Family Adaptability and Cohesion Influences on Positive Health Outcomes for Adolescent and Young Adults Undergoing Stem Cell Transplant for Cancer

Abstract

Stem cell transplant (SCT) is a physically and emotionally difficult experience for adolescents/young adults (AYA) with cancer. AYA undergoing SCT require high levels of support to deal with illness-related distress. Family adaptability and cohesion are key protective factors influencing AYA outcomes throughout the SCT treatment process. Research on the influences of family protective factors on SCT outcomes for AYA is minimal. Purposes of this secondary analysis are to: 1) longitudinally examine the trajectory of family adaptability/cohesion and well-being; 2) describe AYA perceived family adaptability/cohesion and well-being at each of 3 three time points; 3) describe relationships between adaptability, cohesion and well-being from each time point to all other subsequent time points; 4) examine the longitudinal influence of adaptability/cohesion on well-being. The Haase Resilience in Illness Model (RIM) that guides this study identifies two risk factors and five protective factors that influence resilience and quality of life outcomes. The study design was longitudinal, descriptive. The sample included 53 AYA, 11 to 24 years of age, undergoing SCT for cancer at 11 pediatric or adult hospitals. AYA completed measures on a secure web-based server immediately prior to, during, and 90 days post-SCT. The RIM-related variables family adaptability, cohesion, and well-being were measured by the Family Adaptability and Cohesion Scale (FACES II) and Index of Well-Being (IWB). Descriptive and correlational statistics were used to analyze the data. We found that improvement in adaptability/cohesion is not strongly associated with improvement in well-being from T2 to T1 or T3 to T1, but is statistical significance when compared between T3 to T2. It is necessary to understand how family adaptability/cohesion influences AYA uncertainty and symptoms, coping, derived meaning of illness, and resilience, in order to develop effective family-focused interventions that foster resilience outcomes.