Family Environment Factors Associated with Symptom Distress Among Korean Adolescents and Young Adults with Cancer: A Cross-Sectional Study.
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Background/objectives: To describe and compare Korean AYAs' and parental perspectives on the family environment in terms of agreement and significant differences and examine which variables were associated with AYAs' symptom distress. Sample and setting: Self-report data were collected from a total sample of 113 AYAs, recruited from a pediatric-oncology outpatient clinic at a university-affiliated hospital and community group in South Korea. Because each study aim required different data sources, different analytic samples were used. Specifically, 54 AYA-parent dyads were included for Aim 1, whereas self-report data from 111 AYAs with complete data were used for Aim 2. Methods and variables: This subgroup analysis used a quantitative-descriptive, cross-sectional design. AYAs' and parent perceptions of the family environment (family cohesion and adaptability, family strength, and social support from family) and AYAs' symptom distress were collected using reliable and validated self-report questionnaires and analyzed using descriptive and inferential statistics. Results: AYAs and their parents showed low (family support) to moderate agreement (family strength, family cohesion, and adaptability) on perceptions of family environment (ICC = 0.374-0.612). AYAs reported significantly lower perceptions of family support than their parents, with a small to moderate effect (p < 0.001, d = 0.48). All family environment variables were correlated with AYAs' symptom distress (p < 0.05). Among these variables, AYAs' perceived family strength emerged as the only family environment variable significantly associated with their symptom distress (F = 14.309, p < 0.001, R2 = 0.359, R2adj = 0.334), which was stronger during treatment. Conclusions: AYAs' perceived family strength should be routinely assessed, especially during cancer treatment. Additional nursing interventions focusing on enhancing AYAs' families as a support group are needed.