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ABSTRACT: BACKGROUND:: Resilience is a positive health outcome identified by the Committee on Future Direction for Behavioral and Social Sciences as a research priority for the National Institutes of Health. The Resilience in Illness Model (RIM) was developed from a series of qualitative and quantitative studies, to increase understanding of how positive health protective factors (ie, social integration, family environment, courageous coping, and derived meaning) may influence resilience outcomes. The RIM also includes 2 risk factors: illness-related distress and defensive coping. OBJECTIVE:: The purpose of this 2-part article was to report on evaluation of the RIM for adolescents/young adults (AYAs) with cancer. Here, in part 1, our purpose was to describe the exploratory RIM evaluation, and in part 2 we describe the confirmatory RIM evaluation. METHODS:: An exploratory evaluation of RIM was done using exploratory latent variable structural equation modeling with a combined sample from 2 studies of preadolescents and AYAs with cancer aged 10 to 26 years (n = 202). RESULTS:: Results, including goodness-of-fit indices, support the RIM as a theory with a high level of explained variance for outcomes of resilience (67%) and self-transcendence (63%). Variance explained for proximal outcomes ranged from 18% to 76%. CONCLUSIONS:: Findings indicate that, following confirmatory testing, the RIM may be a useful guide to developing targeted interventions that are grounded in the experiences of the AYAs. IMPLICATIONS FOR PRACTICE:: Understanding of the AYA cancer experience to improve holistic care is increased.
Cancer nursing 03/2013; · 1.88 Impact Factor
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ABSTRACT: PURPOSE: This article describes parental perspectives on the helpfulness and meaningfulness of a behavioral health music therapy intervention targeted to adolescents/young adults (AYA) with cancer undergoing stem cell transplantation. We demonstrate how qualitative methods may be used to understand critical aspects of an intervention and mechanisms by which the intervention impacts the target AYA outcomes of resilience and quality of life. METHODS: A qualitative descriptive design was used to obtain parents' perspectives. A maximum-variation purposive sampling technique was used to sample 16 parents whose AYA had been randomized to the intervention group. A semistructured open-ended interview was conducted between 100 and 160 days after the AYA's transplant. RESULTS: Results were grouped into three categories: (1) helpfulness and meaningfulness of the intervention to AYA adjustment to the transplantation experience; (2) helpfulness and meaningfulness of the intervention for parents; and (3) AYA ability to participate in the intervention during the acute phase of transplant. CONCLUSIONS: Parents observed and interacted with their AYA who participated in a targeted behavioral intervention. Thus, parents were able to describe mechanisms through which the intervention was helpful and meaningful for the AYA and indirect personal benefits for themselves. The results suggest the importance of the targeted outcomes identified in the Resilience in Illness Model and mechanisms of action in the Contextual Support Model of Music Therapy, and identify approaches for future study.
Journal of Adolescent Health 02/2013; 52(2):170-178. · 3.33 Impact Factor
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ABSTRACT: The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies.
Psycho-Oncology 11/2011; 20(11):1193-201. · 3.34 Impact Factor
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ABSTRACT: Music-based interventions are used to address a variety of problems experienced by individuals across the developmental lifespan (infants to elderly adults). In order to improve the transparency and specificity of reporting music-based interventions, a set of specific reporting guidelines is recommended. Recommendations pertain to seven different components of music-based interventions, including theory, content, delivery schedule, interventionist, treatment fidelity, setting, and unit of delivery. Recommendations are intended to support Consolidated Standards for Reporting Trials (CONSORT) and Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statements for transparent reporting of interventions while taking into account the variety, complexity, and uniqueness of music-based interventions.
Journal of Health Psychology 03/2011; 16(2):342-52. · 1.22 Impact Factor
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ABSTRACT: Recent advances in technology provide support for multisite, Web-based data-entry systems and the storage of data in a centralized location, resulting in immediate access to data for investigators, reduced participant burden and human entry error, and improved integrity of clinical trial data. The purpose of this article was to describe the development of a comprehensive, Web-based data management system for a multisite randomized behavioral intervention trial. Strategies used to create this study-specific data management system included interdisciplinary collaboration, design mapping, feasibility assessments, and input from an advisory board of former patients with characteristics similar to the targeted population. The resulting data management system and development strategies provide a template for other behavioral intervention studies.
Computers, informatics, nursing: CIN 11/2010; 29(6):337-43. · 0.95 Impact Factor
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ABSTRACT: Determining how music-based interventions have been described in published literature is an important first step in evaluating whether guidelines for reporting music-based interventions need to be developed. Twenty-two pediatric intervention studies that met specified inclusion criteria were reviewed for content in 11 areas. This review revealed significant gaps in intervention reporting. Problems were particularly pronounced in eight areas: music qualities, intervention materials, intervention components, intervention delivery schedule, interventionist, treatment fidelity, setting and music delivery method. Development of reporting guidelines for music-based interventions is needed to improve reporting and advance evidence-based practice.
Journal of Health Psychology 06/2009; 14(4):490-501. · 1.22 Impact Factor
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Sheri L Robb,
Alicia A Clair,
Masayo Watanabe,
Patrick O Monahan,
Faouzi Azzouz,
Janice W Stouffer,
Allison Ebberts,
Emily Darsie,
Courtney Whitmer,
Joey Walker,
Kirsten Nelson,
Deanna Hanson-Abromeit,
Deforia Lane,
Ann Hannan
Psycho-Oncology 10/2008; 17(9):957. · 3.34 Impact Factor
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Sheri L Robb
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ABSTRACT: The purposes of this pilot study were two-fold: First, to document and compare attentive behavior during music and play-based group instructional sessions and second, to document and compare 4 group participation behaviors during music and play-based sessions. The 4 group participation behaviors included facing a central speaker, following onestep directions, manipulating objects according to their function, and remaining seated. Six of the 12 children enrolled completed the study, with all participants enrolled in an early intervention program due to visual impairments. Study participants were between the ages of 4 and 6 years inclusively. Children participated in 4, 30-minute instructional sessions. Two instructional sessions were music-based and two were play-based with the 4 sessions equally distributed across a 2-week period. An ABBA design was used to control for possible order effects. Each session was videotaped to facilitate collection of behavioral data. Statistical analysis of these data revealed that attentive behavior was significantly higher during music based-sessions (t(5) = 5.81; p =.002). Mean scores for the remaining group participation behaviors were higher in the music condition, but these differences were not statistically significant. Discussion regarding differential outcomes among participants, as well as an exploration of theories related to music, arousal, and attention are discussed in an effort to guide future research.
Journal of music therapy 02/2003; 40(4):266-82. · 0.80 Impact Factor
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ABSTRACT: Purposes of this exploratory case study were: (1) to examine how anxiety and depression levels vary with phase of bone marrow transplantation (BMT) and (2) to examine the effect of the proposed music therapy treatment protocol on anxiety and depression levels. Six pediatric BMT patients participated in the study. Three participants experienced the music condition and three participants experienced the no-music contact condition. Both conditions consisted of six, one-hour sessions that occurred over a three week period. The Children's Depression Inventory (CDI) was administered at the conclusion of each session to examine changes in depression levels across each phase of treatment. The State Trait Anxiety Inventory for Children (STAIC) served as a pre-/post-session measure of state anxiety. Graphic analysis of scores from the CDI and STAIC indicated a consistent trend in depression and anxiety levels according to phase of treatment for all participants. Four participants (3 music; 1 no-music) experienced decreased anxiety following a majority of sessions.
Journal of Pediatric Oncology Nursing 20(1):2-15. · 0.70 Impact Factor
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ABSTRACT: Part I of this exploratory case study examined patient anxiety levels and depressive symptoms according to phase of bone marrow transplantation (BMT). The second part of this study examines more qualitative outcomes of the music therapy intervention. Purposes of this part of the study included: (1) to examine the lyrical content of patient-generated songs and (2) to compare patient perceptions regarding the effectiveness of a 6-week music condition with a no-music contact condition. Six pediatric BMT patients participated in the study. Three participants experienced the music condition and three participants experienced the no-music contact condition. Both conditions consisted of six, 1-hour sessions that occurred over a 3-week period. Content analysis of patient-generated songs revealed expression of issues related to the following themes: hope, positive coping, appreciation, mental status, control, time, bewilderment, treatment, and diagnosis. Examination of patient-generated songs provided insight into each patient's experience with transplantation and the coping strategies used during treatment. Outcomes from a poststudy questionnaire are summarized.
Journal of Pediatric Oncology Nursing 20(1):16-25. · 0.70 Impact Factor
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ABSTRACT: Parents experience high levels of distress during their child's stem cell transplant that can decrease the ability to support their child and effectively communicate with healthcare providers. Because parents are a primary source of support, their perspectives are very important when evaluating supportive care interventions for their adolescents/young adults.
This study examined parents' perspective of their adolescents or young adults' (AYAs') experience with stem cell transplantation (SCT) and involvement in a therapeutic music video (TMV) intervention.
This was a phenomenological study using parents' interviews. The sample included 7 parents of 6 adolescents/young adults ranging in age from 13 to 21 years hospitalized for SCT for an oncology-related condition. Parents' interviews were conducted 100 days after transplantation. Sessions were audio taped, transcribed, and analyzed using Colaizzi's phenomenological analysis.
We analyzed more than 350 significant statements from 7 parents. Seven theme categories emerged: (1) humbling, humiliating, horrible: parents' perspectives on the cancer experiences and SCT; (2) gratitude for the benefits of TMV intervention; (3) enhanced communication; (4) connectedness; (5) watching my AYA change and grow; (6) process of parent gaining insight; and (7) and an ironic recognition of both the sad and beautiful: parents' response to the TMV intervention.
Parents' narratives suggest that the TMV intervention is a way to buffer the challenges related to SCT, and a larger study is warranted.
These preliminary data offer clinicians insight into parent perceptions about the cancer experience, specifically SCT for their AYA child, and can be used to inform and shape clinical care. Findings reinforce the importance of offering AYAs opportunities to experience independence and mastery and engage in meaningful communication during transplant.
Cancer nursing 33(4):E20-7. · 1.88 Impact Factor
