Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN (Chair), Jane M. Georges, PhD, RN, Ruth Bush, PhD


Cancer, child, coping, hope, parent, uncertainty


Childhood cancer is a rare and unexpected event. Upon diagnosis, normal day to day life stops and is replaced by a “rollercoaster ride” of tests, treatments, and decisions. Parents are the primary decision-makers for their child. Coping ability influences the decisions parents make about treatment. Survival has improved over the past 40 years increasing hope for a cure, however, uncertainty about the child’s disease pervades the entire illness trajectory and beyond. Little is known about how hope and uncertainty affect parental coping with a child’s cancer diagnosis. The purpose of this study was to examine the relationships between hope, uncertainty, and coping among parents of children being treated for cancer. Mishel’s model of Uncertainty in Illness was used as the conceptual framework. This study aimed to 1) describe the socioeconomic and demographic characteristics of this parent population, 2) describe the demographic and disease characteristics of a group of children undergoing treatment for cancer and, 3) to determine relationships between hope, uncertainty and coping in parents of children being treated for cancer. A descriptive, cross-sectional study design was used. Participants included 120 parents whose child was being treated for cancer at a large, academic pediatric healthcare center in southern California. Data were collected over a 14 month period. Study measures included the Parents Perception of Uncertainty Scale, the Herth Hope Index, and the Ways of Coping Questionnaire. Demographic questionnaires were completed for both the parent being studied and their child being treated. This study found that parental hope is influenced by uncertainty; as uncertainty decreases, hope increases. Increased parental age is associated with decreased hope and coping. As days from diagnosis increase, uncertainty increases. Single parents have higher levels of uncertainty than parents who are in a committed relationship as do parents who have less than a 12th grade education. Surprisingly, multivariate regression did not support the influence of hope or uncertainty on coping outcomes as suggested by Mishel’s framework. Parent groups at risk for psychosocial problems are identified and evidence is provided to support the need for intensive and ongoing psychosocial support for parents of children with cancer.

Document Type

Dissertation: Open Access