DOI: https://doi.org/10.14710/nmjn.v14i3.54943

Parental Resilience Determinants in Children with Cancer in Indonesia: A Path Analysis

*Dwi Novrianda orcid scopus  -  Department of Pediatrics and Maternity Nursing, Faculty of Nursing, Universitas Andalas, Indonesia
Mohd. Jamil  -  Department of Psychiatric and Community Nursing, Faculty of Nursing, Universitas Andalas, Indonesia
Rauza Sukma Rita  -  Department of Biochemistry, Faculty of Medicine, Universitas Andalas, Indonesia
Open Access Copyright (c) 2025 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: Determining parental resilience in children with cancer is essential to ensuring parents’ involvement in caring for children in hospitals. Existing quantitative research evaluates factors influencing resilience in mothers but has not fully explored the determinants of resilience in parents of children with cancer. Studying parents more broadly is essential, as contemporary caregiving roles increasingly involve both mothers and fathers, offering a more comprehensive understanding of family dynamics.

Purpose: This study aimed to analyze the determinants of parental resilience in children with cancer.

Methods: Correlational research with a cross-sectional design was conducted in the pediatric ward of a tertiary hospital in Indonesia. A total of 102 parents of children with cancer were recruited using consecutive sampling. Data were collected using a demographic questionnaire, the 10-item Connor Davidson Resilience Scale (10-item CDRC), the Hert Hope Index (HHI), the International Personality Item Pool – Big Five Factor Markers 50 (IPIP-BFM-50), Parenting Stress Index (PSI), and the Survey of Family Environment (SFE). Quantitative data were analyzed using path analysis.

Results: The results showed that the mean (SD) of the resilience score was 27.20 (5.79), personality 102.44 (19.11), hope 24.80 (6.04), parenting stress 39.22 (10.15), coping 39.84 (9.81), and family environment 84.57 (21.87). Resilience was directly influenced by hope (p=0.000), family environment (p=0.001), and coping (p=0.051). Personality indirectly influenced resilience (p=0.004). Path analysis revealed a Chi-square value of 0.000, a Root Mean Squared Estimate of Approximation (RMSEA) of 0.286, and values for the Normed Fit Index (NFI), Comparative Fit Index (CFI), Incremental Fit Index (IFI), and Goodness-of-Fit Index (GFI) were nearly close to 1, indicating the model had a nearly good fit.

Conclusion: Parental resilience was determined by hope, family environment, and coping. Strengthening these factors can enhance resilience and support better outcomes for families and children with cancer. 

Note: This article has supplementary file(s).

Fulltext View|Download |  Research Instrument
Untitled
Subject
Type Research Instrument
  Download (83KB)    Indexing metadata
Keywords: Coping strategies; family environment; hopes; parenting stress; personality

Article Metrics:

Article Info
Section: Articles
Language : EN
Recent articles
Anxiety and Sleep Disturbances Among Nurses Working at COVID-19 Dedicated Hospitals in Bangladesh Effects of Massage Therapy on Anxiety in Heart Disease Patients: A Systematic Review Interprofessional Education Perception among Faculty in Health Allied Professions in the Philippines: A Preliminary Study More recent articles
Most cited articles
Correlation between Coping Strategies and Quality of Life among Myocardial Infarction Patients in Nepal Cardiac Rehabilitation Enhancing Programs in Patients with Myocardial Infarction: A literature Review Emergency Training, Education And Perceived Clinical Skills For Tsunami Care Among Nurses In Banda Aceh, Indonesia Effects of Peer Support Program on Self-Management in Patients with End-Stage Renal Disease Undergoing Hemodialysis Dietary Behaviors among Patients with Type 2 Diabetes Mellitus in Yogyakarta, Indonesia More cited articles
  1. Akhtar, H., & Azwar, S. (2019). Indonesian adaptation and psychometric properties evaluation of the big five personality inventory: IPIP-BFM-50. Jurnal Psikologi, 46(1), 32-44. https://doi.org/10.22146/jpsi.33571
  2. Andriastuti, M., Fathinasari, A. D., Arafah, N. R., Asa, A. A., Salsabila, K., & Primacakti, F. (2024). Family functioning, parental cancer-related emotions, and quality of life in childhood cancer patients. Paediatrica Indonesiana, 64(3), 250–257. https://doi.org/10.14238/pi64.3.2024.250-7
  3. Arruda-Colli, M. N. F., Perina, E. M., & Santos, M. A. (2015). Experiences of Brazilian children and family caregivers facing the recurrence of cancer. European Journal of Oncology Nursing, 19(5), 458–464. https://doi.org/10.1016/j.ejon.2015.02.004
  4. Astuti, N. P., Sujianto, U., & Kusuma, H. (2019). Perkembangan konsep dan alat ukur harapan dalam peningkatan kualitas hidup pasien penyakit ginjal tahap akhir (PGTA): Analytic review [Development of concepts and measurement tools for hope in improving the quality of life of end-stage renal disease (ESRD) patients: Analytic review]. Jurnal Ilmu Keperawatan Medikal Bedah, 2, 41–51
  5. Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88(3), 588–606. https://doi.org/10.1037/0033-2909.88.3.588
  6. Berry, J. O., & Jones, W. H. (1995). The parental stress scale: Initial psychometric evidence. Journal of Social and Personal Relationships, 12(3), 463–472. https://doi.org/10.1177/0265407595123009
  7. Borrescio-Higa, F., & Valdés, N. (2022). The Psychosocial burden of families with childhood blood cancer. International Journal of Environmental Research and Public Health, 19, 599. https://doi.org/10.3390/ijerph19010599
  8. Bowes, L., & Jaffee, S. R. (2015). Biology, genes, and resilience: Toward a multidisciplinary approach. Trauma, Violence, & Abuse, 14(3), 195–208. https://doi.org/10.1177/1524838013487807
  9. Cheng, A. W. Y., & Lai, C. Y. Y. (2023). Parental stress in families of children with special educational needs: A systematic review. Frontiers in Psychiatry, 14, 1198302. https://doi.org/10.3389/fpsyt.2023.1198302
  10. Chung, J. O. K., Li, W. H. C., Ho, L. L. K., & Cheung, A. T. (2023). The association of resilience with way of coping, psychological well-being and quality of life in parents of children with cancer. International Journal of Environmental Research and Public Health, 20(10), 5765. https://doi.org/10.3390/ijerph20105765
  11. Dufault, K., & Martocchio, B. (1985). Hope: Its spheres and dimensions. Nursing Clinics of North America, 20(2), 379-391. https://doi.org/10.1016/S0029-6465(22)00328-0
  12. Ekawarna, E., Putri, R. H., & Denmar, D. (2022). Analysis of the effect of entrepreneurship education, family environment, and entrepreneurship commitment on entrepreneurship intention. International Journal of Social Science and Human Research, 05(05), 1926–1940. https://doi.org/10.47191/ijsshr/v5-i5-41
  13. Faccio, F., Renzim C., Giudice, A. V., & Pravettoni, G. (2018) Family resilience in the oncology setting: Development of an integrative framework. Frontiers in Psychology, 9, 666. https://doi.org/10.3389/fpsyg.2018.00666
  14. Ferrand, A., Gorgos, A., Ali, N., & Payot, A. (2018). Resilience rather than medical factors: How parents predict quality of life of their sick newborn. The Journal of Pediatrics, 200, 64 - 70.e5. https://doi.org/10.1016/j.jpeds.2018.05.025
  15. Foster, K., Mitchell, R., Young, A., Van, C., & Curtis, K. (2019). Resilience-promoting factors for parents of severely injured children during the acute hospitalisation period: A qualitative inquiry. Injury, 50(5), 1075–1081. https://doi.org/10.1016/j.injury.2018.12.011
  16. Goldberg, L. R. (1992). The development of markers for the Big-Five factor structure. Psychological Assessment, 4(1), 26–42. https://doi.org/10.1037/1040-3590.4.1.26
  17. Granek, L., Barrera, M., Shaheed, J., Nicholas, D., Beaune, L., D’Agostino, N., Bouffet, E., & Antle, B. (2013). Trajectory of parental hope when a child has difficult-to-treat cancer: A prospective qualitative study. Psycho-Oncology, 22(11), 2436–2444. https://doi.org/10.1002/pon.3305
  18. Herth, K. (1992). Abbreviated instrument to measure hope: Development and psychometric evaluation. Journal of Advanced Nursing, 17(10), 1251–1259. https://doi.org/10.1111/j.1365-2648.1992.tb01843.x
  19. Hildenbrand, A. K., Alderfer, M. A., Deatrick, J. A., & Marsac, M. L. (2014). A mixed methods assessment of coping with pediatric cancer. Journal of Psychosocial Oncology, 32(1), 37–58. https://doi.org/10.1080/07347332.2013.855960
  20. Hohashi, N., & Honda, J. (2012). Development and testing of the survey of family environment (SFE): A novel instrument to measure family functioning and needs for family support. Journal of Nursing Measurement, 20(3), 212–229. https://doi.org/10.1891/1061-3749.20.3.212
  21. Hooper, D., Coughlan, J., & Mullen, M. R. (2008). Structural equation modelling: Guidelines for determining model fit. Electronic Journal of Business Research Methods, 6(1), 53–60
  22. Jöreskog, K. G., & Sörbom, D. (1996). LISREL 8: Structural equation modeling with the SIMPLIS command language. Lincolnwood, IL: Scientific Software International, Inc., 1–226. https://books.google.com/books/about/LISREL_8.html?hl=id&id=f61i3quHcv4C
  23. Kamihara, J., Nyborn, J. A., Olcese, M. E., Nickerson, T., & Mack, J. W. (2015). Parental hope for children with advanced cancer. Pediatrics, 135(5), 868–874. https://doi.org/10.1542/peds.2014-2855
  24. Kumalasari, D., Gani, I. A. A., & Fourianalistyawati, E. (2022). Adaptasi dan properti psikometri parental stress scale versi Bahasa Indonesia [Adaptation and psychometric properties of the Indonesian version of the parental stress scale]. Jurnal Psikologi Ulayat, 9(2), 332–353 https://doi.org/10.24854/jpu527
  25. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer
  26. Luo, Y., Li, H. C. W., Xia, W., Cheung, A. T., Ho, L. L. K., & Chung, J. O. K. (2022). The lived experience of resilience in parents of children with cancer: A phenomenological study. Frontiers in Pediatrics, 10, 871435. https://doi.org/10.3389/fped.2022.871435
  27. Luo, Y., Xu, J., Xie, J., Xiao, P., & Cai, Q. (2023). The mediating role of resilience in the relationship between stress and psychological distress in parents of children with cancer. Journal of Health Psychology, 29(4), 266-274. https://doi.org/10.1177/13591053231202635
  28. Novrianda, D., Refnandes, R., & Mutia, Y. (2016). Hubungan karakteristik dan strategi koping dengan parenting stress orang tua yang memiliki anak leukemia di RSUP Dr. M. Djamil Padang [The relationship between characteristics and coping strategies with parenting stress in parents who have children with leukemia in M. Djamil Padang Hospital] [Diploma's thesis, Universitas Andalas]. http://scholar.unand.ac.id/17582/
  29. Nurhidayah, I., Hidayat, M. N., & Sutini, T. (2022). Parents’ coping strategies in caring for children with special needs: A narrative review. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 7(3), 741–748. https://doi.org/10.30604/jika.v7i3.1010
  30. Perwitasari, P., & Wulandari, R. P. (2024). Validity and reliability of Connor-Davidson Resilience Scale (CD-RISC) 10-items on pregnant women. International Journal of Midwifery Research, 4(1), 1–8. https://doi.org/10.47710/ijmr.v4i1.68
  31. Plaza, J. C., Sevilla, M. D. G., Rico, G. M., & Murillo, C. P. M. (2017). Parenting stress and coping strategies in mothers of children receiving early intervention services. Journal of Child and Family Studies, 26(11), 3192–3202. https://doi.org/10.1007/s10826-017-0802-9
  32. Rosenberg, A. R., Wolfe, J., Bradford, M. C., Shaffer, M. L., Yi-Frazier, J. P., Curtis, J. R., Syrjala, K. L., & Baker, K. S. (2014). Resilience and psychosocial outcomes in parents of children with cancer. Pediatric Blood and Cancer, 61(3), 552–557. https://doi.org/10.1002/pbc.24854
  33. Rustøen, T., Cooper, B. A., & Miaskowski, C. (2010). The importance of hope as a mediator of psychological distress and life satisfaction in a community sample of cancer patients. Cancer Nursing, 33(4), 258–267. https://doi.org/10.1097/NCC.0b013e3181d6fb61
  34. Sawang, S., Oei, T. P. S., Goh, Y. W., Mansoer, W., Markhum, E., & Ranawake, D. (2010). Confirmatory factor analysis of the way of coping checklist-revised (WCCL-R) in the Asian context. Applied Psychology, 59(2), 202–219. https://doi.org/10.1111/j.1464-0597.2009.00378.x
  35. Schoors, M. Van, Loeys, T., Goubert, L., Berghmans, G., Ooms, B., Lemiere, J., Norga, K., & Verhofstadt, L. L. (2019). Couples dealing with pediatric blood cancer: A study on the role of dyadic coping. Frontiers in Psychology, 10, 402. https://doi.org/10.3389/fpsyg.2019.00402
  36. Schwartz-Attias, I., Krulik, T., & Ronen, T. (2024). Well-being in parents of children with cancer: Illness perceptions’ mediating role for hope and social support. Frontiers in Psychology, 15, 1206520. https://doi.org/10.3389/fpsyg.2024.1206520
  37. Seiler, A., & Jenewein, J. (2019). Resilience in cancer patients. Frontiers in Psychiatry, 10, 208. https://doi.org/10.3389/fpsyt.2019.00208
  38. Simanjuntak, S. R., Gannika, L., & Usman, S. (2023). Predictors of resilience among the parents of children with cancer. Caring: Indonesian Journal of Nursing Science, 5(2), 72–78. https://doi.org/10.32734/ijns.v5i2.13883
  39. Sisk, B. A., Kang, T. I., & Mack, J. W. (2018). Sources of parental hope in pediatric oncology. Pediatric Blood and Cancer, 65(6), e26981. https://doi.org/10.1002/pbc.26981
  40. Toledano-Toledano, F., Luna, D., Moral De La Rubia, J., Martínez Valverde, S., Bermúdez Morón, C. A., García, M. S., & Vasquez Pauca, M. J. (2021). Psychosocial factors predicting resilience in family caregivers of children with cancer: A cross-sectional study. International Journal of Environmental Research and Public Health, 18(2), 748. https://doi.org/10.3390/ijerph18020748
  41. Tucker, L. R., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38(1), 1–10. https://doi.org/10.1007/BF02291170
  42. Ye, Z. J., Qiu, H. Z., Li, P. F., Liang, M. Z., Wang, S. N., & Quan, X. M. (2017). Resilience model for parents of children with cancer in mainland China-An exploratory study. European Journal of Oncology Nursing, 27, 9–16. https://doi.org/10.1016/j.ejon.2017.01.002
  43. Zarina, A., Radhiyah, R., Hamidah, A., Zakaria, S. Z. S., & Jamal, R. (2012). Parenting stress in childhood leukaemia. Medicine & Health, 7(2), 73–83

Last update:

No citation recorded.

Last update: 2025-06-28 23:02:49

No citation recorded.