title: Psychological resilience in adolescent and young adult survivors of lower extremity bone tumors.
abstract: BACKGROUND
  The psychosocial outcomes of young adult survivors of childhood bone tumors are not well known. This study: (a) examined perceived social support (SS) and benefit-finding (BF) with respect to surgical intervention, gender, and age; (b) compared SS and psychological outcomes to normative values; and (c) examined the relationship between these social and psychological outcomes and sexual functioning.
  
  
  METHODS
  Twenty-eight participants (18-32 years) completed outcome-specific questionnaires for SS, BF, depression, self-worth, and sexual functioning. Surgical intervention was grouped into limb sparing (LS; allograft-fusion and endoprosthesis) and ablative procedures (AMP; amputation or Van Nes rotationplasty). Age at study was grouped into ≤25 or ≥26 years of age.
  
  
  RESULTS
  Compared to normative values, survivors reported significantly less depressive symptoms (P = 0.005), and higher self-evaluations of intellectual capabilities (P = 0.009). No significant differences in SS and BF were found between surgical and age groups. Males perceived significantly higher SS than females (P = 0.027). Significant positive correlations were found between perceived SS and sexual functioning (r = 0.397), sexual experiences (r = 0.423), and satisfaction with sexual relationships (r = 0.408). Negative correlation was found between global SS and depression scores (r = -0.397). Similar correlations were found with the subscales of the SS, depression, and self-worth measures. BF was significantly positively correlated only to SS (r = 0.552).
  
  
  CONCLUSIONS
  Bone tumor survivors, particularly males, demonstrated remarkable psychosocial resiliency with SS possibly serving as a protective factor for survivors' psychological and sexual functioning.
authors.affiliation: The Hospital for Sick Children, Child Health Evaluative Sciences, Research Institute, Toronto, Ontario, Canada.
authors.forename: Tanya
authors.initials: T
authors.lastname: Teall
authors.forename: Maru
authors.initials: M
authors.lastname: Barrera
authors.forename: Ronald
authors.initials: R
authors.lastname: Barr
authors.forename: Mariana
authors.initials: M
authors.lastname: Silva
authors.forename: Mark
authors.initials: M
authors.lastname: Greenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000523:psychology*; D050281:Bones of Lower Extremity / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D055500:Resilience, Psychological; D012725:Sexual Behavior / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D055815:Young Adult