Where There Is a Will There Is a Way: Defining the Path between Hope, Pain and Quality Of Life in Pediatric Acute Lymphoblastic Leukemia Survivors
Foxwell, Aleksandra Aceska
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Acute Lymphoblastic Leukemia (ALL) is the most common childhood cancer, with an expected long-term survival rate of approximately 80 – 85%. Observations have lead researchers to believe that adolescent and young adult survivors of childhood ALL have an unexpectedly high frequency of lower back pain. This increase of pain is attributed to the number of lumber punctures during treatment. Various factors influence levels of pain (i.e. BMI, exercise and neuroticism) and pain has been shown to have a negative effect on quality of life. Hope, a construct that has not been widely studied in the oncology literature, may be a buffer between pain and quality of life, meaning that those with higher hope are able to cope with their pain more effectively and in turn have a better quality of life. Moreover, because survivors have had an aversive experience, they may have increased levels of hope, thus despite high pain levels have a positive quality of life. Results suggested that ALL survivors reported higher pain ratings than siblings, but lower total hope and agency. Agency and total hope were significant predictors of QoL at time 2 over and above QoL at time 1 and mediated the relationship between pain time 1 and QoL time 2 when QoL time was not a covariate. These results conclude that hope and more specifically, agency, should be further examined in pediatric oncology and merits the development and investigation of a hope intervention.