introduction: Invasive procedures in pediatric nursing practice require a child-centered approach to minimize pain levels associated with manifestations of stress, anxiety, and long-term traumatic reactions.Method: This cross-sectional study aimed at identifying nurses’ perception of stress, anxiety, and pain levels in children and adolescents (0–18 years) undergoing invasive procedures, and strategies used to minimize the associated distress. Based on a literature review, an online questionnaire was developed that evaluates the distress associated with frequent invasive procedures and strategies used to reduce discomfort.Results: Participants were 157 nurses who provided nursing care to children in all types of healthcare settings, such as hospitals and community health centers. Nurses evaluated lumbar puncture and catheter insertion as the procedures that caused more stress, anxiety, and pain in all age groups. ANOVA and post-hoc analyses indicate that nurses perceived adolescents as experiencing less stress than children in all the invasive procedures. Pediatric specialist nurses perceived a significantly higher total level of distress (an index that indicates stress, anxiety or pain in the whole group of procedures) compared to nurses with other specialties or generalist nurses, in all age groups. Non-pharmacological strategies were the most frequently used strategies used by nurses for minimizing distress in children, including distraction (51.2%), preparation (30.7%), and sensory techniques (14.6%). Pharmacological strategies, such as topical anesthetics and light sedation, were less frequently used.Conclusion: This study highlights the importance of specialized training and knowledge concerning strategies to reduce distress in pediatric invasive procedures, suggesting the need for more significant investment in education and support for nursing professionals to improve patient experience.

A child’s oncological or chronic disease is a stressful situation for parents. This stress may make it difficult for appropriate management strategies aimed at promoting the child’s well-being and helping him or her cope with a disease to be adopted. In particular, this study focuses on the possible connections between the variable national cultural influences and the parental strategies used to cope with a child’s severe disease by comparing the experiences of Italian and Portuguese mothers. The study investigates differences and cross-cultural elements among the coping strategies used by Italian and Portuguese mothers of children with oncological or chronic disease. Two groups of mothers took part: 59 Italian mothers (average age 37.7 years; SD=4.5) and 36 Portuguese mothers (average age 39.3 years; SD=4.6). The tool used was the Italian and the Portuguese versions of the COPE inventory that measures five coping strategies: Social Support, Avoidance Coping, Positive Aptitude, Religious Faith and Humor, Active Coping. There were statistically significant differences between Portuguese and Italian mothers regarding Social Support (F(3, 94)=6.32, P=0.014, η2=0.065), Religious Faith and Humor (F(3, 94)=20.06, P=0.001, η2=0.18, higher values for Portuguese mothers) and Avoidance Coping (F(3, 94)=3.30, P=0.06, η2=0.035, higher values for Italian mothers). Regarding child’s disease, the only statistically significant difference was in Religious Faith and Humor (F(3, 94)=7.49, P=0.007, η2=0.076, higher values for mothers of children with chronic disease). The findings of specific cultural transversalities provide the basis for reflection on important factors emerging on the relationship between physicians and parents. In fact, mothers’ coping abilities may allow health workers involved in a child’s care not only to understand how parents face a distressful event, but also to provide them with professional support.