The Study of Resilience and Life Adaptation Among Adolescent Survivors of Brain Tumors in Taiwan
Date Issued
2007
Date
2007
Author(s)
Chen, Chin-Mi
DOI
en-US
Abstract
Background. Resilience is an important concept in the positive psychosocial adjustment of adolescents to adversity. However, few studies have compared differences in resilience and its influence among adolescent survivors of brain tumors (ASBT) with that among healthy adolescents. The researcher hypothesized that resilience is influenced by emotion-related health problems, purpose in life, and perceived social support.
Purpose. The aims were 1) to clarify normative development and impact of illness in ASBT by comparing them to healthy adolescents in terms of resilience and the effect of types of health problems on resilience, 2) to test the relationship among resilience and influences on resilience in ASBT, when resilience is an outcome, and 3) to examine the effect of resilience on the relationships between emotion-related health problems and life adaptation in ASBT, when resilience is a process.
Theory and Method. The theoretical framework was based on life-span developmental theory, Haase’s Adolescent Resilience Model, and Frankl’s existential analysis. This study used a cross-sectional, case-control design. Convenience sampling was used to recruit participants who were ASBT and 13 to 18 years old. Random sampling was used to recruit healthy adolescents matched with ASBT by school level, gender and living area. Data were collected by a structured questionnaire (a demographic questionnaire and 7 scales).
Analysis. Four of the 7 scales were translated and back-translated from English to Mandarin according to principles of instrument translation. Descriptive statistics were used to illustrate the distribution of variables. T-test was used to analyze differences in group means for independent and dependent variables. Multiple regression was used to analyze the contribution of each predictor to explaining total variance in the ASBT group. Path analysis was used to identify the process of forming resilience in ASBT.
Results. The study participants included 60 ASBT and 120 healthy adolescents. ASBT and healthy adolescents were on average 15.4 years (SD = 1.56) and 15.17 years (SD = 1.65), respectively. Participants in both groups were predominantly male (63.3%) and studying in junior high school (55%). The findings were as follows. 1) ASBT and healthy adolescents did not differ significantly in resilience. However, resilience was more strongly and negatively affected by emotion-related problems (Beta value = -0.34, p < .05) in ASBT than in healthy adolescents with emotion-related health problems. 2) Except for emotion-related problems, medical history and demographics were not risk factors for resilience in ASBT. The negative effect of emotion-related health problems on resilience (Beta = 0.43, p < .01) in ASBT accounted for 26.9% of the variance in resilience. 3) ASBT with emotion-related health problems didn’t develop their resilience until they perceived support family support (R-square = .57). 4) “Purpose in life” reduced the effect of emotion-related health problems on resilience up to 51.4% (R-square = .49). 5) Path analysis showed that health care providers’ support not only directly enhanced resilience in ASBT, but also indirectly nurtured their resilience by assisting them and their families to achieve purpose in life by themselves. 6) Regarding resilience as a process of life adaptation, resilience reduced the effect of emotion-related health problems on life adaptation up to 48.7% (R-square = .56).
Conclusions. This study’s results can be summarized by five conclusions after considering limitations of the study. 1) Differences in resilience between ASBT and healthy adolescents were due to emotion-related health problems, not “having a brain tumor” only. 2) The impact of emotion-related health problems on resilience was more severe in ASBT than in healthy adolescents. 3) Emotion-related health problems were identified as a risk factor for resilience in both ASBT and in healthy adolescents. 4) Perceived family support, perceived support from health care providers, and purpose in life were identified as protectors of resilience in ASBT. 5) For ASBT, resilience mediated between emotion-related health problems and life adaptation. These results suggest that health care professionals could foster resilience in ASBT by screening them soon after diagnosis for emotion-related health problems, strengthening their family support system, and supporting their purpose in life.
Subjects
青少年
存活者
兒童腦瘤
復原力
生活適應
adolescent
survivors
childhood brain tumor
resilience
life adaptation
Type
other
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