Toward Better Conversations: Assessing Caregiver–Child Communication in Pediatric Oncology

Authors

• Micah A. Skeens, Abigail Wexner Research Institute at Nationwide Children’s Hospital
• Anna Olsavsky, Abigail Wexner Research Institute at Nationwide Children’s Hospital
• Mariam Kochashvili, Abigail Wexner Research Institute at Nationwide Children’s Hospital
• Nadeen Alshakhshir, University of Minnesota - Twin Cities
• Mays Basha, Emory University
• Amy R. Newman, Marquette UniversityFollow
• Kathleen Montgomery, University of Wisconsin - Madison

Document Type

Article

Publication Date

2-2026

Publisher

Springer

Source Publication

Supportive Care in Cancer

Source ISSN

0941-4355

Original Item ID

DOI: 10.1007/s00520-026-10446-y

Abstract

Purpose

Effective parent–child communication is central to coping with psychosocial challenges of pediatric cancer, yet few studies have examined how caregivers and children perceive their communication. This study investigated differences between caregiver and child reports of communication and associations with family relationship quality. We hypothesized children would report more open and positive communication than caregivers report, reflecting directional discrepancies in communication quality.

Methods. Seventy-six caregiver–child dyads (N = 152) were recruited from two Midwestern pediatric hospitals. Children aged 8–17 with cancer and their caregivers independently completed measures of parent–child communication (PCCS) and family relationships (PROMIS). Descriptive statistics, correlations, and paired- and independent-samples t-tests examined differences and associations across dyads. Exploratory Actor–Partner Interdependence Models (APIM) investigated dyadic associations between child and caregiver communication and child family relationships.

Results. Caregivers (10-item: M = 3.90, SD = 0.55; 20-item: M = 3.94, SD = 0.58) and children (M = 4.15, SD = 0.61) reported generally high-quality communication. However, significant differences emerged: children rated caregivers as more attentive listeners (t(74) = 2.53, p = .01, Cohen’s d = 0.29), emotionally open (t(74) = 2.30, p = .02, Cohen’s d = 0.27), and willing to discuss problems (t(74) = 2.86, p = .005, Cohen’s d = 0.33) than caregivers reported children. Across correlation and APIM analyses, child-reported communication was strongly associated with child-reported family relationships and caregiver-reported communication was strongly associated with caregiver-reported child family relationships (actor effects). Older caregiver and child age was linked to lower communication scores.

Conclusions. Interdependent caregiver and child perceptions of communication represent an underrecognized factor influencing family functioning in pediatric cancer. Findings underscore the importance of routine communication assessment and highlight the need for developmentally tailored interventions.

Comments

Published version. Supportive Care in Cancer, Vol. 34, No. 210 (2026): 1-19. DOI. This article is © Springer. 

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Skeens, Micah A.; Olsavsky, Anna; Kochashvili, Mariam; Alshakhshir, Nadeen; Basha, Mays; Newman, Amy R.; and Montgomery, Kathleen, "Toward Better Conversations: Assessing Caregiver–Child Communication in Pediatric Oncology" (2026). College of Nursing Faculty Research and Publications. 1093.
https://epublications.marquette.edu/nursing_fac/1093