title: Promoting resilience among parents and caregivers of children with cancer.
abstract: BACKGROUND
  Promoting resilience is an aspect of psychosocial care that affects patient and whole-family well-being. There is little consensus about how to define or promote resilience during and after pediatric cancer.
  
  
  OBJECTIVE
  The aims of this study were (1) to review the resilience literature in pediatric cancer settings; (2) to qualitatively ascertain caregiver-reported perceptions of resilience; and (3) to develop an integrative model of fixed and mutable factors of resilience among family members of children with cancer, with the goal of enabling better study and promotion of resilience among pediatric cancer families.
  
  
  METHODS
  The study entailed qualitative analysis of small group interviews with eighteen bereaved parents and family members of children with cancer treated at Seattle Children's Hospital. Small-group interviews were conducted with members of each bereaved family. Participant statements were coded for thematic analysis. An integrative, comprehensive framework was then developed.
  
  
  RESULTS
  Caregivers' personal appraisals of the cancer experience and their child's legacy shape their definitions of resilience. Described factors of resilience include baseline characteristics (i.e., inherent traits, prior expectations of cancer), processes that evolve over time (i.e., coping strategies, social support, provider interactions), and psychosocial outcomes (i.e., post-traumatic growth and lack of psychological distress). These elements were used to develop a testable model of resilience among family members of children with cancer.
  
  
  CONCLUSIONS
  Resilience is a complex construct that may be modifiable. Once validated, the proposed framework will not only serve as a model for clinicians, but may also facilitate the development of interventions aimed at promoting resilience in family members of children with cancer.
authors: Division of Pediatric Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington, USA. abby.rosenberg@seattlechildrens.org
authors: Abby R
authors: AR
authors: Rosenberg
authors: K Scott
authors: KS
authors: Baker
authors: Karen L
authors: KL
authors: Syrjala
authors: Anthony L
authors: AL
authors: Back
authors: Joanne
authors: J
authors: Wolfe
mesh_terms: D000328:Adult; D000368:Aged; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research; D055500:Resilience, Psychological; D013727:Terminal Care / Q000523:psychology*; D014861:Washington; D055815:Young Adult
references: J Pers. 2009 Dec;77(6):1805-32
references: 19807863
references: J Res Pers. 2008 Aug 1;42(4):1031-1046
references: 19649310
references: J Paediatr Child Health. 2010 Jul;46(7-8):431-6
references: 20546103
references: J Pediatr Oncol Nurs. 2004 Sep-Oct;21(5):289-99; discussion 300-4
references: 15381798
references: Lancet Oncol. 2007 Aug;8(8):706-14
references: 17644038
references: J Clin Psychiatry. 2006;67 Suppl 2:46-9
references: 16602815
references: J Clin Oncol. 2008 Oct 10;26(29):4759-64
references: 18779605
references: J Pediatr Oncol Nurs. 2007 May-Jun;24(3):152-65
references: 17475981
references: J Clin Oncol. 2012 Apr 10;30(11):1154-9
references: 22412134
references: J Pediatr Psychol. 2009 Sep;34(8):803-16
references: 19091806
references: J Clin Psychol. 2002 Mar;58(3):307-21
references: 11836712
references: Child Care Health Dev. 2010 Jan;36(1):123-9
references: 19961498
references: J Clin Oncol. 2007 Apr 10;25(11):1403-11
references: 17416860
references: JAMA. 2000 Nov 15;284(19):2469-75
references: 11074776
references: J Pediatr Psychol. 1997 Oct;22(5):749-58
references: 9383934
references: Soc Sci Med. 2012 Mar;74(5):753-6
references: 22300714
references: J Adv Nurs. 1997 Jan;25(1):123-9
references: 9004020
references: Cancer Epidemiol Biomarkers Prev. 2003 May;12(5):426-32
references: 12750237
references: Support Care Cancer. 1997 Nov;5(6):466-84
references: 9406361
references: Pediatrics. 2010 May;125(5):e1124-34
references: 20435702
references: J Pers. 2009 Dec;77(6):1777-804
references: 19807864
references: Psychooncology. 2009 Jul;18(7):691-9
references: 19021127
references: BMJ. 2000 Jan 8;320(7227):114-6
references: 10625273
references: J Pediatr Psychol. 2010 Nov;35(10):1116-32
references: 20444851
references: J Pediatr Psychol. 2006 May;31(4):413-9
references: 16093518
references: Bone Marrow Transplant. 2000 Aug;26(4):427-35
references: 10982290
references: Curr Opin Pediatr. 2006 Oct;18(5):527-38
references: 16969168
references: Qual Health Res. 2005 Oct;15(8):1055-73
references: 16221879
references: Cancer J. 2008 Nov-Dec;14(6):414-9
references: 19060607
references: J Pediatr Psychol. 2007 Oct;32(9):1099-110
references: 17626069
references: Annu Rev Clin Psychol. 2011;7:511-35
references: 21091190
references: Curr Opin Pediatr. 2006 Oct;18(5):558-62
references: 16969172
references: J Pediatr Psychol. 1998 Jun;23(3):169-78
references: 9640896
references: J Pediatr Psychol. 2006 Oct;31(9):978-88
references: 16514049
references: Child Dev. 2000 May-Jun;71(3):543-62
references: 10953923
references: Psychooncology. 2002 Mar-Apr;11(2):132-41
references: 11921329
references: Pediatrics. 2006 Dec;118 Suppl 3:S203-18
references: 17142557
references: J Clin Oncol. 2012 Apr 10;30(11):1160-77
references: 22412146
references: Blood. 2010 May 13;115(19):3879-85
references: 20228275
references: Acta Oncol. 2011 Apr;50(3):373-80
references: 20586659
references: Palliat Support Care. 2011 Sep;9(3):251-62
references: 21838946
references: Depress Anxiety. 2003;18(2):76-82
references: 12964174
references: Hosp Community Psychiatry. 1993 Feb;44(2):162-7
references: 8432502
references: J Clin Oncol. 2012 Apr 10;30(11):1178-86
references: 22412139
references: Am J Community Psychol. 1988 Aug;16(4):591-607
references: 3055936
references: J Clin Oncol. 2010 Apr 20;28(12):2002-7
references: 20231679
references: J Pediatr Psychol. 2004 Apr-May;29(3):211-9
references: 15131138
references: Ann N Y Acad Sci. 2006 Dec;1094:1-12
references: 17347337
references: Clin Psychol Rev. 2010 Jul;30(5):479-95
references: 20395025
references: Soc Sci Med. 2007 Jan;64(2):411-6
references: 17064832