ArticleCancer medicine2026
Perceived Family Functioning, Family Resilience, and Multidimensional Sleep Problems Among Chinese Children and Adolescents With Cancer: The Indirect Association of Depression and Anxiety.
Article in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundMultidimensional sleep problems are prevalent among children and adolescents with cancer. Although perceived family functioning and family resilience are known to be associated with sleep problems, the contributions of depression and anxiety remain unquantified.
aimsTo examine associations of perceived family functioning and family resilience with multidimensional sleep problems and quantify indirect associations through depression and anxiety among Chinese children and adolescents undergoing active cancer treatment.
methodsThis cross-sectional study used baseline data from 518 patients aged 7 to < 18 years in the Chinese Childhood Cancer Survivorship Wellbeing Cohort. Perceived family functioning and family resilience were assessed using the Family APGAR Questionnaire and Family Hardiness Index, respectively. Depression and anxiety were measured using the pediatric PROMIS scales, and multidimensional sleep problems were assessed using the BEARS Sleep Screening Scale. A mutually adjusted, multiple-predictor parallel mediation model used 5000 bootstrap resamples and adjusted for sociodemographic and clinical covariates. A parallel indirect-association sensitivity analysis with the BEARS summed score modeled as a Poisson count outcome was performed.
resultsPerceived family functioning was negatively correlated with anxiety (r = -0.341), depression (r = -0.355), and sleep problems (r = -0.240), and family resilience was negatively correlated with anxiety (r = -0.283), depression (r = -0.311), and sleep problems (r = -0.222; all p < 0.001). After depression and anxiety were included, perceived family functioning remained directly associated with fewer sleep problems (B = -0.061, p < 0.05), with a significant total indirect association (B = -0.048, bias-corrected 95% bootstrap CI: -0.071 to -0.028). Family resilience showed a nonsignificant direct association but a significant total indirect association (B = -0.010, bias-corrected 95% bootstrap CI: -0.016 to -0.004).
conclusionsDepression and anxiety showed significant indirect associations between family protective factors and sleep problems. Interventions addressing family dynamics and psychological distress may improve sleep outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.