The Resilience in Illness Model Part 2: Confirmatory Evaluation in Adolescents and Young Adults With Cancer

Abstract

Background Empirically derived and tested models are necessary to develop effective, holistic interventions to improve positive health outcomes in adolescents and young adults (AYA) with cancer, yet few exist. This paper is the second of two papers reporting on evaluation of the Resilience in Illness Model (RIM) as a predictive model to guide positive health research and practice. Objective To report the confirmatory model evaluation of the RIM. Methods A confirmatory evaluation of RIM was done using baseline data from a sample of 113 AYA aged 11 to 24 years who were undergoing hematopoietic stem cell transplant and enrolled in a randomized controlled trial of a behavioral intervention to enhance resilience. Data were analyzed using latent variable structural equation modeling. Results Goodness-of-fit indices supported RIM as a confirmed model and accounted for large amounts of variance in the outcomes of self-transcendence (62%) and resilience (72%), and in three of five mediators, specifically social integration (74%), courageous coping (80%), and hope-derived meaning (87%) as well as small to moderate amounts of variance in the remaining mediators of defensive coping (1%) and family environment (35%). Conclusions Findings establish the RIM as a plausible predictive framework for explaining ways AYA with cancer transcend their illness and achieve resilience resolution, and for guiding intervention studies in this population. Additional research is needed to explore RIM's transferability based on stage of illness, other chronic diseases, and cultural diversity. Implications for Practice Results support the RIM as an appropriate guide for developing and evaluating interventions to foster positive adjustment in AYA with cancer.

A Mobile-Based Mindfulness and Social Support Program for Adolescents and Young Adults With Sarcoma: Development and Pilot Testing

“…Examination of the RIM-based [24,25] interview themes guided the development of the Mindfulness for Resilience in Illness program content. Specifically, a persistent theme of anxiety related to uncertainty surrounding reoccurrence and treatment adverse effects confirmed the utilization of a mindfulness-based program.…”

“…Our overall qualitative approach was deductive, informed by a preexisting Resilience in Illness Model that described factors associated with resilience in illness [24,25] in AYA with cancer.…”

“…Three separate interview guides were created for AYA, parents, and health care providers. The first section of the interview guides was informed by the Resilience in Illness Model (RIM) [24,25], which identified psychosocial factors associated with resilience in AYA with cancer (ie, spiritual perspective, social integration, family environment, coping skills, and hope-derived meaning). This model was chosen to help identify potential resilience-enhancing program components.…”

“…The coding scheme was created by the research team. We used deductive coding, informed by the RIM model [24,25]. As such, author ED created an initial coding structure based on the interview guide, with each factor in the RIM model represented.…”

“It Changed Our Outlook on How We Want to Live”: Cancer as a Transformative Health Experience for Young Adult Survivors and Their Family Members

“…At the same time, illness transformations should also be studied in tandem with concepts such as resilience (Rosenberg, Yi-Frazier, Wharton, Gordon, & Jones, 2014) to determine whether resilience and illness transformations are sequential steps (i.e., if resilience emerges before transformations or vice versa). For example, Haase and colleagues’ resilience in illness model sheds light on the factors that can help adolescents and young adults with cancer achieve positive adjustment to chronic illness (Haase, Kintner, Monahan, & Robb, 2014; Haase et al, 2017). Resilience outcomes include managing illness-related stressors, feeling a sense of accomplishment related to managing the illness, and, consistent with this study, experiencing motivation to help and inspire others.…”