The Resilience in Illness Model: Dialogue on Applicability in Other Illness Conditions and Difficult/Traumatic Life Circumstances

Abstract

Session presented on Saturday, July 26, 2014: Background: Individuals who develop a positive approach to deal with difficult life circumstance and/or traumatic events are often called 'resilient'. In the United States, the Institute of Medicine and National Institutes of Health identified research on positive health concepts, such as resilience, as a priority. Over her 35 year career as a nurse researcher, Dr. Joan Haase developed the Resilience in Illness Model (RIM) in adolescents/young adults (AYA) with chronic illnesses, especially cancer. The resulting RIM explains large amounts of variance in outcomes of self-transcendence (62%) and resilience resolution (67%) for AYA with cancer. In 2011, the Nursing Discipline Committee of the Children's Oncology Group (a cooperative pediatric oncology research group in North America, Australia, New Zealand and parts of Europe) adapted the RIM as the organizing framework for their research. Dr. Haase and her colleagues are currently conducting multi-site randomized controlled clinical trials through the Children's Oncology Group to evaluate interventions to enhance resilience in AYA and their parents. Outcomes from the therapeutic music video intervention study for AYA undergoing hematopoietic stem cell transplant for cancer showed significant improvement in several RIM factors, compared to the control group. These studies support RIM as a useful framework to guide the research and RIM measures were sensitive to group differences. Purpose: American and international nurse researchers have asked about applicability of the RIM in other chronic illness conditions, other age groups, and other difficult and/or traumatic life circumstances, such as war or natural disaster. Because further research is needed to evaluate the RIM's applicability in other illnesses and circumstances, the purposes of this session are to: 1) describe the current RIM and ongoing interventions; and, 2) foster dialogue among session attendees regarding how the RIM may be useful and/or adapted for research on other illness conditions and/or traumatic life situations. Methods: In this session Dr. Haase will: 1.Describe the current RIM as developed through model development and intervention studies in AYA with chronic conditions. 2.Describe protective factors in the RIM and lead audience dialogue about the ways these factors may be useful to improve resilience in other cultures and individuals facing other illnesses and/or traumatic events (e.g. illness, war, natural disaster). Protective factors include: spiritual perspective, including spiritual beliefs and practices; social integration, including communication and perceived support from health care providers, friends, and the community; family environment, including family adaptability, cohesion and communication; courageous coping, including confrontive, optimistic, and supportant coping; and hope-derived meaning. 3. Discuss risk factors that may negatively influence positive health outcomes and lead audience dialogue regarding how these are similar and different in other cultures, illness conditions or circumstances. Risk factors in the RIM include: illness related distress (uncertainty and symptom distress) and defensive coping (emotive, evasive, and fatalistic coping). 4.Describe the mixed methods approach used to develop the RIM measure model and lead audience dialogue about resilience-related measurement issues. Outcomes: Participants will gain knowledge regarding factors that influence resilience outcomes and explore potential adaptations and applications of the RIM internationally.