Author Affiliations: Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Dr Bajjani-Gebara); College of Nursing, University of Arizona, Tucson (Drs Insel, Reed, Moore, and Badger); Department of Nursing Research and Quality Outcomes, Children's National Medical Center, Washington, DC (Dr Hinds).
Cancer Nurs. 2019 Sep/Oct;42(5):E41-E52. doi: 10.1097/NCC.0000000000000662.
Childhood cancer profoundly impacts the well-being of many parental caregivers in the United States yearly. Empirical evidence is extensive for negative well-being and scarce for positive well-being in this population.
Study aims were to (1) describe resilience, self-transcendence, and positive (general well-being) and negative well-being (depression and anxiety); (2) examine if caregiver-related personal factors (resilience and/or demographic characteristics) and/or child-related contextual factors (child's cancer and/or demographic characteristics) are associated with well-being; and (3) test if self-transcendence mediates the relationship between resilience and well-being.
A cross-sectional study whereby 80 caregivers of children diagnosed with childhood cancer for at least 2 months completed study questionnaires. Descriptive statistics explored sample demographics, well-being, self-transcendence, and resilience levels. Bivariate correlations examined factors associated with well-being. One-way analysis of variance and independent-samples t tests explored differences in well-being across levels of independent variables. Baron and Kenny's mediation analysis tested if self-transcendence mediated the relationship between resilience and well-being.
Positive well-being and negative well-being coexist in parental caregivers. No child-related contextual factors related to caregivers' well-being. Parental caregivers' resilience and self-transcendence positively related to their general well-being and negatively related to their depression and anxiety. Satisfaction with current financial status positively related to general well-being and negatively related to depression. Self-transcendence mediated the relationship between resilience and well-being.
Findings confirm the importance of focusing on both positive and negative well-being, their associated factors, and mediators.
The authors discuss practice implications to enhance self-transcendence such as journaling, mindfulness techniques, activities to connect with nature, and others.
儿童癌症每年都会对美国许多父母照顾者的幸福感产生深远影响。在该人群中，有大量关于负面幸福感的实证证据，但关于积极幸福感的证据却很少。
研究旨在：（1）描述弹性、自我超越、积极（总体幸福感）和消极幸福感（抑郁和焦虑）；（2）研究照顾者相关的个人因素（弹性和/或人口统计学特征）和/或儿童相关的环境因素（儿童癌症和/或人口统计学特征）与幸福感的关系；（3）测试自我超越是否在弹性与幸福感之间起中介作用。
本研究采用横断面研究方法，80 名儿童确诊为癌症且至少患病 2 个月的儿童的父母照顾者完成了研究问卷。描述性统计方法探讨了样本人口统计学、幸福感、自我超越和弹性水平。采用双变量相关分析研究与幸福感相关的因素。采用单因素方差分析和独立样本 t 检验探讨了不同独立变量水平下的幸福感差异。巴伦和肯尼的中介分析测试了自我超越是否在弹性与幸福感之间起中介作用。
积极的幸福感和消极的幸福感共存于父母照顾者中。没有与照顾者幸福感相关的儿童相关环境因素。父母照顾者的弹性和自我超越与他们的总体幸福感呈正相关，与他们的抑郁和焦虑呈负相关。对当前财务状况的满意度与总体幸福感呈正相关，与抑郁呈负相关。自我超越在弹性和幸福感之间起中介作用。
研究结果证实了关注积极和消极幸福感、其相关因素和中介因素的重要性。
作者讨论了提高自我超越的实践意义，例如写日记、正念技巧、与自然联系的活动等。
