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The Resilience in Illness Model, Part 1: Exploratory Evaluation in Adolescents and Young Adults With Cancer

Haase, Joan E. PhD, RN, FAAN; Kintner, Eileen K. PhD, RN; Monahan, Patrick O. PhD; Robb, Sheri L. PhD, MT-BC

doi: 10.1097/NCC.0b013e31828941bb
Articles: Online Only

Background: Resilience is a positive health outcome identified by the Committee on Future Direction for Behavioral and Social Sciences as a research priority for the National Institutes of Health. The Resilience in Illness Model (RIM) was developed from a series of qualitative and quantitative studies, to increase understanding of how positive health protective factors (ie, social integration, family environment, courageous coping, and derived meaning) may influence resilience outcomes. The RIM also includes 2 risk factors: illness-related distress and defensive coping.

Objective: The purpose of this 2-part article was to report on evaluation of the RIM for adolescents/young adults (AYAs) with cancer. Here, in part 1, our purpose was to describe the exploratory RIM evaluation, and in part 2 we describe the confirmatory RIM evaluation.

Methods: An exploratory evaluation of RIM was done using exploratory latent variable structural equation modeling with a combined sample from 2 studies of preadolescents and AYAs with cancer aged 10 to 26 years (n = 202).

Results: Results, including goodness-of-fit indices, support the RIM as a theory with a high level of explained variance for outcomes of resilience (67%) and self-transcendence (63%). Variance explained for proximal outcomes ranged from 18% to 76%.

Conclusions: Findings indicate that, following confirmatory testing, the RIM may be a useful guide to developing targeted interventions that are grounded in the experiences of the AYAs.

Implications for Practice: Understanding of the AYA cancer experience to improve holistic care is increased.

Author Affiliations: School of Nursing, Indiana University, Indianapolis (Drs Haase and Robb); School of Nursing, University of Texas, Austin (Dr Kintner); and School of Medicine, Department of Biostatistics, Indiana University, Indianapolis (Dr Monahan).

Funding was received from the National Institutes of Health/National Institute of Nursing Research grant 1R29 NR03882, Resilience and Quality of Life in Adolescents with Cancer; Walther Cancer Institute, Indianapolis, Indiana, Factors Affecting Quality of Life Outcomes for Adolescents With Cancer.

The authors have no conflicts of interest to disclose.

Correspondence: Joan E. Haase, PhD, RN, FAAN, School of Nursing, Indiana University, 1111 Middle Dr, Indianapolis, IN 46202 (

Accepted for publication January 21, 2013.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins