Graduation Year

2020

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Nursing

Major Professor

Constance Visovsky, Ph.D., A.R.N.P.

Committee Member

Harleah Buck, Ph.D., RN, FPCH, FAAN

Committee Member

Andrew Bugajski, Ph.D., RN

Committee Member

Kristine A. Donovan, Ph.D., MBA

Keywords

oncology, psychosocial, mediation variable, social support

Abstract

Adolescents and young adults (AYAs) with cancer face physical, psychosocial, emotional, and developmental challenges that are unique to their age group. In facing the crisis of a cancer diagnosis, both social support and hope have been shown to be tools utilized by some AYAs. However, AYAs have higher rates of anxiety and depression than in older adults which may have an effect on their levels of hope.

This cross-sectional study examined the mechanistic effects of hope on the relationship between personal characteristics of age, gender, and social support, the disease characteristics of type of cancer and length of time since diagnosis, and the outcome of global anxiety and depression in adolescents and young adults with cancer. Levels of social support, hope, anxiety, and depression were evaluated, and the effects of hope on global anxiety and depression were evaluated. The instruments used in this study are an investigator developed Demographic Tool, The Multidimensional Scale of Perceived Social Support, the Herth Hope Index, and the Hospital Anxiety and Depression Scale.

Results: A total of 63 AYAs were enrolled in the study (mean age 24.4 years, 85% white, non-Hispanic females). In general, the AYAs had high levels of perceived social support (M=66.44, SD=11.22) and moderate to high levels of hope (M=36.52, SD=5.6). A majority of the participants (83%) had borderline to abnormal levels of anxiety (M=10.79, SD=3.4), while 38% had borderline to abnormal levels of depression (M=6.16, SD=2.9). Age, type of cancer, and length of time since diagnosis did not correlate with perceived social support, hope, or global anxiety and depression. Perceived social support is positively correlated with hope r(61)= .359, p=.004; and negatively correlated to global anxiety and depression r(61)= -.247, p=0.5. Hope is positively correlated with perceived social support r(61)= .359, p=.004; and negatively correlated with global anxiety and depression r(61)= -.561, p<.001. Hope is found to partially mediate the relationship between social support and global anxiety and depression.

Conclusion: Hope mediates the relationship between perceived social support and global anxiety and depression. Interventions need to be developed to foster hope and social support in AYAs with cancer to combat the higher levels of global anxiety and depression.

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