How to improve quality of life in children with cancer from family-based perspectives? Insights from network analysis

Objective: A child's cancer diagnosis is a significant family event, and there is a need to explore factors that influence the quality of life of children with cancer from family-based perspectives. This study aimed to explore the interrelationships between parental burnout, sibling relationship quality, and quality of life in children with cancer. Methods: This cross-sectional study enrolled 218 children with cancer and their parents in three tertiary hospitals in Shandong Province using convenience sampling. Children completed the Chinese version of the Pediatric Quality of Life Inventory 4.0, while their parents completed the Parental Perceptions of Children's Sibling Relationship Quality Questionnaire and Maslach Burnout Inventory, and provided their own sociodemographic information, as well as their children's sociodemographic and clinical characteristics. Network analysis was employed to examine the relationships between variables. Results: In the overall network, social functioning in children with cancer exhibited the highest strength (r_s ​= ​1.03), while warmth in sibling relationship quality showed the highest bridge strength (r_bs ​= ​0.42). Social functioning was positively associated with warmth in sibling relationship quality (r ​= ​0.15), and negatively associated with personal achievement (r ​= ​−0.13) and depersonalization (r ​= ​−0.09) in parental burnout. Emotional functioning was negatively associated with emotional exhaustion in parental burnout (r ​= ​−0.10) and jealousy in sibling relationship quality (r ​= ​−0.10). Conclusions: There are significant interrelationships between the network structure of family related variables and quality of life in children with cancer. These findings offer guidance for healthcare professionals focusing on family-based interventions to improve the quality of life of children with cancer.