Profiles of parental coping with paediatric cancer and their associations with parental illness adaptation.

The study was cross-sectional, so it cannot show that coping style caused worse adjustment or that stress caused avoidant coping. The researchers planned 116 parents but analysed 89, and several profiles were small, especially the avoidant coper group with 4 parents, so group comparisons are unstable. Participants were mostly from one centre, mostly Jewish, mostly married or coupled and mostly higher educated, and they could read Hebrew, Arabic or English, so the findings may not fit other families. Parents with a psychiatric condition before the child's cancer diagnosis and children with end-stage prognosis were excluded, so families with severe psychiatric or terminal illness circumstances were not represented. Coping and outcome data were mostly self-reported questionnaires, so the same reporting style may influence the associations.

This work was supported by the Rambam Health Campus and the Faculty of Health and Welfare University of Haifa Mutual Fund. The authors declared no conflicts of interest.

Do not conclude that avoidant coping causes worse adjustment or that active coping will improve outcomes. The study is cross-sectional, and the avoidant group had only 4 parents, so the associations cannot establish cause or treatment effect.