Do problem-solving skills help mitigate emotional distress through perceived control and self-efficacy in parents of children with cancer?

Introduction: Parents of children with cancer face psychological challenges that can result in significant distress. It has been found that problem-solving (PS) could mitigate emotional distress (ED) in this population, but mechanisms of this relation are poorly understood. This study aimed to assess whether there is a link between PS and ED through perceived control and self-efficacy. Methods: We included 119 parents (67 mothers, 52 fathers, including 50 couples) whose child was diagnosed with cancer. We evaluated whether PS was associated with ED through perceived control and self-efficacy in couples of parents. Results: We found no direct association between PS and ED (β = −0.01, p = 0.92). Our results indicated a significant indirect effect between ED and PS with perceived control as the intermediary variable (β = −0.24, p < 0.001, 95% CI [−0.41, −0.11]). However, there was no indirect association between ED and PS with self-efficacy as the intermediary variable (β = −0.04, p = 0.26, 95% CI [−0.11, 0.09]). The effect size was large in magnitude (R² = 0.59 for ED). Conclusion: The mitigating role of PS on ED is better explained by an enhanced experience of control than by improved self-efficacy. Future interventions should directly target the action mechanism behind PS and ED in both mothers and fathers by targeting their perceived control.