Sociodemographic and Healthcare Factors Associated with Preserved Social Functioning in Cancer-Bereaved (RP211).

1. Identify parental sociodemographic and child treatment and end-of-life factors associated with preserved parental social functioning, a key outcome in early bereavement. 2. Recognize elements of supportive interventions that may augment early bereavement social functioning in parents of children who died from cancer. Social functioning in bereaved parents is a key marker of psychosocial well being in early bereavement. Parental social functioning was associated with feeling prepared for their child's EOL and the absence of significant financial hardship. Interventions focused on reducing financial hardship and preparing families for EOL may improve bereavement outcomes. Parents who experience the death of a child from cancer experience life-long grief and are at risk of poor psychosocial and physical health outcomes. Early supportive interventions may improve parental social function, a strong marker of psychosocial wellbeing, even in the setting of ongoing distress. Yet we do not know which pre-death factors are associated with early bereavement parental social functioning and would therefore be potential intervention targets. In this study, we sought to determine which parental sociodemographic and child treatment and EOL characteristics were associated with parental social functioning early in bereavement. Parents of children from two centers who died from cancer 6 to 24 months prior were mailed a survey that included validated tools and additional Likert-scale based questions. We used univariable and multivariable logistic regressions to examine which parental sociodemographic and child treatment and end-of-life (EOL) factors were associated with preserved social functioning within the first 2 years following a child's death (defined as T score of ≥40 on the PROMIS Ability to Participate in Social Roles and Activities-Short Form). We assessed for elements household material hardship (HMH) using two questions and dichotomized responses into 'financial stability' (i.e., no HMH) and 'at least one element of HMH' identified. 128 parents representing 88 children completed the survey; most respondents identified as Female (63%), and White non-Hispanic (88%). In univariate analysis, white racial identified, secondary caregiver status, high satisfaction with family relationships, financial stability, ability to plan location of death, and feeling prepared for EOL circumstances were associated with preserved parental social functioning. In multivariate modeling, parents with financial stability were over 4x more likely than those with at least one element of HMH (adjusted odds ratio (AOR) of 4.73 (95% CI 1.64, 13.69), p< 0.004), and those that who were 'prepared for their child's end-of-life circumstances' were over 5x more likely than those parents who were 'not prepared' (AOR 5.46 (95% CI 1.87,15.87), p< 0.002) to have preserved social functioning. Preserved parental social functioning in early bereavement is associated with feeling prepared for their child's EOL and the absence of significant HMH. Interventions focused on educating parents on what to expect as their child nears EOL and on offsetting financial hardships may improve parental psychosocial and health outcomes in bereavement. This is the first study examine the role of pre-death factors on parental bereavement and novel in the focus, not on negative psychosocial outcomes, but instead on those parents who have preserved social functioning despite living through the death of their child. We have identified targets for future supportive interventions in cancer-bereaved parents. Family caregivers,/Pediatrics [ABSTRACT FROM AUTHOR]