A dyadic approach to understanding anxiety and child overall health in pediatric oncology: insights from an actor-partner interdependence model.

Authors

Anna L Olsavsky, Madeline R Peek, Kathleen E Montgomery, Micah A Skeens

Published in

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. Volume 35. Issue 8. Jun 15, 2026. Epub Jun 15, 2026.

Abstract

Though child and caregiver anxiety are known to contribute to child overall health, this has not been examined dyadically. This cross-sectional study dyadically examined anxiety (child-self, caregiver-self) and child overall health (child-self, caregiver-proxy) in pediatric cancer.
Children and caregivers (n = 76 dyads; n = 152) from two Midwestern children's hospitals self- or proxy-reported child overall health, and their own anxiety. Descriptive statistics and bivariate analyses (e.g., correlations, t-tests) examined associations among demographics, medical characteristics, and focal variables. An Actor-Partner Interdependence Model (APIM) evaluated dyadic associations between child and caregiver self-reports of anxiety (independent variables) and child self- and caregiver proxy-reports of child overall health (dependent variables). Associations between independent and dependent variables for one reporter are actor effects, whereas across reporters are partner effects.
Among 76 child (88.2% White; 34.2% Female; M = 13.35-years-old, SD = 3.20) and caregiver (92.1% White, 69.7% Female) dyads, children (M = 46.64, SD = 9.09) and caregivers (M = 39.33, SD = 8.97) reported below-average child overall health. Children reported below-average anxiety levels (M = 46.31, SD = 10.05), and caregivers reported above-average anxiety levels (M = 55.18, SD = 8.37). APIM analyses revealed significant actor effects: higher levels of self-reported anxiety were associated with lower levels of child overall health (b = - 0.29, p < .001). Marginally non-significant partner effects revealed greater anxiety was linked to lower partner reports of child overall health (b = - 0.14, p = 0.051).
Our findings underscore supporting the family system within pediatric cancer and suggest mitigating caregiver anxiety may have downstream benefits. Interventions are needed for caregivers and children to support their mental and overall health during cancer treatment.

PMID:
42295495
Bibliographic data and abstract were imported from PubMed on 15 Jun 2026.

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