title: A model linking uncertainty, post-traumatic stress, and health behaviors in childhood cancer survivors.
abstract: OBJECTIVE
  To consolidate the literature and provide a model to explain the links among uncertainty, post-traumatic stress syndrome, and health behaviors in adolescent and young adult childhood cancer survivors.
  
  
  METHODS
  A systemic review of related literature and theory was used for the proposed model. The literature pertaining to the Uncertainty in Illness Theory, childhood cancer late effects, post-traumatic stress, and health behaviors was reviewed and critiqued from three data sets from 1979-2007: MEDLINE, PsycInfo, and CINAHL. Key words used for the search were uncertainty and post-traumatic stress as well as health behaviors, including smoking, alcohol use, unsafe sex, sunscreen use, and physical inactivity.
  
  
  RESULTS
  Childhood cancer survivors living with chronic uncertainty may develop a new view of life and, as a result, adopt more health-promotion behaviors and engage in less health-risk behaviors. However, survivors living with chronic uncertainty may generate symptoms similar to post-traumatic stress disorder and, therefore, adopt fewer health-promotion behaviors and engage in more health-risk behaviors.
  
  
  CONCLUSIONS
  The uncertainty that pervades the childhood cancer experience can lead to the development of symptoms that resemble those of post-traumatic stress. The symptoms can interfere with the adoption of healthy lifestyle behaviors and avoidance of health-risk behaviors.
  
  
  CONCLUSIONS
  The theoretically derived model outlined in this article can be used to guide clinical interventions and additional research into the health behaviors of childhood cancer survivors.
authors.affiliation: Department of Nursing, National Taiwan University, Taipei, Taiwan. yallee@ntu.edu.tw
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Lee
authors.forename: Bih-Shya
authors.initials: BS
authors.lastname: Gau
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Hsu
authors.forename: Hsiu-Hao
authors.initials: HH
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004032:Diet; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D007223:Infant; D008019:Life Style; D008297:Male; D008960:Models, Psychological; D009043:Motor Activity; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D015995:Prevalence; D012309:Risk-Taking; D012907:Smoking / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology; D017741:Survivors / Q000523:psychology*; D035501:Uncertainty; D055815:Young Adult