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Well-being, Self-transcendence, and Resilience of Parental Caregivers of Children in Active Cancer Treatment

Where Do We Go From Here?

Bajjani-Gebara, Jouhayna, PhD, RN, PMHNP-BC, PMHCNS-BC; Hinds, Pamela, PhD, RN, FAAN; Insel, Kathleen, PhD, RN; Reed, Pamela, PhD, RN, FAAN; Moore, Ki, DNSc, RN, FAAN; Badger, Terry, PhD, RN, PMHCNS-BC, FAAN, FAPOS

doi: 10.1097/NCC.0000000000000662
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Background 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.

Objective 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.

Methods 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.

Results Positive well-being and negative well-being coexist in parental caregivers. No child-related contextual factors related to caregiverswell-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.

Conclusions Findings confirm the importance of focusing on both positive and negative well-being, their associated factors, and mediators.

Implications for practice The authors discuss practice implications to enhance self-transcendence such as journaling, mindfulness techniques, activities to connect with nature, and others.

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).

The opinions or assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the Department of Defense or the Uniformed Services University of the Health Sciences.

The authors have no funding or conflicts of interest to disclose.

Correspondence: Jouhayna Bajjani-Gebara, PhD, RN, PMHNP-BC, PMHCNS-BC, Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814 (jouhayna.bajjani-gebara@usuhs.edu).

Accepted for publication August 22, 2018.

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