Parent and adolescent adjustment to pediatric cancer: Associations with coping,social support,and family function

This article presents preliminary results investigating the relationship between parental and adolescent adjustment and coping and their relationship to social support and family functioning in a sample of adolescents (ages 11-18) with cancer and one of their parents. Parents and adolescents from two pediatric oncology clinics completed measures of distress, coping, social support, and family cohesion/adaptability. Low levels of distress were reported by both children and their parents with positive correlations noted between parent and child adjustment. Adolescents reported that their parents and a close friend were the greatest sources of social support and described their families as having a high degree of cohesion and adaptability. Both adolescents and parents used more adaptive than maladaptive coping strategies, although distress was associated with reduced use of adaptive coping. Adolescents are able to adapt to cancer in the context of strong family and social supports. In addition, there is a relationship between parental and adolescents adjustment, and between greater use of adaptive coping styles and lower distress.     

Family stress,perceived social support and coping following the diagnosis of a child's congenital heart disease

BACKGROUND: Congenital heart disease (CHD) is now estimated to be the second most prevalent chronic illness. A child's chronic illness may have effects that have pervasive consequences for family life. Recently, attention has focused on resiliency variables, especially social support and coping strategy, regulating the impact of stress. In the resiliency model of family stress, adjustment and adaptation, social support is viewed as one of the primary moderators or mediators between stress and well-being. AIMS: The purpose of this study was to explore the relationships of family stress, perceived social support, and coping and determine the resiliency factor associated with coping by families who have a child with chronic illness. DESIGN: In a secondary analysis of a large longitudinal study, the sample consisted of 92 families who had a child under age 12 who was newly diagnosed with CHD within the last 3-4 months. FINDINGS: Results from regression analysis revealed that perceived social support operated as a resiliency factor between family stress and both parental and family coping. Child and family characteristics appeared to be the important predictors of perceived social support and parental coping. Although perceived social support appeared to be an important predictor of parental and family coping, neither the moderating nor mediating model was supported in full but partial causal relations were confirmed. CONCLUSIONS: Findings provided evidence for the theoretical and empirical significance of perceived social support as a predictor of family coping. Further, these findings suggest that perceived social support is a factor influencing the resiliency of relatively high-risk groups of families who have a child with chronic illness.     

Adolescent subjective well-being and family dynamics

The purpose of this study was to examine the relationships between adolescent subjective well-being (SWB) and family dynamics perceived by adolescents and their parents. A sample of 239 pupils (51% female) from seventh and ninth grades completed the Berne questionnaire of SWB (youth form), two subscales from an original Finnish SWB scale and the Family Dynamics Measure II, and one of their parents (n = 239) filled in the Family Dynamics Measure II. Results indicated that parents assessed family dynamics better than did their adolescent child. Furthermore, there was no association between family dynamics perceived by adolescents and family dynamics assessed by one of their parents or between the adolescent SWB and parental perception of family dynamics. Multiple stepwise regression analysis indicated that certain aspects of family dynamics perceived by adolescents were related to adolescent global satisfaction and ill-being. Specifically, adolescents' perception of high level of mutuality and stability in the family as well as male gender and lack of serious problems in family were predictors of adolescent global satisfaction. Furthermore, disorganization in the family and poor parental relationship perceived by adolescents, being female, serious problems and illness in family predicted a high level of adolescent global ill-being.     

Marital status, marital transitions, well-being, and spinal cord injury: an examination of the effects of sex and time

Kalpakjian CZ, Houlihan B, Meade MA, Karana-Zebari D, Heinemann AW, Dijkers MP, Wierbicky J, Charlifue S. Marital status, marital transitions, well-being, and spinal cord injury: an examination of the effects of sex and time.

Objective

To examine the applicability of marital resource (marriage has substantial benefits for well-being over not being married) or marital crisis (marital dissolution leads to poorer well-being) models to the spinal cord injury (SCI) population by studying the effects of sex, marital status, and marital transitions on well-being.

Design

Prospective cohort study from the SCI Model Systems National Database.

Setting

Community.

Participants

Men (n=4864) and women (n=1277) who sustained traumatic SCI and completed a minimum of 1 follow-up interview beginning at 1 year through 15 years postinjury.

Interventions

None.

Main Outcomes Measures

Life satisfaction, depressive symptoms, and self-perceived health status by using linear mixed models for longitudinal data.

Results

In general, well-being improved over time since injury. Hypothesis testing supported the marital crisis model, as marital loss through being or becoming separated or divorced and being or becoming widowed, had the most consistent and negative impact across well-being outcomes, whereas being or becoming married had an advantage for only lower depression symptoms over time. However, marital dissolution or loss did not have a uniformly adverse impact on well-being outcomes, and this effect often was moderated by sex, such that widows had higher depressive symptoms and poorer self-perceived health than widowers, but separated or divorced women had higher life satisfaction and self-perceived health than men. Irrespective of sex, being separated or divorced versus being single was associated with higher depressive symptoms over time.

Conclusions

Results support the marital crisis model and that women and men can experience marital dissolution differently. All marital loss does not result in compromised well-being and all marriage does not enhance well-being, highlighting complex dynamics worthy of further investigation in this population.     

Evaluation of a conceptual model based on Mishel's theories of uncertainty in illness in a sample of Taiwanese parents of children with cancer: A cross-sectional questionnaire survey

BackgroundThe prognoses of childhood cancers have improved over the last few decades. Nevertheless, parental uncertainty about the absolute cure and possible relapse pervades the entire illness trajectory. Despite illness-related uncertainty is significantly related to psychological distress, continual uncertainty may serve as a catalyst for positive psychological change and personal growth in the context of surviving cancer.ObjectivesThe purpose of this study was to examine a conceptual model that depicts coping and growth in Taiwanese parents living with the continual uncertainty about their child's cancer. The conceptual model was guided by Mishel's theories of Uncertainty in Illness. The impact of the child's health status, parents’ education level and perceived social support on parental uncertainty was analyzed. The mediating effect of coping as well as the influence of parental uncertainty and parents’ perceived social support on growth through uncertainty was incorporated in the model testing.MethodsThis study involved a sample of 205 mothers and 96 fathers of 226 children enrolled in a longitudinal cancer study in Taiwan. This study only analyzed the data collected at baseline. A cross-sectional design was utilized to examine the relationships among proposed variables. Parental uncertainty and growth through uncertainty were measured by the translated questionnaires originally developed by Mishel. Parents’ perceived social support and coping were measured by culturally sensitive instruments developed in Taiwan.ResultsThe full research model and its alternative models fit adequately to the data via structural equation modeling tests. Parental uncertainty and parents’ perceived social support were associated with growth through uncertainty which was mediated by coping. Child's health status and parents’ perceived social support would significantly predict parental uncertainty.ConclusionThis study suggests that parental uncertainty has negative impact on coping strategies such as interacting with family members while these coping strategies may help Taiwanese parents gain growth through uncertainty. Coping strategies of searching for spiritual meaning and increasing religious activities were not significantly influenced by parental uncertainty in this study. The two coping strategies may be relevant to growth through uncertainty due to Taiwanese cultural belief. Moreover, the availability of social support promotes growth through uncertainty by its impact on lowering parental uncertainty and encouraging more coping. The findings indicate that Taiwanese parents may gain growth through uncertainty while experiencing their child's cancer. The research model provides possible guidelines for oncology nurses to deliver more culturally competent health care for Taiwanese parents of children with cancer.     

The relationship between meaning of illness, social support, coping strategies, and quality of life for lung cancer patients and their family members

This article explores the relationship between meaning of illness, perceived social support resources, coping strategies used, and quality of life (QOL) by patients with lung cancer and their family members. The study was cross-sectional using interview data from 85 patients and associated family members. Regression results showed that total QOL in patients with lung cancer is predicted most by meaning of illness, specifically, the illness being perceived as manageable. QOL in family members is predicted most by meaning of illness, specifically, less adverse impact. Interestingly, the overall meaning of illness, coping strategies used, and social support were similar in the 2 groups. The results of the study emphasize the importance of acknowledging the circumstances of people's lives, both patients surviving lung cancer and their family members, which contribute to QOL.     

Coping with a possible breast cancer diagnosis: demographic factors and social support

AIM: This paper reports a study examining the relationships between demographic characteristics, social support, anxiety, coping and defence among women with possible breast cancer. BACKGROUND: Awaiting a possible breast cancer diagnosis is an anxiety-provoking situation that demands coping. Social support and demographic characteristics have been reported to influence coping and well-being, but the interconnection is insufficiently understood. DESIGN: A survey design was used, and self-administrated questionnaires were returned by a convenience sample of 117 women in Norway who had undergone breast biopsy. The data were collected from September 1998 to February 2000. INSTRUMENTS: The instruments consisted of: the Social Provisions Scale, State-Trait Anxiety Scale, Utrecht Coping List and Defence Mechanisms Inventory. In addition, data on age, level of education, employment, marital status, and household status were collected. RESULTS: Social support was positively related to instrumental-oriented coping and emotion-focused coping, unrelated to cognitive defence and defensive hostility. Educational level was positively related to instrumental-oriented coping. Educational level, employment and marital status were negatively related to cognitive defence. Educational level was the most important contributor to social support. Attachment and education were the most important contributors to instrumental-oriented coping, with education as the strongest predictor. CONCLUSION: Better coping was linked primarily to education, and secondly to attachment. Unemployment, low level of education and single/divorced/widowed status were related to greater use of cognitive defence. Women who used a defensive hostile style tended to receive poor social support. Nurses need to be aware of the influence of demographic characteristics on social support, coping and defence and to identify poor copers, as these patients are most in need of professional support.     

Metabolic control and quality of life in type 1 diabetes: Do adherence,family support,and school support matter?

This study analyzed the relationship between clinical and demographic variables, family support, school support, and adherence on adolescents' metabolic control and quality of life (QoL) based on Adaptation to Chronic Disease in Childhood's model. The sample included 100 adolescents and 100 parents. Adolescents were assessed on adherence, family support, school support, and QoL. Parents were assessed on family functioning and parental coping. A path analysis was performed to assess the adequacy of the theoretical model to the sample. Daily glycemic monitoring was associated with better metabolic control and diabetes hospitalizations with worse metabolic control. The final model showed adherence, family support, school support, and family functioning having an indirect effect on the relationship between adolescence stage, number of daily glycemic monitorings, number of hospitalizations, and metabolic control/QoL. Adherence had an indirect effect on the relationship between glycemic monitoring and family and school support, suggesting that adolescents need both types of support to perform diabetes self-care tasks. QoL showed a direct effect on metabolic control revealing the importance of QoL in the design of interventions to promote metabolic control in adolescents.     

Family structure and mothers' caregiving of children with cystic fibrosis

The purpose of this investigation is to examine differences in the experiences of mothers of children with cystic fibrosis who are in diverse family structures (first-marriage families, stepfamily households, single-parent households). In particular, mothers' perceptions of children's health, adherence to prescribed treatments, and help received from others were compared and predictors of treatment adherence were examined. Children's health and adherence to treatment regimens were not related to family structure. Mothers had the major responsibility for seeing that cystic fibrosis treatments were followed, regardless of family structure. Single mothers received less help than married and repartnered mothers. Married fathers helped with treatments more than nonresidential divorced fathers and stepfathers. Implications for nursing practice and suggestions for future research are offered.     

The stress process in family caregivers of persons receiving chemotherapy

The purpose of this analysis was to explore strain and depression among family caregivers of persons receiving chemotherapy for cancer using the Pearlin Stress Process Model. Seventy-five family caregivers of persons receiving chemotherapy participated, completing the Caregiver Strain Index and the Depression Subscale of the Profile of Mood States within 3 weeks of the initiation of chemotherapy. Hierarchical regression analyses indicated that 44% of the variance in strain and 40% of the variance in depression were explained by the antecedent variables of caregiver age and gender, patient age and gender, patient functional status, the presence of recurrent disease, perceived efficacy of coping strategies, and perceived adequacy of social support. Further analysis aimed at delineating the mechanisms through which coping and social support operate in the model found no evidence for a moderating or stress-buffering effect. However, coping mediated the relationship between strain and depression and social support mediated the relationship between functional status and depression.     

飞行员主观幸福感与应对方式和社会支持相关性研究

目的探讨飞行员主观幸福感与应对方式和社会支持的相关性。方法对102名空军飞行员采用主观幸福感指数量表、应对方式问卷和领悟社会支持量表进行测评分析。结果飞行员社会支持各维度与主观幸福感各维度呈显著性相关（P〈0．01）,家庭外支持对主观幸福感有显著的正向预测作用（P〈0．01）;消极应对方式和社会支持总分对总体情感指数有显著的预测作用。结论社会支持、家庭外支持和消极应对方式是影响飞行员主观幸福感的重要因素。     

Predictors of depressive symptoms and physical health in caregivers of individuals with schizophrenia

This cross‐sectional study examined relationships among factors influencing caregiver burden, depressive symptoms, and physical health in family caregivers of individuals with schizophrenia. Two hundred family caregivers of individuals with schizophrenia completed standardized questionnaires related to depressive symptoms, physical health, perceptions of burden, coping, and social support. The results revealed that 19.5% of family caregivers of individuals with schizophrenia experienced significant depressive symptoms and 65.5% perceived themselves in poor physical health. Burden, self‐controlling coping strategies, and physical health status were all independently predictive of depressive symptoms. Two emotion‐focused coping strategies (self‐controlling and escape‐avoidance) were independently predictive of caregiver burden. Only burden predicted physical health status. The findings suggest that health professionals who provide community care for those with schizophrenia need to consider the “unit of care” as the family rather than the individual. The health status of family caregivers should be routinely assessed. Individualized interventions to reduce family burden could include community‐based health professionals as well as trained community volunteers, opportunities for social interaction, and improving self‐care for all family members.     

艾滋病患者感知歧视度及其与抑郁、社会支持和应对方式的相关性

目的 探讨艾滋病患者感知歧视度现状,分析其与抑郁、社会支持和应对方式的的相关性.方法 采用便利抽样法选取2019年1月—2020年3月于本院就诊的160例艾滋病患者,并采用一般资料调查表、感知歧视度量表、汉密尔顿抑郁量表、医疗社会支持量表、简易应对方式问卷调查并分析AIDS患者感知歧视度的影响因素.结果 160例AID...     

Outcomes of depression in early adolescents

The purpose of this study was to examine the relationship between depressed mood and depressive symptomatology and the influence of both variables on perceived social support, interpersonal conflict, general well-being, and perceived health status in 144 early adolescents. The subjects responded to instruments measuring the study variables in classroom settings. Two bivariate regression structural equation models were examined using the LISREL 7 computer software program. In the health model, depressed mood had a direct positive effect on depressive symptoms and a direct negative effect on well-being and on perceived health status. Depressive symptoms had a direct negative effect on well-being and on perceived health status. In the interpersonal model, depressed mood had a direct positive effect on depressive symptoms and on conflict and a direct negative effect on social support. Depressive symptoms had a direct positive effect on conflict and a direct negative effect on social support.     

Health and well-being in early adolescents using Rogers' science of unitary human beings

The purpose of this study was to examine the relationship of perceived field motion and human field rhythms to perceived health status, health conception, and well-being in early adolescents to determine which health-related variables are most compatible with Rogers' science of unitary human beings. The sample of 142 early adolescents responded to the study instruments in classrooms. The correlations between perceived field motion and each of the other variables were statistically significant, and increased in magnitude from perceived health status to health conception to well-being. These results give credence to Rogers' evolving philosophical belief that the term well-being is more compatible than health in her science.     

Goal frustration, coping and well-being in the context of adolescent headache: A self-regulation approach

The aim of this study was to investigate the relationships between goal frustration, coping and well-being in the context of adolescent headache. Firstly, we investigated whether adolescents with weekly, monthly or no headache complaints differed with regard to the importance assigned to their personal goals, experience of goal frustration, coping with goal frustration and well-being. Secondly, the extent to which goal and coping factors contributed to well-being and whether this relationship differed according to the frequency of headache complaints was examined. For this purpose, 1202 adolescents aged 12–18 completed self-report questionnaires in schools. Adolescents were divided into three groups based on their experience of headache: no headache reported (38%); monthly headache (40%); weekly headache (18%). Results show that these groups did not differ with respect to the importance they attach to goals. They did, however, differ according to experience of goal frustration, use of strategies to cope with goal frustration and well-being, although effect sizes were small. After controlling for individual and headache characteristics, frustration of self acceptance and health goals, and the use of self blame, rumination and other blame were consistently related to lower well-being. Moreover, interactions with headache group indicated that for adolescents with weekly headache, greater frustration of school and self acceptance goals and a lower importance assigned to health goals was more detrimental to well-being than for those with no headache complaints. We conclude that frustration to goal pursuit and strategies for coping with this frustration are important factors in adolescent well-being and may offer important targets for intervention.     

Social support and well-being in early adolescents: the role of mediating variables

The purpose of this study was to examine the relationship between perceived social support and general well-being in early adolescents and to test two variables, hopefulness and self-esteem, that theoretically mediate this relationship. The final sample consisted of 142 adolescents, ages 12 to 14, who responded to instruments measuring perceived social support hopefulness, self-esteem, and general well-being in classroom settings. Correlational analysis supported the five hypothesized relationships. A series of regression analyses described by Baron and Kenny indicated that hopefulness and self-esteem each were mediators of the relationship between social support and well-being. Implications for nursing practice are addressed.     

Stress and coping of midlife women in divorce transition

This article describes stress and coping by decider status. Participants were 154 women aged 34 to 54 years who were recently divorced from their first marriage and were married 3 years prior to divorce. Participants self-selected into decider statuses as initiators, noninitiators, or mutual deciders. Noninitiators indicated not knowing the divorce experience was going to occur, not having enough time to get ready for it, saw it as something someone else did, and perceived it as a threat. Initiators and mutual deciders viewed the divorce as a challenge. Noninitiators were less positive about the divorce experience than were initiators and mutual deciders. Acceptance or resignation differed significantly for noninitiators and mutual deciders but not between noninitiators and initiators. Characterizing midlife divorce transition experiences provides a foundation for developing primary intervention to support personal growth, healing, and a healthy lifestyle.     

Social support, threat, and coping responses and effectiveness in the functionally disabled

A causal model based on Lazarus' (1966) cognitively oriented theory of psychological stress and coping was tested in a functionally disabled population to determine the effects of social support variables, threat appraisal, and coping responses on coping effectiveness. Social support variables (perceived availability of social support, perceived effectiveness of social support, and personal constraints to the use of social support) were hypothesized to effect coping responses both directly and through the variable of threat appraisal. Coping responses (use of social support, cognitive reappraisal, emotion-focused coping, and problem-focused coping) were hypothesized to directly effect coping effectiveness and to mediate the effect of all other variables. Data from 50 functionally disabled, wheel-chair-bound individuals discharged within 3 years from two rehabilitation facilities were analyzed using path analysis. The model fit the data and accounted for 61% of the variance in coping effectiveness. Findings indicated that perceived availability of social support, but not the use of social support, was significantly and positively related to coping effectiveness through the mediating variables of problem- and emotion-focused coping. In contrast to the relationship of marital status to coping effectiveness usually found in the literature, nonmarried subjects coped more effectively and perceived less threat.