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PubMed2004

Perceived risks and benefits of smoking: differences among adolescents with different smoking experiences and intentions.

BACKGROUND: Explanations of adolescent smoking often make reference to adolescents' beliefs that they are invulnerable to harm. However, empirical examination of whether adolescents do acknowledge risks. Further, few studies have considered perceived benefits in adolescents' behavioral decisions. This study examined perceived smoking-related physical and social risks and benefits between adolescents who have vs. have not smoked and do vs. do not intend to smoke. METHODS: Three hundred and ninety-five students (mean age = 14.0) completed a survey concerning their smoking experiences, intentions, and perceived risks and benefits of smoking. RESULTS: Adolescent smokers and those who intend to smoke estimated their chance of experiencing a smoking-related negative outcome as less likely than did nonsmokers and non-intenders. Smokers and intenders also reported the chance of addiction as less likely than did others. In contrast, adolescent smokers and intenders perceived the chance of experiencing a smoking-related benefit as more likely than did nonsmokers and non-intenders. CONCLUSIONS: The data suggest that rather than solely focusing on health risks as a way to deter adolescent smoking, the role of perceived social risks and benefits in adolescents' smoking may be an additional critical focus for intervention. In addition, efforts should be made to increase adolescents' awareness of the addictive nature of cigarettes.

Adolescent↗
PubMed1998

Interactional processes in families with depressed and non-depressed adolescents: reinforcement of depressive behavior.

Problem-solving interactions were observed in 86 families of depressed adolescents and 408 families of non-depressed adolescents. Sequential analyses indicated that mothers of depressed adolescents were more likely than mothers of non-depressed adolescents to increase facilitative behavior in response to adolescent depressive behavior. Additionally, fathers of depressed adolescents were more likely than their counterparts in families of non-depressed adolescents to decrease aggressive behavior subsequent to adolescent depressive behavior. These analyses suggest that parents of depressed adolescents may be inadvertently reinforcing depressive behavior. Decreases in adolescent depressive symptomatology from year 1 to year 2 were not accompanied by changes in family interaction patterns.

Adolescent↗
PubMed1982

Decreased bone mineral status in lactating adolescent mothers.

To determine the calcium and bone mineral status of lactating adolescents, we compared 12 lactating adolescents with 11 nonlactating adolescents, 11 lactating adults, and 11 nulliparous adolescent control subjects. At two and 16 weeks, there were no differences in maternal serum concentrations of calcium, phosphorus, alkaline phosphatase, or calcidiol (25-hydroxyvitamin D). The bone mineral content at two weeks among the four groups was not different, but at 16 weeks the lactating adolescents' bone mineral content was lower than that in the other groups. The lactating adolescents' bone mineral content was decreased between two and 16 weeks (1.049 +/- 0.088 vs 0.887 +/- 0.054 gm/cm; P less than 0.02). Dietary intakes were similar among the groups for calories, protein, vitamin D, calcium, and phosphorus. However, only three of ten lactating adolescents met the recommended dietary allowance for calcium or phosphorus (1,600 mg/day), whereas eight of ten nonlactating adolescents, six of seven lactating adults, and seven of ten adolescents control subjects met the recommended dietary allowance for calcium or phosphorus (P less than 0.05). Our data suggest that during 16 weeks of lactation, the adolescent mother may be at risk for bone demineralization because of low dietary intakes of calcium or phosphorus.

25-Hydroxyvitamin D 2↗
PubMed2000

A comparison of sexually abused and non-sexually abused adolescents in a clinical treatment facility using the MMPI-A.

OBJECTIVE: In the current study, the adolescent version of the Minnesota Multiphasic Personality Inventory, the MMPI-A, was used to address concerns voiced about the mixing of different developmental ages, use of inadequate comparison groups, and the lack of reliance on reliable and valid measures of psychological, behavioral, and psychosocial problems used in previous studies of sexually abused children and adolescents. METHOD: A total of 107 adolescents in residential treatment (73 boys and 34 girls) were included in the study. Seventy-two of these adolescents had reportedly been sexually abused (42 boys and 30 girls); 35 had not been abused (31 boys and 4 girls). Predictions based on previous research with adolescents were made and tested regarding which MMPI-A validity, clinical, and content scales would differ between the sexually abused and non sexually abused groups of adolescents. RESULTS: Overall, and consistent with many predictions, sexually abused adolescents had both statistically and clinically higher elevations on several MMPI-A scales than did their non-abused counterparts. No scales were more elevated for non-abused adolescents than for abused adolescents. CONCLUSIONS: Sexually abused adolescents in residential treatment, as a group, present with concerns that their non-abused counterparts did not have, or did not share to the same extent. Treatment recommendations based on the MMPI-A scale elevations are provided, limitations of the current study discussed, and directions for further research are suggested.

Adolescent↗
PubMed2002

Diagnostic outcome of adolescent self-reported suicidal ideation at 8-year follow-up.

BACKGROUND: There are few epidemiological data on the outcome of adolescent self-reported suicidal ideation. METHOD: Data from an epidemiological study were used to examine self-reported suicidal ideation in adolescence as a predictor of suicidal ideation and psychiatric diagnoses at 8-year follow-up. RESULTS: Suicidal ideation was reported by 41 (4.5%) of 912 adolescents aged 11-18 and by 19 (2.5%) of 795 young adults aged 19-26. Most parents of adolescents with positive self-report did not report suicidal ideation in their child. Suicidal ideation in adolescents and young adults was associated with other psychiatric problems. Adolescent self-reported suicidal ideation was not a predictor of suicidal ideation or any major psychiatric disorder 8 years later. In males, suicidal ideation in adolescence was associated with specific phobia at follow-up. LIMITATIONS: The sample of adolescents may not be representative of the general population. There were no outcome measures other than DSM-IV diagnoses. Suicidal ideation was assessed by only one item, both at baseline and follow-up. CONCLUSIONS: Adolescents and young adults with self-reported suicidal ideation had high rates of psychiatric problems. Adolescent self-reported suicidal ideation did not predict suicidal ideation or any major psychiatric disorders (i.e. depressive disorders, substance use disorders, or psychotic disorders) at follow-up.

Adolescent↗
PubMed1998

Socio-economic differences in health risk behavior in adolescence: do they exist?

Socio-economic differences in risk behaviors in adolescence can be seen as a prelude to the re-emergence of socio economic health differences in adulthood. We studied whether or not socio-economic differences in health risk behaviors are present in male and female adolescents in The Netherlands. The relation between socio-economic status (SES) and health risk behaviors was examined, by testing both the main and interaction effects of SES and gender on separate health risk behaviors on one hand, and on the behaviors cumulatively on the other. The data were derived from 1984 adolescents in the four northern provinces of The Netherlands. SES was measured by means of the educational level and the occupational status of both parents. Four health risk behaviors were included in this study: smoking, alcohol consumption, soft drug use, and (no) physical exercise. We found that the relationships between SES and health risk behaviors are not as linear as is often found in adulthood. Our findings can be characterised overall by an absence of relationship between SES and health risk behaviors. The only exception applies to sport, which is linearly related to SES. Adolescents in the lower SES groups engage in sport less than adolescents in the higher SES groups. There was an irregular relationship between the father's occupational status and the adolescents' smoking and drinking. Adolescents in the highest, lowest and middle of the six SES groups have the highest rates of health risk behaviors. All observed relationships are similar for both male and female adolescents. A relationship between gender and the separate health risk behaviors was found only for alcohol consumption and drug use. For both male adolescents showed higher rates of risk behavior. Males also scored higher on the cumulative health risk behaviors than their female counterparts. The findings of this study do not support the hypothesis of latent differences in adolescence.

Adolescent↗
PubMed2002

Does tobacco marketing undermine the influence of recommended parenting in discouraging adolescents from smoking?

OBJECTIVE: The tobacco industry contends that parenting practices, not marketing practices, are critical to youth smoking. Our objective was to examine whether tobacco-industry marketing practices undermine the protective effect of recommended authoritative parenting against adolescent smoking. DESIGN AND SETTING: Receptivity to tobacco advertising and promotions was assessed in 1996 from a representative sample of California adolescent never-smokers aged 12 to 14 years. A follow-up survey of 1641 of these adolescents was conducted in 1999 that included measures of the key components of authoritative parenting: parental responsiveness, monitoring, and limit setting. MAIN OUTCOME MEASURE: Smoking initiation in adolescents. RESULTS: Adolescents in families with more-authoritative parents were half as likely to smoke by follow-up as adolescents in families with less-authoritative parents (20% vs 41%, p <0.0001). In families with more-authoritative parents, adolescents who were highly receptive to tobacco-industry advertising and promotions were significantly more likely to smoke (odds ratio=3.52, 95% confidence interval =1.10-11.23), compared to those who were minimally receptive. This effect was not significant in adolescents in families with less-authoritative parents. The overall attributable risk (adjusted for exposure to peer smokers) of smoking from tobacco-industry advertising and promotions was 25%. However, an estimated 40% of adolescent smoking in families with more-authoritative parents was attributable to tobacco-industry advertising and promotions; this was five times the attributable risk seen in families with less-authoritative parents (8%). CONCLUSION: The promotion of smoking by the tobacco industry appears to undermine the capability of authoritative parenting to prevent adolescents from starting to smoke.

Adolescent↗
PubMed2002

Peculiar vulnerability to nicotine oral self-administration in mice during early adolescence.

A "gateway" function toward substance abuse has been suggested for early tobacco smoking. Nicotine actually represents an easily available drug for human adolescents, who are very likely to use a number of different psychoactive agents. Surprisingly, the psychobiological factors involved in this age-related willingness have been poorly investigated. In Experiment 1, nicotine consumption was studied in outbred CD-1 mice during Early (postnatal day (pnd) 24 to 35), Middle (pnd 37 to 48) or Late (pnd 50 to 61) adolescence, in an oral self-administration paradigm. During the drinking session (2 h/day), animals had free choice between either tap water or a nicotine solution (10 mg/l). After a 6-day period, a fading study was carried out, in which nicotine concentration was reduced to 7 mg/l (days 7-9) and 5 mg/l (days 10-12), to assess whether animals would compensate by increasing their intake from the nicotine solution. In Experiment 2, psychopharmacological effects on locomotion induced by the nicotine solution (0, 10, 30 mg/l) during the 1-h drinking session were assessed in Early and Late adolescent mice. In Experiment 1, Early adolescents expressed a marked and stable preference for the nicotine solution, showing a daily nicotine intake of 1.15 +/- 0.04 mg/kg. Middle adolescents did not show any preference for either bottle, whereas a tendency toward avoidance for the nicotine solution was found for Late adolescents. In the fading study, Early adolescents were the only group to show increased consumption from the nicotine bottle as far as nicotine concentration was reduced. A time-course analysis of plasma levels of cotinine (the principal biomarker of nicotine consumption) revealed some pharmacokinetic differences between the three age-groups. In Experiment 2, drinking from a nicotine solution produced a prominent hyperactivity in Early adolescents, whereas a quite opposite profile was associated with older subjects. In summary, even if a role for taste factors cannot be completely ruled out, a peculiar spontaneous drive toward oral nicotine consumption, as well as a nicotine-induced arousal, is specific to Early adolescence in mice. The present animal model might be useful to investigate psychobiological determinants involved in early tobacco smoking in human adolescents

Adolescent↗
PubMed2001

Social cognitive correlates of sexual experience and condom use among 13- through 15-year-old adolescents.

PURPOSE: To examine the role of self-efficacy, outcome expectancies, and perception of peer attitudes in the delay of onset of sexual activity among 13- through 15-year-old adolescents. We also explored the role of self-efficacy, outcome expectancies, and perception of friends' condom use behavior in explaining the use of condoms among sexually active adolescents. METHODS: This study was part of a larger cross-sectional study to evaluate personal characteristics and maternal factors associated with early initiation of sexual intercourse. Mothers and adolescents were recruited from a community-based organization that offered afterschool and summer programs for youth. Enrollment was limited to adolescents aged 13-15 years and their mothers. Mothers and adolescents completed separate interviews. For adolescents, the interviews included the assessment of the variables in the present study. Each interview lasted about 60 min and was conducted by a trained interviewer. Data were analyzed using descriptive statistics and regression analysis. The average age of the 405 adolescent participants was 13.86 years, and approximately 30% of them had engaged in sexual intercourse. Slightly more than half (56%) of participants were male, and 82% were African-American. RESULTS: Participants who were less likely to believe that their friends favored intercourse for adolescents and who held more favorable attitudes about the personal benefits of abstaining from sex were less likely to have initiated sexual intercourse. Among sexually active adolescents, those who expressed confidence in putting on a condom, and in being able to refuse sex with a sexual partner, and who expressed more favorable outcome expectancies associated with using a condom were more likely to use condoms consistently. CONCLUSIONS: Human immunodeficiency virus and pregnancy prevention programs should emphasize peer influences in both the initiation of sexual intercourse and the use of safer sex practices among sexually active adolescents, as well as personal attitudes about consequences to self and confidence in negotiating safer sex practices with one's partner.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Health care use and charges for adolescents enrolled in a title XXI program.

PURPOSE: To examine the use patterns and charges for adolescents with special health care needs (ASHCN) and adolescents engaging in risky behaviors (ARB) and both (BOTH), compared with adolescents with no identified special health care or risky behavior diagnosis (ANIC) in a pool of adolescent enrollees eligible for Title XXI services. METHODS: Claims and encounter data were used to classify 11,459 who had been enrolled in Florida's Healthy Kids Program for 2 consecutive years into 4 groups: ASHCN (n = 1363); ARB (n = 1801); BOTH (n = 773); and ANIC (n = 7522). Monthly per capita inpatient, outpatient, emergency room, and total use and charges were calculated and compared across groups using the Wilcoxon rank sum test, descriptive statistics, and odds ratios. RESULTS: The data indicated that ASHCN, ARB, and BOTH consume significantly more health care services than ANIC and that their higher use and charges are attributable not only to condition-related costs but also to their higher use of non-condition-related services as well. The data also revealed that adolescents with a special health care diagnosis (ASHCN and BOTH) had a higher percentage of costs owing to inpatient stays, whereas adolescents with a risky behavior diagnosis (ARB and BOTH) had a higher percentage of costs owing to emergency room usage. Finally, relevant to the total resources necessary to provide health care for adolescents, the data showed that 65% of the total annual costs of this program emanate from the 35% of adolescents who have special health care needs, engage in risky behaviors, or both. CONCLUSIONS: This study underscores two important points that can be used to ensure that adequate financing, provider network, and service delivery systems are developed to best meet the needs of the adolescent population: (a) the importance of considering the unique needs of adolescents in reimbursement rate setting strategies and (b) the importance of considering category of service utilization in weighting premiums for various groups.

Adolescent↗
PubMed2002

Parenting style and adolescent's reaction to conflict: is there a relationship?

PURPOSE: To determine if the reactions of adolescents toward hypothetical situations that can lead to conflict and violence varied by parenting style of their mothers. METHODS: This study was part of a larger research project involving adolescents and their mothers participating in a longitudinal HIV-prevention program. Mothers and their adolescents were recruited from a community-based organization (CBO) and interviewed separately. Data were analyzed using the responses of 439 African-American adolescents ranging from ages 11 to 14 years. The responses of adolescents to questions about parenting were used to classify mothers into one of three parenting styles: authoritative, authoritarian, or permissive. The "anticipated reactions to hypothetical situations" scale consists of 11 items with 6 response categories. The six responses were reclassified into three categories ranging from "not at all violent" to "extremely violent." Higher scores indicate more violent reactions to the hypothetical situations. The parenting scale consists of two subscales: a 13-item parental involvement scale and a 13-item parental control scale. Items were rated on a 5-point Likert scale from "strongly disagree" to "strongly agree." Analysis of variance was used to determine if the anticipated reactions of adolescents toward hypothetical situations varied by parenting style of their mothers. RESULTS: Adolescent participants who reported a more permissive parenting style expressed more intense negative reactions toward the hypothetical situations that can provoke conflict. Male adolescents also expressed more intense reactions than females to the situations. There was no difference in intensity of reaction by age after controlling for gender and parenting style. CONCLUSIONS: Parenting style is associated with adolescents' reactions to hypothetical situations that can provoke conflict. This finding highlights the importance of considering parents and their approach to child-rearing as a factor in the adolescent's ability to react to conflict.

Adolescent↗
PubMed2003

Adolescent health care expenditures: a descriptive profile.

PURPOSE: To examine health care spending patterns for U.S. adolescents aged 10 to 18 years using nationally representative household survey data. METHODS: We analyzed data from the 1997 Medical Expenditure Panel Survey on total expenditures and out-of-pocket expenditures for health care based on a sample of 4882 adolescents. RESULTS: Compared with that for adults, health care expenditures for adolescents were low, averaging $799 US dollars per adolescent in 1997. Disabled and functionally impaired adolescents had disproportionately high expenditures ($1960 US dollars per capita). Blacks and adolescents living in poor families had disproportionately low expenditures ($358 and $609 US dollars per capita, respectively). Professional services provided by physicians and dentists accounted for more than one-half of all health care spending for adolescents. Only 2% of adolescents were hospitalized in 1997, but they accounted for about one-fifth of all health care expenditures. The share of health expenditures paid out of pocket varied by type of service, ranging from 3% for inpatient hospital care to 51% for dental care. When covered, insurance provided substantial financial protection for families of adolescents: those with public coverage paid 8%, those with private coverage paid 32%, and those without coverage paid 61% of their health care bills out of pocket. The share of health care bills paid out of pocket would be much lower if dental care was excluded. CONCLUSIONS: On the basis of our findings that health care expenditures for adolescents are low and that insurance coverage provides critically needed financial protection, we conclude that further expansions of public and private health insurance coverage for this population would provide significant benefits at modest additional cost. Additional efforts to improve coverage of services that are not now well-covered, such as dental care, would also be valuable.

Adolescent↗
PubMed2001

Plasma carnitine levels of pregnant adolescents in labor.

STUDY OBJECTIVE: To determine the concentration of plasma carnitine (total, free, and acylcarnitine) during the delivery of uncomplicated pregnancies of adolescent women. To investigate the relationship between maternal and neonatal levels of carnitine and to compare these carnitine levels between pregnant and nonpregnant adolescents. DESIGN: Samples of maternal and umbilical blood were taken at the time of delivery and examined for the determination of the carnitine-total, free, and acylcarnitine-concentration by the use of an enzymatic-radioisotope method. Twenty-two cases of uncomplicated adolescent pregnancies with a normal labor and without perinatal complications were examined. The plasma level of carnitine was also examined in 17 healthy nonpregnant adolescent women, which constituted the control group. RESULTS: The concentrations of plasma carnitine in adolescent pregnancies at the time of delivery were calculated at 19.6 +/- 2.15 microMol/L (total), 12.62 +/- 1.31 microMol/L (free), and 6.98 +/- 1.55 microMol/L (acylcarnitine). The corresponding mean values in umbilical plasma were 30.31 +/- 2.06 microMol/L, 22.39 +/- 1.64 microMol/L, and 7.92 +/-.96 mucroMol/L. There is a statistically significant difference between the mean values in maternal and umbilical plasma (P <.0001 for total and free carnitine and P <.012 for acylcarnitine). The correlations between adolescent pregnant women and their infants as regards total, free, and acylcarnitine were 0.137, 0.018, and 0.33, respectively. Neither of these parameters was statistically significant. The corresponding mean values of carnitine in nonpregnant adolescent women were statistically significantly higher than in adolescent pregnant women (total carnitine: 41.61 +/- 3.09 microMol/L, free: 31.39 +/- 2.81 microMol/L, acylcarnitine: 10.22 +/- 1.88 microMol/L, P <.0001). CONCLUSIONS: The concentration of plasma carnitine at the end of adolescent pregnancy is low compared to the levels of umbilical carnitine at birth and that found in nonpregnant adolescent women. It may not have an obvious impact on the utilization of fatty acids in an uncomplicated full-term pregnancy; however, it suggests the potential risk for neonatal fatty-acid oxidation in a preterm or complicated pregnancy.

Adolescent↗
PubMed2001

Autonomy and relatedness in family interactions with depressed adolescents.

This study investigated family interaction patterns associated with adolescent depression. Twenty adolescent-mother dyads with clinically depressed adolescents participated in the study. Twenty dyads with externalizing youths and 20 nonclinic dyads were included as controls. Dimensions of autonomy and relatedness were rated during a videotaped mother-adolescent problem-solving task. Adolescent perceptions of parent attachment were also evaluated. Results indicated that depressed adolescents and their mothers did not differ in their behavior compared with nonclinic adolescents. Dyads with externalizing adolescents showed the highest impairment in autonomy and relatedness. Depressed adolescents perceived the quality of their relationships with their parents to be impaired relative to nonclinic dyads, as did externalizing adolescents.

Adolescent↗
PubMed1999

Adolescent substance use: preliminary examinations of school and neighborhood context.

In considering the influences of microsystems on adolescent substance use, familial and peer contexts have received the most extensive attention in the research literature. School and neighborhood settings, however, are other developmental contexts that may exert specific influences on adolescent substance use. In many instances, school settings are organized to provide educational services to students who share similar educational abilities and behavioral repertoires. The resulting segregation of students into these settings may result in different school norms for substance use. Similarly, neighborhood resources, including models for substance use and drug sales involvement, may play an important role in adolescent substance use. We briefly review literature examining contextual influences on adolescent substance use, and present results from two preliminary studies examining the contribution of school and neighborhood context to adolescent substance use. In the first investigation, we examine the impact of familial, peer, and school contexts on adolescent substance use. Respondents were 283 students (ages 13 to 18) from regular and special education classrooms in six schools. Although peer and parental contexts were important predictors of substance use, school norms for drug use accounted for variance in adolescent use beyond that explained by peer and parental norms. Data from a second study of 114 adolescents (mean age = 15) examines neighborhood contributions to adolescent substance use. In this sample, neighborhood indices did not contribute to our understanding of adolescent substance use. Implications for prevention are presented.

Adolescent↗
PubMed1993

Adolescent Health. Reflections on a report to the U.S. Congress.

The Office of Technology Assessment (OTA) found that the conventional wisdom that American adolescents are so healthy that they do not require health and related services is not justified; U.S. adolescents often face formidable barriers to obtaining needed health care, and relatively little appropriate attention has been paid to adolescents by the federal government. OTA suggested that Congress could act to (a) increase adolescents' access to health care by supporting comprehensive health services specifically for adolescents, (b) restructure the federal role in adolescent health by creating an office of adolescent health in the U.S. Executive Branch, and (c) improve adolescents' social environments by providing more support to families of adolescents, limiting adolescents' access to firearms, supporting the expansion of their recreational opportunities, and further increasing opportunities for community service. Federal actions taken since OTA's report are summarized.

Adolescent↗
PubMed2004

Individuation among bedouin versus urban arab adolescents: ethnic and gender differences.

Three scales assessing individuation (Objective Measure of Ego-Identity Status [OMEIS], Separation-Individuation Test of Adolescence [SITA], and Multigenerational Interconnectedness Scale [MIS]) were administered to 40 female and 38 male Bedouin Arab adolescents and to 39 female and 38 male urban Arab adolescents in Grade 12. It was hypothesized that Bedouin Arab adolescents and female adolescents would manifest less individuation than urban Arab adolescents and male adolescents, respectively. Results from the OMEIS revealed that the identity foreclosed mean of the Bedouin adolescents was higher than that of the urban adolescents. As for the SITA, significant differences were found between Bedouin and urban Arabs in terms of dependency denial, separation anxiety, teacher enmeshment, peer enmeshment, and rejection expectancy. Significant gender differences were found in regard to dependency denial, and a borderline difference was found for separation anxiety. Significant effects of ethnicity and gender were found on the financial interconnectedness subscale of the MIS. The results support the present hypotheses concerning ethnicity differences and indicate that urbanization seems to narrow the differences in individuation between male and female adolescents.

Adolescent↗
PubMed2001

Self-esteem and hopefulness in adolescents with cancer.

Increased survivorship in childhood cancer has raised questions about adolescents' psychosocial functioning during the treatment experience and long-term adaptation as cancer survivors. This descriptive correlation study examines the relationships among the stages of adolescence, gender, self-esteem, and hopefulness in a sample of 45 adolescents with cancer. The perceived level of self-esteem was measured by using the Coopersmith Self-Esteem Inventory; the amount of hopefulness was measured by using the Hopefulness Scale for Adolescents. Mean scores for self-esteem and hopefulness were comparable to normative data reported for healthy adolescents on each scale. Perceived level of self-esteem and hopefulness did not significantly differ between boys and girls overall; early, middle, and late adolescents; or between boys and girls within each stage of adolescence. A stepwise multiple regression analysis showed self-esteem and the early stage of adolescence accounted for 27.3% (R2 = .306) of the variance in hopefulness scores. Self-esteem was the most significant predictor (F = 12.456, p = .001), explaining 20.7% of the variance (R2 = .225, p = .001). This study contributes to nursing the knowledge of the psychosocial response and the treatment experience in adolescents with cancer. These results can be used in future research to develop and test nursing actions that can influence a perceived sense of self-esteem and hopefulness and potentially allow for continued psychosocial development and effective coping among these adolescents during treatment and into survivorship.

Adolescent↗