The purpose of this study was to explore, using grounded theory, the p
rocess experienced by parents who are dealing with the first recurrenc
e of cancer in their child. The sample of 33 guardians (27 mothers, 1
grandmother, and 5 fathers) was drawn from three pediatric oncology se
ttings. Data were collected through interviews, observations, and medi
cal record review. Thirteen parents were interviewed to validate first
the evolving and, later, the complete study findings. Four interactiv
e components emerged: regulating shock, situation monitoring, alternat
ing realizations, and eyeing care-limiting decisions. The overall orga
nizing construct induced from these components was labeled ''coming to
terms.'' This construct represents the parents' efforts to overcome s
hock and despair to make wise decisions about treatment while acceptin
g that the outcome is beyond their control, and to help their child ha
ve the optimal chance for cure while preparing for the child's possibl
e death.