Coping and Attachment in Pediatric Oncohematology (CopAt)

Coping and Attachment in Pediatric Oncohematology: Multicenter Cross-sectional Study to Assess Emotional Resources and Attachment Dynamics Related to Coping Strategies in Parents of Children With Oncohematologic Disease

Cancer can be a traumatic and particularly salient experience in a person's history. The ways in which the pediatric patient copes with it depend on the interaction of several factors present in his or her life context, primarily the relationship that is established between parent and child.

Despite the paucity of studies in the literature in this regard, it would seem that parental coping is predictive of child coping. Coping strategies represent the ways in which people try to manage traumatic events or stressful everyday situations.

Currently, the literature identifies two main categories of coping strategies: emotion-oriented and problem-oriented strategies. The former are aimed on reducing stress-induced unpleasant emotions (e.g., problem avoidance, positive reappraisal, etc.); the latter, on the other hand, focus on stress dissolution/alteration (e.g., problem identification and resolution, stress cause research). Some studies, previously conducted in oncology, show that emotion-focused coping strategies are associated with better adaptation immediately after diagnosis, but their positive influence tends to weaken over time; problem-focused coping strategies are more correlated with poor adaptation immediately after diagnosis, but in the later stages of treatment.

The clinical experience with patients in the Pediatric Oncohematology Department brings out the need to develop and structure a psychological assessment model, in order to ensure a more effective care of the family units followed.

The research aims, through a single administration of psychological tests, to investigate the role of attachment and some variables (age, gender, stage of treatment, stage of the disease, social support, resilience, ability to adapt to environmental stimuli, emotional state of of caregivers) on the coping strategies implemented by the parents of patients and the patients themselves, in order to differentiate the types of psychological intervention, to try to reduce psychological distress and increase levels of mental well-being.

Study Overview

• Status: Recruiting
• Conditions: Pediatric Cancer; Coping Behavior; Relationship, Parent Child

• Study Type: Observational
• Enrollment (Estimated): 60

Contacts and Locations

• Study Contact: Name: Marco Zecca, MD; Phone Number: +390382501258; Email: m.zecca@smatteo.pv.it

Study Locations

• Italy
  • Monza-Brianza
    • Monza, Monza-Brianza, Italy, 20900
      • Recruiting
      • Ospedale San Gerardo, SC Ematologia Pediatrica
  • Pavia
    • Pavia, Pavia, Italy, 27100
      • Recruiting
      • SC Ematologia 2 - Oncoematologia pediatrica
      • Contact: Marco Zecca, MD; Phone Number: +390382501258; Email: m.zecca@smatteo.pv.it
  • Taranto
    • Taranto, Taranto, Italy, 74100
      • Recruiting
      • Struttura Complessa di Pediatria e Oncoematologia Pediatrica, Ospedale SS Annunziata
      • Contact: Maria Montanaro

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Parents (single/father and mother) of patients in care of Pediatric Oncohematology departments who meet the inclusion criteria and pediatric patients in treatment at the Pediatric Oncohematology departments who meet the inclusion criteria.

Description

Parents Inclusion Criteria:

• parents of both sexes
• age of son/daughter between 8 and 17 years old (included)
• son/daughter being treated at the Pediatric Oncohematology departments involved in the research (Day Hospital and hospitalization)
• good understanding of the Italian language

Parents Exclusion Criteria:

● son/daughter in off-therapy

Patients Inclusion Criteria:

• age between 8 and 17 years old (included), undergoing treatment at the Pediatric Oncohematology departments (Day Hospital and hospitalization)
• parents enrolled in the study
• good understanding of the Italian language

Patients Exclusion Criteria:

● patients in off-therapy

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Parents cohort; Father and mother of each patient in care at the Pediatric Oncohematology department and enrolled in the study. The correlation between attachment dynamics and emotional care resources related to coping strategies will be assessed. Administration of psychological tests will take place one time after the enrollment in the study.
Patients cohort; Pediatric patients in care at the Pediatric Oncohematology department. Administration of psychological tests will take place one time after the enrollment in the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Child-Parent Relationship Scale	Child-Parent Relationship Scale is a 30-item, self-report instrument used to assess conflict and relational closeness, two important aspects in the emotional support provided to the child and compliance with care, as well as perceived parental distress. The Likert scale ranges from 1 to 5, where 1 stands for "Absolutely not true" and 5 stands for "Definitely true." Scoring is done by summing the raw scores of the items in the three sections (positive aspects of the relationship, conflict and dependence) divided by the items in each sub-scale (mean score).	One time just after the enrollment
Coping Orientations to Problem Experienced	"Coping Orientations to Problem Experienced- New Italian Version" is a self-report questionnaire that considers different coping modes. The Likert scale ranges from 1 to 4, where 1 stands for "I usually don't do it" and 4 stands for "I almost always do it." The instrument consists of 60 items, divided into 5 independent dimensions: social support, avoidance strategies, positive attitude, problem orientation and transcendent orientation. The scores from 1 to 4 are based on the responses identified by the subject for each item except for 4 "reverse" responses (items 8-20-36-50) for which the chosen score must be reversed. The items are then divided into groups for the identification of the 5 coping factors (social support, avoidance, positive attitude and transcendent orientation). Higher scores indicate greater use of that specific coping strategy.	One time just after the enrollment

Collaborators and Investigators

• Sponsor: Fondazione IRCCS Policlinico San Matteo di Pavia
• Collaborators: Catholic University of the Sacred Heart; Fondazione Soleterre - Strategie di Pace ONLUS; Università Pavia - Dipartimento di Scienze del Sistema Nervoso e del Comportamento

Publications and helpful links

General Publications

• Lazarus, R. S., and Folkman, S. (1984). Stress, Appraisal and Coping. New York, NY: Springer.
• Sica, C., Magni, C., Ghisi, M., Altoè, G., Sighinolfi, C., Chiri, L. R., & Franceschini, S. (2008). Coping Orientation to Problems Experienced-Nuova Versione Italiana (COPE-NVI): uno strumento per la misura degli stili di coping. Psicoterapia cognitiva e comportamentale, 14(1), 27.
• Monti JD, Winning A, Watson KH, Williams EK, Gerhardt CA, Compas BE, Vannatta K. Maternal and Paternal Influences on Children's Coping with Cancer-Related Stress. J Child Fam Stud. 2017 Jul;26(7):2016-2025. doi: 10.1007/s10826-017-0711-y. Epub 2017 Apr 17.

Study record dates

Study Major Dates

• Study Start (Actual): July 12, 2023
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: February 27, 2025
• First Submitted That Met QC Criteria: February 27, 2025
• First Posted (Actual): March 5, 2025

Study Record Updates

• Last Update Posted (Actual): April 24, 2026
• Last Update Submitted That Met QC Criteria: April 23, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms
• Other Study ID Numbers: CopAt

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No