PhD in Nursing Science Program
Nicole B. Beckmann
Parental Posttraumatic Growth Following Pediatric Hematopoietic Stem Cell Transplant
Dissertation under the direction of Dr. Terrah Foster Akard
Parents of children recovering from hematopoietic stem cell transplant (HSCT) experience significant distress due to unpredictable and potentially life-threatening complications. Distress is heightened by intensive caregiving parents provide the child during the first 100 days after HSCT. Management of distress and adaptation to caregiving responsibilities may be enhanced if parents find benefit in their experiences through posttraumatic growth (PTG), yet little is known about the role of PTG 100 days after pediatric HSCT and how parents’ experiences after HSCT foster PTG. The purpose of the study was to describe parental PTG 100 days after children’s HSCT. The study utilized a mixed methods, cross-sectional design with parents, approximately 100 days after their children received HSCT. A total of 31 parent participants reported environmental, personal, and disease characteristics and completed semi-structured, one-on-one interviews. Among these participants, 24 also completed measures of distress, coping, rumination, and posttraumatic growth. Evidence of parental PTG was described in each of the 5 PTG dimensions (relating to others, new possibilities, personal strength, spiritual change and appreciation of life). PTG was positively associated with parental distress, disengagement coping, and rumination measures of involuntary engagement and disengagement (r = .44-.47, p < .05). Appreciation of life demonstrated the strongest associations with distress and rumination (r = .53-.61, p < .01). Curvilinear relationships were observed for the association of distress, disengagement coping, and involuntary engagement with PTG (p < .05). Four major themes emerged from the interview data to describe parent experiences after HSCT: (a) psychosocial and healthcare contextual factors (b) cognitive, affective, and social support reactions to HSCT (c) problem-based, emotion-based, and cognitive coping strategies and (d) PTG. This study is the first to describe parental PTG 100 days after children’s HSCT. The results of this study increase understanding of how parents’ experiences and caregiving responsibilities contribute to PTG. These findings may guide future research to understand how caregiving influences PTG and how nurses can influence adaptation to HSCT through PTG.