Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
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Predictors of Resilience in Adolescents with Cancer

소아암 청소년의 복원력 예측 요인

  • Received : 2013.01.31
  • Accepted : 2013.07.21
  • Published : 2013.07.31
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Abstract

Purpose: The purpose of this study was to identify the predictors influencing on resilience in adolescents with cancer. Methods: The participants consisted of 107 parents and 107 adolescents who aged ten and eighteen diagnosed with cancer more than six months and currently receiving outpatient treatment or further management after off-therapy. Data was collected using self-report questionnaires and analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple regression. Results: Resilience was significantly different by religion (t=2.472, p=.045) and number of cancer treatment regimens (F=3.155, p=.047). Family problem-solving communication was also significant by number of cancer treatment regimens (F=3.582, p=.031). The higher social support showed the stronger family hardiness and the better family problem-solving communication. In addition, a positive relationship was found between Family Hardiness Index (FHI) (r=.193, p=.046), Family Problem Solving Communication (FPSC) (r=.226, p=.019) and resilience of adolescents with cancer. FPSC (${\beta}$=.356, p=.045) and religion (${\beta}$=.441, p=.002) were predictive factors at ages 10-12, FHI (${\beta}$=.509, p=.029) and FPSC (${\beta}$=.503, p=.037) were predictive factors at ages 13-15 on resilience of adolescents with cancer that explained 16.0% and 24.3% respectively. Conclusion: The findings suggest that nursing interventions should focus on enhancing family resilience and resilience of adolescents with cancer.

목적 본 연구는 소아암 청소년 복원력과 가족 복원력의 관계를 파악하고, 청소년 연령에 따른 복원력 영향 요인을 확인하여 이를 증진하기 위한 간호중재 개발의 기초자료를 제공하고자 수행된 서술적 조사 연구이다. 방법 상급종합병원 2곳에서 소아암으로 진단받은 지 최소 6개월 이상 경과된 외래 치료 중이거나 치료 종료 후 추후 관리 중인 만 10-18세 청소년 107명과 그 부모 107명을 대상으로 설문 조사를 하였다. 결과 가족 강인성, 사회적 지지는 가족의 월평균 수입에 따라 유의한 차이가 있었고, 종교 유무에 따라 소아암 청소년의 복원력은 유의한 차이가 있었다. 병행 치료 수가 3가지 이상인 경우 가족 문제해결 의사소통과 소아암 청소년의 복원력이 높았다. 사회적 지지가 높을수록 가족 강인성, 가족 문제해결 의사소통이 높게 나타났고, 가족 강인성은 가족 문제해결 의사소통, 소아암 청소년의 복원력과 양의 상관관계가 있으며, 가족 문제해결 의사소통은 소아암 청소년의 복원력과 양의 상관관계가 있었다. 소아암 청소년의 복원력에 영향을 미치는 요인은 만 10-12세 소아암 청소년의 경우 종교 유무, 가족 문제해결 의사소통이었고, 만 13-15세 소아암 청소년의 경우 가족 강인성, 가족 문제해결 의사소통으로 나타났다. 결론 본 연구의 결과는 소아암 청소년의 복원력과 가족 복원력을 증진하기 위하여 소아암 청소년의 연령에 따른 복원력 중심의 간호 중재 프로그램 개발의 필요성을 시사한다.

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References

  1. Baggott, C., Dodd, M., Kennedy, C., Marina, N., & Miaskowski, C. (2009). Multiple symptoms in pediatric oncology patients: A systematic review. Journal of Pediatric Oncology Nursing, 26(6), 325-339. doi: 10.1177/1043454209340324.
  2. Black, K., & Lobo, M. (2008). A conceptual review of family resilience factors. Journal of Family Nursing, 14(1), 33-55. doi: 10.1177/107484070 7312237.
  3. Brody, A. C., & Simmons, L. A. (2007). Family resiliency during childhood cancer: The father's perspective. Journal of Pediatric Oncology Nursing, 24(3), 152-165. https://doi.org/10.1177/1043454206298844
  4. Clarke, S. A., Davies, H., Jenney, M., Glaser, A., & Eiser, C. (2005). Parental communication and children's behaviour following diagnosis of childhood leukaemia. Psycho-Oncology, 14(4), 274-281. https://doi.org/10.1002/pon.843
  5. Corey, A. L., Haase, J. E., Azzouz, F., & Monahan, P. O. (2008). Social support and symptom distress in adolescents/young adults with cancer. Journal of Pediatric Oncology Nursing, 25(5), 275-284. doi: 10.1177/ 1043454208321117.
  6. Decker, C. L. (2007). Social support and adolescent cancer survivors: A review of the literature. Psycho-Oncology, 16(1), 1-11.
  7. Dunn, M. J., Rodriguez, E. M., Miller, K. S., Gerhardt, C. A., Vannatta, K., Saylor, M., et al. (2011). Direct observation of mother-child communication in pediatric cancer: Assessment of verbal and non-verbal behavior and emotion. Journal of Pediatric Psychology, 36(5), 565-575. doi: 10.1093/jpepsy/jsq062.
  8. Fletcher, P. C. (2010). My child has cancer: The costs of mothers' experiences of having a child with pediatric cancer. Issues in Comprehensive Pediatric Nursing, 33(3), 164-184. doi: 10.3109/01460862.2010.498698.
  9. Hall, J. A. (2010). An exploratory study of communication, gender-role conflict, and social support of parents of children treated at children's hospital. Journal of Psychosocial Oncology, 28(5), 511-525. doi: 10. 1080/07347332.2010.498461. https://doi.org/10.1080/07347332.2010.498461
  10. Herman-Stahl, M., & Petersen, A. C. (1996). The protective role of coping and social resources for depressive symptoms among young adolescents. Journal of Youth and Adolescence, 25(6), 733-753. doi: 10.1007/BF01537451.
  11. Hunter, A. J. (2001). A cross-cultural comparison of resilience in adolescent. Journal of Pediatric Nursing, 16(3), 172-179. https://doi.org/10.1053/jpdn.2001.24180
  12. Jackson, A. C., Enderby, K., O'Toole, M., Thomas, S. A., Ashley, D., Rosenfeld, J. V., et al. (2009). The role of social support in families coping with childhood brain tumor. Journal of Psychosocial Oncology, 27(1), 1-24. doi: 10.1080/07347330802614634.
  13. Kazak, A. E., Derosa, B. W., Schwartz, L. A., Hobbie, W., Carlson, C., Ittenbach, R. F., et al. (2010). Psychological outcomes and health beliefs in adolescent and young adult survivors of childhood cancer and controls. Journal of Clinical Oncology, 28(12), 2002-2007. doi: 10.1200/JCO.2009.25.9564.
  14. Kim, D. H., & Yoo, I. Y. (2010a). Development of a questionnaire to measure resilience in children with chronic Diseases. Journal of Korean Academy of Nursing, 40(2), 236-246. doi: 10.4040/jkan.2010.40.2.236
  15. Kim, D. H., & Yoo, I. Y. (2010b). Factors associated with resilience of school age children with cancer. Journal of Paediatrics and Child Health, 46(7-8), 431-436. doi: 10.1111/j.1440-1754.2010.01749.x.
  16. Luthar, S. S., & Zigler, E. (1991). Vulnerability and competence: A review of research on resilience in childhood. American Journal of Orthopsychiatry, 61, 6-22. https://doi.org/10.1037/h0079218
  17. Mandleco, B. L., & Perry, J. C. (2000). An organizational framework for conceptualizing resilience in children. Journal of Child and Adolescent Psychiatric Nursing, 13(3), 99-111. https://doi.org/10.1111/j.1744-6171.2000.tb00086.x
  18. Mayer, D. K., Tighiouart, H., Terrin, N., Stewart, S., Peterson, E., Jeruss, S., et al. (2009). A brief report of caregiver needs and resource utilization during pediatric hematopoietic stem cell transplantation. Journal of Pediatric Oncology Nursing, 26(4), 223-229. doi: 10.1177/104345420 9340409.
  19. MCubbin, H. I., Patterson, J., & Glynn, T. (1982). Social support index (SSI). In H. I. McCubbin, A. I. Tompson, & M. A. McCubbin (Ed.), Family assessment: Resiliency, coping and adaptation-inventories for research and practice (pp. 357-389). Madison, WI: University of Wisconsin.
  20. McCubbin, M. A., & McCubbin, H. I. (1996). Resiliency in families: A conceptual model of family adjustment and adaptation in response to stress and crisis. In H. I. McCubbin, A. I. Tompson, & M. A. McCubbin (Ed.), Family assessment: Resiliency, coping and adaptation-interventions for research and practice. Madison, WI: University of Wisconsin System.
  21. McCubbin, M. A., McCubbin, H. I., & Thompson, A. I. (1986). Family hardiness index (FHI). In H. I. McCubbin, A. I. Tompson, & M. A. McCubbin (2001), Family measures: Stress, coping and resiliency (pp 274-280). Hawaii, WI: Kamehameha Schools.
  22. McCubbin, M. A., McCubbin, H. I., & Tompson, A. I. (1988). Family problem solving communication (FPSC). In H. I. McCubbin, A. I. Tompson, & M. A. McCubbin (1996), Family assessment: Resiliency, coping and adaptation-inventories for research and practice (pp. 639-686). Madison, WI: University of Wisconsin System.
  23. National Cancer Information Center. (2010). Cancer Facts & Figures 2010. Seoul: Jung, J. S., Choi, S. Y., & Bang, J. Y.
  24. Olson, A. L., Johansen, S. G., Powers, L., Pope, J. B., & Klein, R. (1993). Cognitive strategies of children with chronic illness. Journal of Developmental and Behavioral Pediatrics, 14(4), 217-223.
  25. Seitz, D., Besier, T., Debatin, K., Grabow, D., Dieluweit, U., Hinz, A., et al. (2010). Posttraumatic stress, depression and anxiety among adult long-term survivors of cancer in adolescence. European Journal of Cancer, 46(9), 1596-1606. doi: 10.1016/j.ejca.2010.03.001.
  26. Semple, C. J., & McCance, T. (2010). Parents' experience of cancer who have young children: A literature review. Cancer Nursing, 33(2), 110-118. doi: 10.1097/NCC.0b013e3181c024bb.
  27. Sim, M. K. (2004). Influence of resiliency factors on adaptation in families of children with cancer. Korean Journal of Child Health Nursing, 10(4), 383-394.
  28. Tremolada, M., Bonichini, S., Altoe, G., Pillon, M., Carli, M., & Weisner, T. S. (2011). Parental perceptions of health-related quality of life in children with leukemia in the second week after the diagnosis: A quantitative model. Supportive Care in Cancer, 19(5), 591-598. doi: 10.1007/s00520-010-0854-5.
  29. Vrijmoet-Wiersma, C. M. J., van Klink, J. M. M., Kolk, A. M., Koopman, H. M., Ball, L. M., & Maarten Egeler, R. (2008). Assessment of parental psychological stress in pediatric cancer: A review. Journal of Pediatric Psychology, 33(7), 694-706. doi: 10.1093/jpepsy/jsn007.
  30. Williamson, H., Harcourt, D., Halliwell, E., Frith, H., & Wallace, M. (2010). Adolescents' and parents' experiences of managing the psychosocial impact of appearance change during cancer treatment. Journal of Pediatric Oncology Nursing, 27(3), 168-175. doi: 10.1177/10434 54209357923.

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