'I have cried a lot'

Background: A considerable body of research has explored implications of severe parental illness on children. However, less is known about what children and adolescents with a severely ill parent experience as the most challenging.

Aims: To describe what children with a severely ill parent experience as their most difficult challenge.

Methods: A qualitative descriptive design with a manifest content analysis was used on data from a cross-sectional, multicenter study on children of patients in five Norwegian Health trusts. Data consisted of written textual responds from 238 children (age 8-18) to one open-ended question in a self-report questionnaire.

Results: The overall theme concerning the children's most difficult challenge was named 'the drama of life unfoldment', reflecting the parental illness' impact on themselves, their relationships with others, and their life circumstances. The subthemes consisted of: Children's experiences of difficult thoughts and feelings; negatively impaired relationship with parents, friends and others; and challenging life events and obstacles in welfare.

Conclusions: The most difficult challenge experienced by the children with a severely ill parent implies life unfoldment challenges and include negative personal and relational impact, challenging life events and obstacles in welfare.