Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN.
J Dev Behav Pediatr. 2019 Apr;40(3):208-216. doi: 10.1097/DBP.0000000000000641.
The present study aimed to examine the relationship of optimism and connectedness with psychological adjustment outcomes in children with cancer and determine whether these relations differ for children with cancer and comparison peers.
Participants were 155 children with cancer and 143 comparison youth without a history of cancer, aged 8 to 17 years at study entry, who were followed longitudinally over a 3-year period. Participants completed self-report measures at 3 time points: baseline optimism at study entry (T1), connectedness at 1 year after baseline (T2), and emotional symptoms at 3 years after baseline (T3). A series of regression analyses were conducted using conditional process analysis to examine whether connectedness mediated the relationship between optimism and psychological adjustment and whether this was moderated by health status (i.e., history of childhood cancer vs no history of cancer or other serious or chronic illness).
Connectedness to parents, peers, and friends significantly mediated the relationship between optimism and psychological adjustment (b parents = -0.1387, 95% confidence interval [CI] [-0.2341 to -0.0515]; b peers = -0.2021, 95% CI [-0.3575 to -0.0818]; b friends = -0.0703, 95% CI [-0.1640 to -0.0050]). However, this mediation was not significantly moderated by having a history of cancer. Cancer history did moderate the direct relationship between optimism and psychological adjustment and between connectedness to parents and psychological adjustment.
Findings suggest that patients with cancer are doing remarkably well with regard to adjustment. Connectedness with parents and peers mediates the relationship between optimism and psychological adjustment. As such, children with cancer who are identified as experiencing poor adjustment may benefit from interventions to foster connectedness.
本研究旨在探讨乐观主义和联系感与癌症患儿心理适应结果的关系，并确定这些关系是否因癌症患儿和对照组患儿而异。
参与者为 155 名癌症患儿和 143 名无癌症病史的对照组青少年，在研究开始时年龄为 8 至 17 岁，在 3 年的时间内进行了纵向随访。参与者在 3 个时间点完成了自我报告的测量：研究开始时的基线乐观（T1）、基线后 1 年的联系感（T2）和基线后 3 年的情绪症状（T3）。使用条件过程分析进行了一系列回归分析，以检验联系感是否在乐观与心理适应之间的关系中起中介作用，以及健康状况（即是否患有儿童癌症或无癌症或其他严重或慢性疾病）是否对此起调节作用。
与父母、同伴和朋友的联系感显著中介了乐观与心理适应之间的关系（父母：b=-0.1387，95%置信区间[-0.2341，-0.0515]；同伴：b=-0.2021，95%置信区间[-0.3575，-0.0818]；朋友：b=-0.0703，95%置信区间[-0.1640，-0.0050]）。然而，这种中介作用并没有因患有癌症而显著调节。癌症史确实调节了乐观与心理适应之间的直接关系，以及与父母的联系感与心理适应之间的直接关系。
研究结果表明，癌症患儿在适应方面表现得非常出色。与父母和同伴的联系感中介了乐观与心理适应之间的关系。因此，被识别为适应不良的癌症患儿可能受益于培养联系感的干预措施。
