Background/Objectives:Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer, with intense treatments affecting both children and their families. Limited information is available on parental distress and psychological well-being during the first treatment year, with most studies focusing on individuals rather than the family system. This study explores longitudinal changes in parental distress (psychological morbidity and traumatic stress symptoms), coping strategies, family resilience and functioning, and psychological well-being. The study also examines the mediating roles of family resilience, family functioning, and coping strategies in the relationships between parental distress and psychological well-being.Methods: A prospective study was conducted with 46 parents of children newly diagnosed with ALL, assessing parental distress, family functioning and resilience, coping, and psychological well-being across three treatment phases: consolidation (T0), delayed intensification (T1), and maintenance (T2).Results: Parental distress and family resilience significantly decreased from T0 to T2, while parental coping improved over time. Family functioning deteriorated from T0 to T1, stabilizing thereafter. Psychological well-being followed a non-linear trajectory, initially declining from T0 to T1 and improving from T1 to T2. Mediation analyses revealed that family resilience and family functioning partially mediated the relationships between parental distress and psychological well-being. Parental coping did not emerge as a mediator.Conclusions: Parental psychological adjustment in the context of ALL is dynamic and influenced by individual and family factors. Interventions that strengthen family functioning and resilience are crucial for supporting parental psychological well-being during treatment. A family-centered approach in healthcare delivery is essential to address individual and systemic challenges.
背景/目的：急性淋巴细胞白血病（ALL）是最常见的儿童恶性肿瘤，其高强度治疗对患儿及其家庭均产生深远影响。目前关于治疗首年内父母心理困扰与心理健康状况的研究较为有限，且多数研究聚焦于个体而非家庭系统。本研究旨在探讨父母心理困扰（心理病理性症状与创伤应激症状）、应对策略、家庭韧性及功能以及心理健康状况的纵向变化轨迹，并分析家庭韧性、家庭功能及应对策略在父母心理困扰与心理健康关系中的中介作用。 方法：本研究采用前瞻性设计，纳入46名新诊断ALL患儿的父母，在巩固治疗期（T0）、延迟强化期（T1）和维持治疗期（T2）三个阶段评估其心理困扰、家庭功能与韧性、应对方式及心理健康状况。 结果：从T0到T2阶段，父母心理困扰与家庭韧性显著降低，而父母应对能力随时间推移逐步改善。家庭功能在T0至T1期间出现恶化，此后趋于稳定。心理健康呈现非线性变化轨迹：T0至T1期间先下降，T1至T2期间逐步改善。中介分析显示，家庭韧性与家庭功能在父母心理困扰与心理健康关系中起部分中介作用，而父母应对策略未显现中介效应。 结论：ALL患儿父母的心理适应过程具有动态性特征，受个体及家庭因素共同影响。在治疗期间，通过增强家庭功能与韧性的干预措施对维护父母心理健康至关重要。医疗保健服务应采用以家庭为中心的模式，以应对个体及系统层面的挑战。
肿瘤(癌症)患者之家