Abstract
OBJECTIVE: Family rituals are associated with adaptive functioning in pediatric illness, including quality of life (QoL). This article explores the role of family cohesion and hope as mediators of this association in children with cancer and their parents. METHODS: Portuguese children with cancer (N = 389), on- and off-treatment, and one of their parents completed self-report measures. Structural equation modeling was used to examine direct and indirect links between family rituals and QoL. RESULTS: When children and parents reported higher levels of family rituals, they also reported more family cohesion and hope, which were linked to better QoL. At the dyadic level, children's QoL was related to parents' family rituals through the child's family cohesion. This model was valid across child's age-group, treatment status, and socioeconomic status. CONCLUSIONS: Family rituals are important in promoting QoL in pediatric cancer via family cohesion and hope individually and via family cohesion in terms of parent-child interactions.