ORIGINAL ARTICLE Differences in mothers’ and fathers’ health-related quality of life after pediatric SCT: a longitudinal study M Barrera 1,2,3 , E Atenafu 3 , J Doyle 4 , D Berlin-Romalis 5 and K Hancock 1 1 Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada; 2 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; 3 Department of Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; 4 Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada and 5 Department of Social Work, Blood & Marrow Transplant Program, Neuro-Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada The purpose of this study was to examine longitudinally health-related quality of life (HRQOL) and related factors in mothers and fathers of children who undergo SCT, before, and 1 and 2 years after SCT. A total of 84 parents (49 mothers/35 fathers) of patients diagnosed mainly with leukemia completed a HRQOL measure before SCT, 46 at 1 year (26 mothers/20 fathers) and 50 parents (31 mothers/19 fathers) at 2 years post SCT. Physical and psychosocial HRQOL summary scores are reported. Parents’ age and gender, child’s diagnosis, radiation history, age, behavior and physical health were examined. Linear mixed models for repeated measures with a covariate structure were used for analysis. Physical HRQOL did not differ between mothers and fathers or over time. Maternal and paternal psychosocial HRQOL scores improved by 2 years post SCT. Child’s behavior problems and poor health, and maternal age (younger) predicted poor maternal psychosocial HRQOL 2 years post SCT. Child’s behavior problems, diagnosis and treatment severity predicted poor paternal psychosocial HRQOL. These findings identify similar (child’s poor behavior) and differential risk factors (parental young age, disease and treatment severity, and child’s poor health status) for poor HRQOL for mothers and fathers. These findings can guide comprehensive family-care interventions before, during and after pediatric SCT. Bone Marrow Transplantation (2012) 47, 855–859; doi:10.1038/bmt.2011.190; published online 26 September 2011 Keywords: mothers’ and fathers’; HRQOL; pediatric SCT; longitudinal Introduction When a child undergoes BM transplantation or SCT, parents are likely to experience severe distress. The proce- dure is marked by long-term medical complications and mortality rates that range between 20 and 80% 1 year post transplant, 1 which can have a severe impact on parental psychological distress and health-related quality of life (HRQOL). The psychological and HRQOL outcomes for children who survive SCT are well documented. 2–5 The psychological and HRQOL outcomes of parents of children with cancer have also been extensively researched. 6–9 Although parental psychological distress during the acute stage post pediatric SCT is well documented, 10–18 their long-term psychological and HRQOL outcomes have received less attention. Little is known about the impact of pediatric SCT on fathers, as most of this research has involved mothers. This longitudinal study focuses on HRQOL outcomes in both parents. HRQOL is a well-accepted multidimensional health concept that includes physical, social and psychological domains. In a large cross-sectional study in the Netherlands, parents of chronically ill children (for example, asthma, diabetes and brain tumors) reported significantly worse HRQOL than parents of healthy children. 6 In a Canadian cross- sectional study, compared with population norms, parents of children undergoing cancer treatment reported low physical and psychosocial HRQOL. 7 Fear of disease recurrence and worries about their own health have been reported by parents 1–10 years post-pediatric SCT with the highest distress reported by those parents whose children were 24 months post SCT. 12 Finally, on using standardized measures of HRQOL, mothers reported no significant change in physical or psychosocial HRQOL 1 year post pediatric SCT, 14 although contradictory findings were also reported. 12,15 To summarize, there is limited long-term longitudinal research investigating parental HRQOL when a child undergoes SCT; fathers’ outcomes are lacking and gender differences are rare in this context. In this manuscript, we examined longitudinally maternal and paternal HRQOL before, and 1 and 2 years after SCT, and compared these Received 30 December 2010; revised and accepted 15 August 2011; published online 26 September 2011 Correspondence: Dr M Barrera, Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. E-mail: maru.barrera@sickkids.ca Bone Marrow Transplantation (2012) 47, 855–859 & 2012 Macmillan Publishers Limited All rights reserved 0268-3369/12 www.nature.com/bmt