Illness unpredictability and psychosocial adjustment of adolescent and young adults impacted by parental cancer: the mediating role of unmet needs

Purpose Given the large number of adolescents and young adults (AYAs) impacted by parental cancer and the potential for negative psychosocial outcomes in this vulnerable population, this study examined the mediating role of ofspring unmet needs with regard to parental cancer and the relation between AYAs psychosocial adjustment and perceived illness unpredictability. Methods A total of 113 AYAs (aged 11–24 years) living with a parent diagnosed with cancer completed a questionnaire assessing illness unpredictability, ofspring unmet needs, and psychosocial adjustment (i.e., health-related quality of life and internalizing problems). Results Higher ofspring unmet needs were associated with lower health-related quality of life (r=–0.24**) and higher internalizing problems (r=0.21*). Ofspring unmet needs mediated the relation between illness unpredictability and healthrelated quality of life (standardized indirect efect=–0.100* [–0.183, –0.018]) but not internalizing problems (standardized indirect efect=0.067 [–0.015, 0.148]). In particular, higher illness unpredictability was related to higher unmet needs (β=0.351**) which, in turn, predicted lower health-related quality of life (β=–0.286**). Conclusion These fndings identify ofspring unmet needs and illness unpredictability as implicated in AYAs positive psychosocial adjustment to parental cancer. Given that AYAs are at greater risk of elevated psychosocial difculties, interventions should target ofspring unmet needs and perception of illness unpredictability to mitigate the adverse effects of parental cancer.