Abby R Rosenberg1, Helene Starks, Barbara Jones. 1. Cancer and Blood Disorders Center, Seattle Children's Hospital, 4800 Sand Point Way NE, M.S. M.B.8.501, PO Box B-6553, Seattle, WA, 98105, USA, abby.rosenberg@seattlechildrens.org.
Abstract
PURPOSE: Promoting parent resilience may provide an opportunity to improve family-level survivorship after pediatric cancer; however, measuring resilience is challenging. METHODS: The "Understanding Resilience in Parents of Children with Cancer" was a cross-sectional, mixed-methods study of bereaved and non-bereaved parents. Surveys included the Connor-Davidson Resilience scale, the Kessler-6 psychological distress scale, the Post-Traumatic Growth Inventory, and an open-ended question regarding the ongoing impact of cancer. We conducted content analyses of open-ended responses and categorized our impressions as "resilient," "not resilient," or "unable to determine." "Resilience" was determined based on evidence of psychological growth, lack of distress, and parent-reported meaning/purpose. We compared consensus impressions with instrument scores to examine alignment. Analyses were stratified by bereavement status. RESULTS: Eighty-four (88 %) non-bereaved and 21 (88 %) bereaved parents provided written responses. Among non-bereaved, 53 (63 %) were considered resilient and 15 (18 %) were not. Among bereaved, 11 (52 %) were deemed resilient and 5 (24 %) were not. All others suggested a mixed or incomplete picture. Rater-determined "resilient" parents tended to have higher personal resources and lower psychological distress (p = <0.001-0.01). Non-bereaved "resilient" parents also had higher post-traumatic growth (p = 0.02). Person-level analyses demonstrated that only 50-62 % of parents had all three instrument scores aligned with our impressions of resilience. CONCLUSIONS: Despite multiple theories, measuring resilience is challenging. Our clinical impressions of resilience were aligned in 100 % of cases; however, instruments measuring potential markers of resilience were aligned in approximately half. Promoting resilience therefore requires understanding of multiple factors, including person-level perspectives, individual resources, processes of adaptation, and emotional well-being.
PURPOSE: Promoting parent resilience may provide an opportunity to improve family-level survivorship after pediatric cancer; however, measuring resilience is challenging. METHODS: The "Understanding Resilience in Parents of Children with Cancer" was a cross-sectional, mixed-methods study of bereaved and non-bereaved parents. Surveys included the Connor-Davidson Resilience scale, the Kessler-6 psychological distress scale, the Post-Traumatic Growth Inventory, and an open-ended question regarding the ongoing impact of cancer. We conducted content analyses of open-ended responses and categorized our impressions as "resilient," "not resilient," or "unable to determine." "Resilience" was determined based on evidence of psychological growth, lack of distress, and parent-reported meaning/purpose. We compared consensus impressions with instrument scores to examine alignment. Analyses were stratified by bereavement status. RESULTS: Eighty-four (88 %) non-bereaved and 21 (88 %) bereaved parents provided written responses. Among non-bereaved, 53 (63 %) were considered resilient and 15 (18 %) were not. Among bereaved, 11 (52 %) were deemed resilient and 5 (24 %) were not. All others suggested a mixed or incomplete picture. Rater-determined "resilient" parents tended to have higher personal resources and lower psychological distress (p = <0.001-0.01). Non-bereaved "resilient" parents also had higher post-traumatic growth (p = 0.02). Person-level analyses demonstrated that only 50-62 % of parents had all three instrument scores aligned with our impressions of resilience. CONCLUSIONS: Despite multiple theories, measuring resilience is challenging. Our clinical impressions of resilience were aligned in 100 % of cases; however, instruments measuring potential markers of resilience were aligned in approximately half. Promoting resilience therefore requires understanding of multiple factors, including person-level perspectives, individual resources, processes of adaptation, and emotional well-being.
Authors: Abby R Rosenberg; Joanne Wolfe; Miranda C Bradford; Michele L Shaffer; Joyce P Yi-Frazier; J Randall Curtis; Karen L Syrjala; K Scott Baker Journal: Pediatr Blood Cancer Date: 2013-11-19 Impact factor: 3.167
Authors: Ronald C Kessler; Jennifer Greif Green; Michael J Gruber; Nancy A Sampson; Evelyn Bromet; Marius Cuitan; Toshi A Furukawa; Oye Gureje; Hristo Hinkov; Chi-Yi Hu; Carmen Lara; Sing Lee; Zeina Mneimneh; Landon Myer; Mark Oakley-Browne; Jose Posada-Villa; Rajesh Sagar; Maria Carmen Viana; Alan M Zaslavsky Journal: Int J Methods Psychiatr Res Date: 2010-06 Impact factor: 4.035
Authors: Abby R Rosenberg; Joyce P Yi-Frazier; Claire Wharton; Karen Gordon; Barbara Jones Journal: J Adolesc Young Adult Oncol Date: 2014-12-01 Impact factor: 2.223
Authors: Yuanhui Luo; Ho Cheung William Li; Wei Xia; Ankie Tan Cheung; Laurie Long Kwan Ho; Joyce Oi Kwan Chung Journal: Front Pediatr Date: 2022-05-30 Impact factor: 3.569
Authors: Abby R Rosenberg; Karen L Syrjala; Paul J Martin; Mary E Flowers; Paul A Carpenter; Rachel B Salit; K Scott Baker; Stephanie J Lee Journal: Cancer Date: 2015-08-19 Impact factor: 6.860