title: Contributors and Inhibitors of Resilience Among Adolescents and Young Adults with Cancer.
abstract: Purpose:Self-perceived resilience may enable coping and mitigate poor psychosocial outcomes among adolescent and young adult (AYA) patients with cancer. In order to inform the development of resilience-promoting interventions, we aimed to: (1) describe AYA patient-reported resilience and (2) identify AYA patient-reported contributors and inhibitors of resilience.Methods:The "Resilience in Adolescents and Young Adults with Cancer" study was a prospective longitudinal mixed-methods study. Consecutive Caucasian patients aged 14-25 years old enrolled 14-60 days following their diagnosis of cancer and completed one-on-one semi-structured interviews both at the time of enrollment and 3-6 months later. Constant comparative analyses identified salient themes describing modifiable contributors and inhibitors to patient-perceived resilience.Results:Seventeen patients (85% of those approached) enrolled in the study. The mean age was 17 years (SD=2.6) and 53% were female. All patient definitions of resilience inferred an ability to handle adversity. Five themes emerged as predominant contributors or inhibitors of resilience: (1) stress and coping; (2) goals, purpose, and planning; (3) optimism; (4) gratitude and meaning; and (5) connection and belonging. Merged analyses suggested that AYA resilience was a balance that may be enabled by promoting certain skills.Conclusion:AYA patients with cancer perceive resilience as a balance. Learned skills in stress management, goal-setting, and benefit-finding may empower AYAs during their cancer experience, in turn improving long-term psychosocial outcomes.
authors.affiliation: Division of Pediatric Hematology/Oncology, Seattle Children's Hospital , Seattle, Washington. ; Department of Pediatrics, University of Washington , Seattle, Washington. ; Treuman Katz Center for Pediatric Bioethics , Seattle, Washington. ; Fred Hutchinson Cancer Research Center , Seattle, Washington.
authors.forename: Abby R
authors.initials: AR
authors.lastname: Rosenberg
authors.affiliation: Department of Pediatrics, University of Washington , Seattle, Washington. ; Division of Pediatric Endocrinology, Seattle Children's Hospital , Seattle, Washington.
authors.forename: Joyce P
authors.initials: JP
authors.lastname: Yi-Frazier
authors.affiliation: Division of Pediatric Hematology/Oncology, Seattle Children's Hospital , Seattle, Washington.
authors.forename: Claire
authors.initials: C
authors.lastname: Wharton
authors.affiliation: Division of Pediatric Hematology/Oncology, Seattle Children's Hospital , Seattle, Washington.
authors.forename: Karen
authors.initials: K
authors.lastname: Gordon
authors.affiliation: School of Social Work, University of Texas , Austin, Texas. ; The Institute for Grief , Loss, and Family Survival, Austin, Texas.
authors.forename: Barbara
authors.initials: B
authors.lastname: Jones
keywords: coping; meaning-making; psychosocial outcomes; resilience; stress; survivorship