title: The Resilience in Illness Model Part 2: Confirmatory Evaluation in Adolescents and Young Adults With Cancer.
abstract: BACKGROUND
  Empirically derived and tested models are necessary to develop effective, holistic interventions to improve positive health outcomes in adolescents and young adults (AYA) with cancer, yet few exist. This article is the second of 2 articles reporting on evaluation of the Resilience in Illness Model (RIM) as a predictive model to guide positive health research and practice.
  
  
  OBJECTIVE
  The aim of this study was to report the confirmatory model evaluation of the RIM.
  
  
  METHODS
  A confirmatory evaluation of RIM was done using baseline data from a sample of 113 AYA aged 11 to 24 years who were undergoing hematopoietic stem cell transplant and enrolled in a randomized controlled trial of a behavioral intervention to enhance resilience. Data were analyzed using latent variable structural equation modeling.
  
  
  RESULTS
  Goodness-of-fit indices supported RIM as a confirmed model that accounted for large amounts of variance in the outcomes of self-transcendence (62%) and resilience (72%), and in 3 of 5 mediators, specifically social integration (74%), courageous coping (80%), and hope-derived meaning (87%), as well as small to moderate amounts of variance in the remaining mediators of defensive coping (1%) and family environment (35%).
  
  
  CONCLUSIONS
  Findings establish the RIM as a plausible predictive framework for explaining ways AYA with cancer transcend their illness and achieve resilience resolution and for guiding intervention studies in this population. Additional research is needed to explore RIM's transferability based on stage of illness, other chronic diseases, and cultural diversity.
  
  
  CONCLUSIONS
  Results support the RIM as an appropriate guide for developing and evaluating interventions to foster positive adjustment in AYA with cancer.
authors.affiliation: Author Affiliations: School of Nursing, Indiana University (Drs Haase, Robb, and Phillips), and Research in Palliative and End-of-Life Communications and Training Signature Center (Drs Haase, Robb, and Burns), Indiana University-Purdue University, Indianapolis (IUPUI); School of Nursing, University of Wisconsin, Madison (Dr Kintner); School of Medicine, Indiana University, Indiana University-Purdue University, Indianapolis (Mr Stump and Dr Monahan); Children's Mercy Hospitals and Clinics, Kansas City, Missouri (Dr Stegenga); and Purdue School of Engineering and Technology, Indiana University-Purdue University, Indianapolis (Dr Burns).
authors.forename: Joan E
authors.initials: JE
authors.lastname: Haase
authors.forename: Eileen K
authors.initials: EK
authors.lastname: Kintner
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Robb
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Stump
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Monahan
authors.forename: Celeste
authors.initials: C
authors.lastname: Phillips
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Stegenga
authors.forename: Debra S
authors.initials: DS
authors.lastname: Burns
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D012649:Self Concept; D055815:Young Adult