Hope and pediatric health

Snyder's Hope Theory and its application in pediatric health have been receiving increased attention recently. Within the last three years, research has primarily focused on adolescents and/or young adults, and pediatric cancer populations. Generally, higher hope scores are associated with positive outcomes in pediatric studies. There has also been increased interest in the role of hope in pediatric health interventions, with some studies indicating that hope is malleable and that changes in hope are associated with changes in health outcomes. Limitations in this research area include (1) a few longitudinal and follow-up studies assessing the stability of changes in hope, (2) the need to determine directionality regarding hope and health outcome relations, and (3) some inconsistencies in the conceptualization of hope.

Youth Exposed to Terrorism: the Moderating Role of Ideology

The present review examines the moderating role of ideology on the effects of war, armed conflict, and terrorism on youth. Ideology is an important factor given the central role played by religio-political ideology and nationalism in present-day conflicts. Ideologies or worldviews represent cognitive frameworks that imbue the traumatic situation with meaning and order. Analysis of the pool of studies identified three categories of ideologically based moderating factors, each representing an aspect of social construction of traumatic events, namely, religion, political ideology, and self-concept. The two closely related categories of religion and politico-religious beliefs showed both positive and negative effects on psychological and psychiatric outcomes among youth. The third category of different aspects of self-concept yielded consistently positive moderating effects. The mechanisms by which each category of ideology moderates effects of exposure to war, armed conflict, and terrorism are discussed, and research and clinical implications are presented.

The mediating roles of cancer-related rumination in the relationship between dispositional hope and psychological outcomes among childhood cancer survivors

OBJECTIVE

This study aimed to examine the effects of dispositional hope on psychopathology as well as self-perceived positive change in childhood cancer survivors through the potential mediation of cancer-related ruminations.

METHODS

A cross-sectional design was used, and a group of childhood cancer survivors (N = 89; mean age = 23.2 years; age range = 17.2-31.3 years) were studied. Dispositional hope level was measured by the Hope Scale; positive and negative cancer-related ruminations were assessed by the Chinese Cancer-related Rumination Scale; depression symptoms were measured by Beck Depression Inventory; and anxiety symptoms were measured by Beck Anxiety Inventory. Positive adjustment outcome of posttraumatic growth (PTG) was assessed by the Chinese Post-traumatic Growth Inventory. Multiple regressions were used to analyze the relationship between dispositional hope and the outcome variables of PTG, anxiety and depression and the potential mediators of positive and negative cancer-related rumination.

RESULTS

Dispositional hope was positively related to PTG, and the correlation was specifically mediated by positive cancer-related rumination. Dispositional hope also correlated with lower levels of depression and anxiety, specifically mediated by negative cancer-related rumination.

CONCLUSION

The present finding supported hope as a significant positive factor for childhood cancer survivors, which was associated with PTG and better psychological adjustment. The findings may inform development of therapeutic intervention programs aimed at increasing childhood cancer patients' hope levels, which may be correlated with more positive cancer-related thoughts and better adjustment. The present study, which examined survivors diagnosed at young age, may enrich existing studies on the effect of onset age and adjustment outcomes.

A longitudinal path analysis of peer victimization, threat appraisals to the self, and aggression, anxiety, and depression among urban African American adolescents

Threat appraisals-individuals' perceptions of how stressful situations may threaten their well-being-are an important but understudied mechanism that could explain links between peer victimization and adjustment. The goal of the present study was to examine relationships between physical and relational victimization by peers, threats to the self, and aggression, anxiety, and depression to better understand the cognitive evaluations that make youth vulnerable to negative adjustment. The sample comprised two cohorts of African American adolescents (N = 326; 54 % female; M = 12.1; SD = 1.6) and their maternal caregivers, who participated in three waves of a longitudinal study. Path models revealed significant direct effects from Time 1 relational victimization, but not physical victimization, to Time 2 threat appraisals (i.e., negative self-evaluations and negative evaluations by others), controlling for Time 1 threat appraisals. Significant direct effects were found from Time 2 threats of negative evaluations by others to Time 3 youth-reported aggression, controlling for Time 1 and Time 2 aggression. Significant direct effects also were found from Time 2 threats of negative self-evaluations to T3 youth-reported depression, controlling for Time 1 and Time 2 depression. Overall, findings highlight the need to consider the role of threats to the self in pathways from peer victimization to adjustment and the implications these appraisals have for youth prevention and intervention efforts.

The family care coordinator: paving the way to seamless care

The care of a child/adolescent with cancer or a blood disorder is complex and often long term, involving many interdisciplinary team members across services and geographical boundaries. This experience can be overwhelming for patients and their families, highlighting the need for a family care coordinator (FCC) to help them navigate their care path. The purpose of this article is to illustrate the concept of family care coordination as experienced by the IWK Health Center in Nova Scotia, Canada, with the intent of sharing a valuable model of care with other pediatric hematology/oncology services. Key components of the role are ongoing assessment, education, partnerships, communication, support, and advocacy. Essential resources and pathways are required to implement the role and optimize patient/family outcomes, facilitating consistent and accessible care, enhancing quality and safety, building trust, and gleaning efficiencies. Inherent FCC challenges are identified as time constraints, replacement issues, maintaining professional boundaries, and emotional burnout. A FCC can enable seamless, individualized care for children/adolescents and their families with pediatric oncological and hematological disorders, optimizing the outcomes for all involved.

Community violence exposure, threat appraisal, and adjustment in adolescents

Validity data are presented for a new measure of threat appraisals in response to community violence. Adolescents (N = 358; 45% male; 91% African American, M = 12.10 years, SD = 1.63) and their maternal caregivers participated in two waves of a longitudinal interview study focused on the consequences of exposure to community violence. Structural equation modeling revealed that a six-factor correlated model best fit the data, indicating that the six subscales of the threat appraisal measure represent distinct but related constructs. The factor structure was invariant across age and gender. Exposure to violence was associated prospectively with caregiver- and adolescent-rated adjustment problems. Each of the six threat appraisals mediated links between exposure to violence at Wave 1 and adolescent-rated internalizing adjustment problems 1 year later.