He Shan, You Li-Ming, Zheng Jing, Bi Yu-Lan
Author Affiliations: School of Nursing, Chongqing Medical University, Chongqing (Ms He); and School of Nursing (Ms He and Drs You and Zheng) and Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou (Ms Bi), China.
Cancer Nurs. 2016 May-Jun;39(3):205-12. doi: 10.1097/NCC.0000000000000279.
Having a child in the family with acute leukemia (AL) is a challenge for the parents and can trigger parental uncertainty. Through positive coping with uncertainty, parents can demonstrate positive psychological changes, including higher adaptability.
The purposes of this study were to measure uncertainty, coping strategies, and growth through uncertainty (GTU) and explore the relationships among them in parents of children with AL in China. Related factors of parental uncertainty were also explored.
A descriptive and correlative design was used. Ninety-five parents of children with AL participated. Parental uncertainty, coping, and GTU were measured by the translated Chinese versions of scales originally developed by Mishel, McCubbin, and Mishel.
Parental uncertainty was found to be prevalent in parents of children with AL in China. It did not have a direct impact on GTU, but rather was mediated through coping. Coping was negatively associated with unpredictability (r = -0.225, P < .05), while positively associated with GTU (r = 0.391, P < .01).
Through reordering of priorities of life events, parents acquired GTU during the process of their child's illness and treatment. Use of positive coping strategies by parents could help them to manage the stress associated with the unpredictability of child's illness and to promote a healthy maintenance of GTU.
Nurses could assume a more active role in identifying sources and level of parental uncertainty, encouraging parents to stay optimistic, and promoting change in perceptions of uncertainty from danger to opportunity.
家中有孩子患急性白血病（AL）对父母来说是一项挑战，可能引发父母的不确定性。通过积极应对不确定性，父母可以展现出积极的心理变化，包括更高的适应能力。
本研究旨在测量不确定性、应对策略以及通过不确定性实现的成长（GTU），并探讨中国急性淋巴细胞白血病患儿父母中这些因素之间的关系。还探究了父母不确定性的相关因素。
采用描述性和相关性设计。95名急性淋巴细胞白血病患儿的父母参与了研究。父母的不确定性、应对方式和GTU通过最初由米舍尔、麦库宾和米舍尔编制的量表的中文翻译版本进行测量。
在中国，急性淋巴细胞白血病患儿的父母中普遍存在不确定性。它对GTU没有直接影响，而是通过应对方式起中介作用。应对方式与不可预测性呈负相关（r = -0.225，P < .05），与GTU呈正相关（r = 0.391，P < .01）。
通过重新排列生活事件的优先级，父母在孩子患病和治疗过程中获得了GTU。父母采用积极的应对策略有助于他们应对与孩子疾病不可预测性相关的压力，并促进GTU的健康维持。
护士可以在识别父母不确定性的来源和程度、鼓励父母保持乐观以及促进将对不确定性的认知从危险转变为机遇方面发挥更积极的作用。
