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Anxiety, Caregivers, Depression, Mediator, Oncology nursing, Parents, Pediatric cancer, Self-transcendence, Well-being



  1. Bajjani-Gebara, Jouhayna PhD, RN, PMHNP-BC, PMHCNS-BC
  2. Hinds, Pamela PhD, RN, FAAN
  3. Insel, Kathleen PhD, RN
  4. Reed, Pamela PhD, RN, FAAN
  5. Moore, Ki DNSc, RN, FAAN
  6. Badger, Terry PhD, RN, PMHCNS-BC, FAAN, FAPOS


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 caregivers' well-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.