Evidence map›Paper›PMID 40081622›Full record

ArticleJournal of pain and symptom management2025

Relationship Between Parental Distress and Proxy Symptom Reports in Pediatric Palliative Care.

Douglas L Hill, Russell T Nye, Jackelyn Y Boyden, Emily E Johnston, Pamela Hinds, Sarah Friebert, Jori Bogetz, Tammy I Kang, Matt Hall, Joanne Wolfe and 2 more

Abstract read
In one paragraph

Article in Journal of pain and symptom management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. A dyadic approach to understanding anxiety and child overall health in pediatric oncology: insights from an actor-partner interdependence model.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Douglas L HillJustin Ingerman Center for Palliative Care (D.L.H., R.T.N., C.F.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Russell T NyeJustin Ingerman Center for Palliative Care (D.L.H., R.T.N., C.F.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Biomedical and Health Informatics (R.T.N.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Jackelyn Y BoydenDepartment of Family and Community Health (J.Y.B.), University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA; Department of Pediatrics (J.Y.B.), The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Emily E JohnstonDepartment of Pediatrics (E.E.J.), Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Pamela HindsChildren's National Hospital (P.H.), Department of Nursing Science, Professional Practice & Quality; Department of Pediatrics, The George Washington University, Washington, District of Columbia, USA.
Sarah FriebertDepartment of Pediatrics (S.F.), Division of Palliative Care, Akron Children's Hospital and Rebecca D. Considine Research Institute, Akron, Ohio, USA.
Jori BogetzDepartment of Pediatrics (J.B.), Division of Bioethics and Palliative Care, University of Washington School of Medicine, Seattle, Wasington, USA.
Tammy I KangDepartment of Pediatrics (T.I.K.), Section of Palliative Care, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.
Matt HallChildren's Hospital Association (M.H.), Lenexa, Kansas, USA.
Joanne WolfeDepartment of Pediatrics (J.W.), Massachusetts General Hospital and Brigham and Women's Hospital, Boston, Massachusetts, USA.
Chris FeudtnerJustin Ingerman Center for Palliative Care (D.L.H., R.T.N., C.F.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics (C.F.), Medical Ethics and Health Policy, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: feudtner@chop.edu.
PPCRN SHARE Project Group

Funding

Pediatric Palliative Care Research Network SHARE ProjectR01NR016223 · NINR · CHILDREN'S HOSP OF PHILADELPHIA · PI FEUDTNER, JOHN CHRIS, WOLFE, JOANNE · 2016 to 2020
$2.8M
Home-based Experiences of Palliative and Hospice Care for Children and Caregivers (EXPERIENCE) ProjectF32NR019517 · NINR · CHILDREN'S HOSP OF PHILADELPHIA · PI BOYDEN, JACKELYN Y · 2020 to 2021
$138k
NINR NIH HHS F32 NR019517NINR NIH HHS R01 NR016223
6 · The paper itself

Abstract

contextIn pediatric palliative care (PPC), patients often are not able to report symptoms so proxy reports from parents are used. Whether psychological distress in the proxies affects reports of patients' symptoms is unknown.

objectiveTo measure the influence of parents' distress on proxy-reported scores regarding symptoms by analyzing pairs of parents reporting on the same child.

methodsIn a large prospective cohort study of PPC patients, we collected parents' reports of child symptoms (Memorial Symptom Assessment Scale) and their own psychological distress (Kessler-6). In this quasi-experimental design study, we examined data from pairs of parents reporting symptoms for the same child. Using regression modelling, we estimated the association between parental distress scores and patient total symptom scores across the entire sample accounting for clustering within families, and then measured the association within-families of the absolute differences of the two parents' distress and the difference in their symptom scores.

resultsAmong 152 parents in 76 families, 50.0% were female, 80.9% were White, and the mean age was 36.4 (SD 9.0) years. Across the sample, each 1-point increase in reported parental distress was associated with a 1.07 (95% CI, 0.87-1.28; P < 0.001) increase in proxy-reported patient symptom score. Within families, relative to the other parent, each 1-point increase in the difference of the distress scores was associated with a 0.33-point (95% CI, 0.32-0.35; P = 0.006) increase in the difference in symptom scores.

conclusionPsychological distress appears to influence proxy reports of symptoms which has implications for future research and clinical practice.

Indexed as

Palliative CareParentsProxyPsychological DistressStress, PsychologicalAdolescentAdultChildChild, PreschoolFemaleHumansMaleProspective StudiesSymptom Assessmentparentpediatric palliative careProxy reportpsychological distresssymptom measurement

Identifiers

PMID40081622
PMCPMC12065655

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.