Ajuste y adaptación psicosocial de adultos jóvenes supervivientes de un cáncer en etapa pediátrica: Revisión sistemática / Psychosocial adjustment and adaptation in young adults surviving pediatric cancer: A systematic review

Introducción: Los efectos a largo plazo de tumores en la infancia pueden alterar la trayectoria de adaptación y ajuste psicosocial de los supervivientes en etapas de vida posteriores. Objetivo: Esta revisión sistemática se centra en analizar las experiencias de crecimiento postraumático, estrés postraumático, malestar emocional y dificultades psicosociales sufridas por jóvenes adultos supervivientes a un cáncer en etapa pediátrica. Resultados: Los resultados sugieren una trayectoria mayoritaria que podría definirse como adaptativa, en la que se observa tanto crecimiento postraumático (prevalencia superior al 60%), como síntomas de estrés postraumático (prevalencia inferior al 30%). No obstante, en comparación con población control no oncológica, estos supervivientes tienen mayor riesgo de padecer síntomas de ansiedad y depresión, de alcanzar menores logros educativos y profesionales, y de permanecer solteros o vivir solos, lo que se hipotetiza que podría estar relacionado con las secuelas de cada tipo de tumor y tratamiento, y no únicamente con la vivencia de la enfermedad. Conclusiones: La atención a jóvenes adultos supervivientes a un cáncer pediátrico debería centrarse en proporcionar mayor apoyo médico y psicosocial a largo plazo, a través del abordaje interdisciplinar y la atención centrada en la persona, como aproximación que favorezca una trayectoria de ajuste adaptativa.(AU)

Introduction: Long-term effects of childhood tumors can alter the trajectory of adjustment and psychosocial adjustment of survivors later in life. Purpose: This systematic review focuses on analyzing the experiences of posttraumatic growth, posttraumatic stress, emotional distress, and psychosocial difficulties experienced by young adult survivors of pediatric cancer. Results: The results suggest a more prevalent trajectory that could be conceptualize as adaptive, in which both post-traumatic growth (prevalence greater than 50%) and post-traumatic stress symptoms (prevalence less than 30%) are observed. However, compared to the non-oncology control population, these survivors are at higher risk for anxiety and depressive symptoms, lower educational and occupational attainment, and remaining single or living alone, which is hypothesized to be related to the sequelae of each tumor type and treatment, and not just the disease experience. Conclusions: Care for young adult survivors of pediatric cancer should focus on providing enhanced long-term medical and psychosocial support through an interdisciplinary approach and person-centered care as an approach that supports a trajectory of adaptive adjustment.(AU)

Estrés cotidiano en supervivientes de cáncer / Daily stress in cancer survivors

Introducción: El número de supervivientes de cáncer ha aumentado considerablemente en los últimos años. Estas personas presentan necesidades asistenciales específicas, y se sienten vulnerables ante cualquier tipo de problema de salud, por lo que, contrariamente a lo que sería esperable, la finalización del tratamiento parece dar inicio a una etapa extremadamente estresante para los supervivientes. Objetivo: Describir las características del malestar cotidiano durante situaciones consideradas estresantes para los supervivientes de cáncer. Metodología: Se ha usado una Evaluación Ecológica Momentánea para recoger información sobre las actividades cotidianas de los supervivientes de cáncer al final del día. Muestra: Sesenta supervivientes de varios tipos de cáncer, que han contestado a un cuestionario online durante 15 días consecutivos. Resultados: Los supervivientes han experimentado un evento estresante un 55,12% de los días registrados, de los cuales el 45,41% de ellos fue atribuido al hecho de ser superviviente y generó niveles de malestar más elevados. El evento estresante más frecuente, cuando se atribuye a la supervivencia, ha sido el problema físico (87,60%). Conclusiones: El problema físico es claramente un evento estresante relacionado con la fase de supervivencia y, es un problema que no parece resolverse con el tiempo. En general, los eventos estresantes atribuidos a la supervivencia generan más malestar.Palabras clave: Cáncer, supervivientes, estrés cotidiano, fatiga, bienestar psicológico (AU)

Introduction: The number of cancer survivors has dramatically increased in recent years. These people have specific healthcare needs, and feel vulnerable to any type of health problems. Contrary to what would be expected, when cancer treatment is finished an extremely stressful stage for survivors begins. Objectives: To describe the characteristics of daily distress during everyday situations considered stressful by cancer survivors. Methodology: Using Ecological Momentary Assessment, information about daily activities of cancer survivors was recorded at the end of the day. Sample: Sixty survivors of various types of cancer, who answered an online survey for a total of 15 consecutive days. Results: Survivors experienced a stressful event at 55,12% of the days recorded, and 45,41% of these days the event was related to the fact of being a survivor and generated higher levels of discomfort. Physical problem was the most frequent stressful event attributed to survival (87.60% of them). Conclusions: the physical problem related to the survival stage is clearly a stressful factor that does not seem to resolve itself over time. To a great extent, stressful events linked to the survival experience, give rise to more distress (AU)

Estructura básica de una página web para apoyo psicológico a adolescentes cuyos padres tienen cáncer / Basic structure of a web page for psychological support to adolescents whose parents have cancer

Cuando un padre o una madre enferma de cáncer, a los hijos les afecta el diagnóstico, siendo los adolescentes el grupo más vulnerable a sufrir las consecuencias. Éstos consideran que sus necesidades son poco escuchadas. Por lo tanto se propone crear los elementos de una página web de apoyo psicológico para adolescentes con padres con cáncer. A partir de entrevistas semiestructuradas con adolescentes, padres afectados, y psicooncólogas, y de la comparación de estos datos con los provenientes de la literatura, hemos llegado a la conclusión de que la página web debería incluir tres elementos fundamentales: información, asesoramiento para el uso de estrategias de afrontamiento, y posibilidad de interactuar con otros adolescentes en la misma situación y también con profesionales. Es también muy necesario que la página web no sea iatrogénica por lo que se propone un sistema de filtros que permitan dirigir al adolescente a los contenidos adecuados para su situación, evitando, en la medida de lo posible, que realice interpretaciones y desarrolle expectativas erróneas que puedan generarle confusión o malestar

When a father or a mother gets diagnosed with cancer, children are affected too. Adolescents are the most vulnerable group to suffer the consequences. They consider that their surrounding do not listen to their necessities. That is why we propose an innovative approach to create the elements of a psychological support website for adolescents with parental cancer. The procedure was based on conducting semistructured interviews with adolescents, affected parents and psycho-oncologist. Results been given from the comparison between the interviews that have been done in this research and the results of the scientific literature. We concluded that the website should include three fundamental elements: Information, coping strategies counseling, and the possibility to interact with other adolescents in the same situation as well as with professionals. It is of great importance to avoid that the website should be iatrogenic. That is the reason why we propose a filter’s system that allows to direct the adolescent to the adequate content for his/her situation. These filters avoid, as much as possible, the wrong misinterpretation and expectations that can generate confusion and discomfort

Dimensional analysis of personality in adolescents with suicidal behavior.

OBJECTIVES: This study is aimed at validating the dimensional internalizing and externalizing approach to personality in a sample of adolescents with suicidal behavior and analyzing the psychopathological and syndromic differences between adolescents from each dimension. METHOD: It is a descriptive and cross-sectional study of 75 adolescents (75% women) who attended the emergency service of a pediatric hospital due to suicidal behavior. Sociodemographic, clinical and psychopathological data and personality profiles (MACI) were gathered. RESULTS: The factorial analysis found two factors (total variance of 77.65%): an internalizing (28% of the cases) and an externalizing profile (72% of the cases). Statistically significant differences were obtained between the two profiles in the expressed concerns and the clinical syndromes of the MACI. CONCLUSIONS: Two differentiated personality profiles were found in our sample of adolescents with suicidal behavior. The externalizing profile was more prevalent. These profiles should guide clinical decisions and help plan therapeutic interventions to reduce the risk of suicidal behavior relapse.

Análisis dimensional de la personalidad del adolescente con conducta suicida / Dimensional analysis of personality in adolescents with suicidal behavior

Objetivos. El presente trabajo tiene por objetivo validar el enfoque bidimensional de personalidad internalizante y externalizante en una muestra de adolescentes con conducta suicida y analizar las diferencias psicopatológicas y sindrómicas entre los adolescentes que tienden a una u otra dimensión. Método. Estudio descriptivo transversal con una muestra de 75 adolescentes (79% chicas) que acudieron a urgencias de un hospital pediátrico por conducta suicida. Se recogieron datos sociodemográficos, clínicos, psicopatológicos y de perfiles de personalidad (MACI). Resultados. El análisis factorial extrajo dos factores (total varianza 77.56%): un perfil internalizante (28% de casos) y otro externalizante (72% de los casos). Se observaron diferencias estadísticamente significativas entre perfiles en preocupaciones expresadas y síndromes clínicos del MACI. Conclusiones. Se obtienen dos perfiles diferenciados de personalidad en la muestra de adolescentes con conducta suicida, siendo el perfil externalizante el más prevalente. Estos perfiles deberían ayudar a tomar decisiones clínicas y planificar intervenciones para reducir el riesgo de repetición de la conducta suicida

Objectives. This study is aimed at validating the dimensional internalizing and externalizing approach to personality in a sample of adolescents with suicidal behavior and analyzing the psychopathological and syndromic differences between adolescents from each dimension. Method. It is a descriptive and cross-sectional study of 75 adolescents (75% women) who attended the emergency service of a pediatric hospital due to suicidal behavior. Sociodemographic, clinical and psychopathological data and personality profiles (MACI) were gathered. Results. The factorial analysis found two factors (total variance of 77.65%): an internalizing (28% of the cases) and an externalizing profile (72% of the cases). Statistically significant differences were obtained between the two profiles in the expressed concerns and the clinical syndromes of the MACI. Conclusions. Two differentiated personality profiles were found in our sample of adolescents with suicidal behavior. The externalizing profile was more prevalent. These profiles should guide clinical decisions and help plan therapeutic interventions to reduce the risk of suicidal behavior relapse

Predictors of Suicide Behavior Relapse in Pediatric Population.

Identifying patients at increased risk of suicide remains a challenge today. It has been reported that 10% of patients committing a suicide attempt end up dying and that both the risk and the severity of clinical symptomatology increase with the number of attempts. Within the framework of selective and indicated prevention, it is essential to identify the group of patients with an increased risk of recurrence. The objective of this study is to identify factors predicting suicide attempt relapse to improve the decision making process in the therapeutic approach to suicidal behavior. The methodology employed was a longitudinal design aimed at identifying factors, in a binary logistic regression model (stepwise), predicting the repetition of suicidal behavior among a sample of 417 participants aged between 8 and 17 years old, at the six months follow-up. A statistically significant model χ2(3, N = 417) = 18.610; p < .001; Nagelkerke R 2 = .096 including the following factors was obtained: current diagnosis of personality disorder/maladaptive personality OR = .806, p = .028, 95% CI [1.091, 4.595], personal history of self-injury OR = .728, p = .043, 95% CI [1.023, 4.192], and family history of psychopathological diagnosis OR = .925, p = .021, 95% CI [1.151, 5.530]. Considering these results, having a diagnosis of personality disorder or maladaptive personality traits, presence or history of self-harm and family history of psychopathology draws a predictive profile of autolytic attempt recurrence during the six months after the initial intervention at the emergency room.

Predictors of suicide behavior relapse in pediatric population

Identifying patients at increased risk of suicide remains a challenge today. It has been reported that 10% of patients committing a suicide attempt end up dying and that both the risk and the severity of clinical symptomatology increase with the number of attempts. Within the framework of selective and indicated prevention, it is essential to identify the group of patients with an increased risk of recurrence. The objective of this study is to identify factors predicting suicide attempt relapse to improve the decision making process in the therapeutic approach to suicidal behavior. The methodology employed was a longitudinal design aimed at identifying factors, in a binary logistic regression model (stepwise), predicting the repetition of suicidal behavior among a sample of 417 participants aged between 8 and 17 years old, at the six months follow-up. A statistically significant model χ2(3, N = 417) = 18.610; p < .001; Nagelkerke R 2 = .096 including the following factors was obtained: current diagnosis of personality disorder/maladaptive personality OR = .806, p = .028, 95% CI [1.091, 4.595], personal history of self-injury OR = .728, p = .043, 95% CI [1.023, 4.192], and family history of psychopathological diagnosis OR = .925, p = .021, 95% CI [1.151, 5.530]. Considering these results, having a diagnosis of personality disorder or maladaptive personality traits, presence or history of self-harm and family history of psychopathology draws a predictive profile of autolytic attempt recurrence during the six months after the initial intervention at the emergency room

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The Hidden Sufferers: Parental Reactions to Childhood Cancer during Treatment and at Survival.

This study was twofold: 1) to assess parental reactions to childhood cancer throughout the oncological experience and 2) to explore associations between parents' reactions during treatment and cancer-related distress at survival. A cross-sectional descriptive study collecting data (at survival) from retrospective (perceived social support, optimism, distress, coping in the worst situation) and current variables (general stress, distress regarding cancer, benefit finding) was carried out. Forty-one parents of childhood cancer survivors were assessed. High levels of distress (M = 9.5, SD = 1.32, range 4-10) and self-reported efforts to overcome difficulties occurring during the hospitalization (M = 7.48, SD = 3.01, range 0-10) were found. However, parents received high social support from very different sources. This could explain the satisfactory levels of optimism found (43.9% of the sample, M ≥ 16, range 9 - 24). Most parents reported to use engagement (M = 2.57, SD = 0.41, range 1-4) and help-seeking (M = 2.52, SD = 0.53, range 1-4) coping strategies to overcome difficulties. Some parents recognized to use psychological defenses when coping with the distress of cancer. However, this disengagement style was less preferred (M = 1.62, SD = 0.37, range 1-4). Finally, 22% of parents reported positive consequences and 60% reported positive and negative consequences too. When exploring how treatment experiences can influence cancer-related distress in survivorship, we observed that those who received less social support used more disengagement coping and referred higher efforts to overcome difficulties during treatment, displayed persistent distress at survival. These same parents showed higher scores on general stress. Besides, these results were not influenced by child's sequelae at survival. These findings support the hypothesis that "the end of treatment is not the end". Consequently, special attention should be placed in screening parents experiences throughout different milestones of cancer to design tailored interventions aimed at reducing persistent distress at survival.

The hidden sufferers: parental reactions to childhood cancer during treatment and at survival

This study was twofold: 1) to assess parental reactions to childhood cancer throughout the oncological experience and 2) to explore associations between parents’ reactions during treatment and cancer-related distress at survival. A cross-sectional descriptive study collecting data (at survival) from retrospective (perceived social support, optimism, distress, coping in the worst situation) and current variables (general stress, distress regarding cancer, benefit finding) was carried out. Forty-one parents of childhood cancer survivors were assessed. High levels of distress (M = 9.5, SD = 1.32, range 4-10) and self-reported efforts to overcome difficulties occurring during the hospitalization (M = 7.48, SD = 3.01, range 0-10) were found. However, parents received high social support from very different sources. This could explain the satisfactory levels of optimism found (43.9% of the sample, M ≥ 16, range 9 - 24). Most parents reported to use engagement (M = 2.57, SD = 0.41, range 1-4) and help-seeking (M = 2.52, SD = 0.53, range 1-4) coping strategies to overcome difficulties. Some parents recognized to use psychological defenses when coping with the distress of cancer. However, this disengagement style was less preferred (M = 1.62, SD = 0.37, range 1-4). Finally, 22% of parents reported positive consequences and 60% reported positive and negative consequences too. When exploring how treatment experiences can influence cancer-related distress in survivorship, we observed that those who received less social support used more disengagement coping and referred higher efforts to overcome difficulties during treatment, displayed persistent distress at survival. These same parents showed higher scores on general stress. Besides, these results were not influenced by child’s sequelae at survival. These findings support the hypothesis that 'the end of treatment is not the end'. Consequently, special attention should be placed in screening parents experiences throughout different milestones of cancer to design tailored interventions aimed at reducing persistent distress at survival (AU)

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¿Qué referencias espirituales verbalizan los pacientes atendidos por un equipo hospitalario de cuidados paliativos? / Which spiritual sentences are expressed by patients attending a palliative care unit?

OBJETIVO: Registro de las expresiones con contenido espiritual del paciente a través de sus verbalizaciones espontáneas mientras es atendido por un equipo de cuidados paliativos. Material y MÉTODO: Estudio prospectivo de registro textual de comentarios con referencias espirituales que los pacientes verbalizaron y que posteriormente se clasificaron en los diferentes dominios y necesidades espirituales. Pacientes atendidos por el equipo de cuidados paliativos entre noviembre de 2009 y mayo de 2010. Se recogieron datos sociodemográficos y datos clínicos como: ubicación del paciente, contenido del comentario/s, fecha del comentario, profesional al que se le transmite, género, edad y localización tumoral. RESULTADOS: Durante el periodo de estudio el equipo de cuidados paliativos atendió a 276 pacientes nuevos de los cuales 86 (31,2%) verbalizaron 119 comentarios espirituales y 102 necesidades espirituales. La localización tumoral más frecuente fue la de neoplasia de pulmón (16,2%). La edad media de la muestra fue de 68,8 años siendo el 58% hombres. El personal de enfermería fueron las profesionales que más comentarios espirituales identificaron (41,2%) y la interconsulta hospitalaria la ubicación donde más se registraron (48,8%). Con relación a los dominios espirituales, el 67,4% de los 86 pacientes expresaron al menos una verbalización que se incluía en el dominio intrapersonal, el 51,2% expresaron al menos un comentario referente al dominio interpersonal y el 19,8% de los pacientes lo hicieron dentro del dominio transpersonal. Del dominio intrapersonal se destacaba que un 41,8% de los pacientes que expresaron comentarios espirituales se referían a la desesperanza-deseos de morir. Respecto a las necesidades espirituales, los porcentajes más elevados correspondieron a la necesidad de volver a leer su vida (un 22% de los pacientes) y a la necesidad de encontrar sentido a la existencia y el devenir: la búsqueda de sentido (un 25,5% de los pacientes). CONCLUSIONES: En un tercio de los pacientes atendidos se detectaron expresiones con referencia espiritual. El porcentaje de pacientes que expresaron comentarios espirituales podría haber sido mayor si se hubiera diseñado un plan específico de intervención para evaluar y abordar las cuestiones espirituales

AIM: To record spiritual expressions made spontaneously by patients while attending a palliative care unit. MATERIAL AND METHOD: Prospective study registering all sentences made spontaneously by PATIENTS: Sentences were subsequently classified into different domains and spiritual needs by the palliative care professionals. Patients seen by the palliative care team between November 2009 and May 2010. Socio-demographic and clinical data such as: location of the patient, the content of the comment/s, date of the comment, professional that is transmitted, gender, age and tumor location were collected. RESULTS: During the study period the palliative care team attended 276 new patients, of whom 86 (31.2%) expressed 119 comments spiritual and 102 spiritual needs. Nurses were the professionals who identified more spiritual comments (41.2%) and the hospital consultation the location where most were recorded (48.8%). In relation to the spiritual domains, 93.7% of the 86 patients expressed expressions that were included in the domain of intrapersonal, 61.7% made reference to the interpersonal domain and 26.8% to the transpersonal. Within the intrapersonal domain highlighted that a 41.8% of the patients with spiritual comments referred to hopelessness- desire for hastened death. Respect to the spiritual needs the highest percentages corresponded to the need to lifetime re-examination (22% of patients) and the need to look for meaning to existence (25.5% of patients). CONCLUSIONS: Almost one third of patients expressed spiritual features. The percentage of patients who expressed spiritual comments could have been greater if a specific plan of action to assess and address the spiritual issues had been designed

Surviving cancer: The psychosocial outcomes of childhood cancer survivors and its correlates.

This study assessed the psychosocial outcomes of adolescent cancer survivors and their relationship with personal and socio-familiar factors. Using a cross-sectional design, 41 survivors answered the four psychosocial dimensions of the KIDSCREEN-52 questionnaire and measures for social support and coping. Similarly, 41 parents answered coping and cancer-related distress measures. All psychosocial scores were within normative values (50 ± 10). Multiple linear regression analyses revealed four models with a range of explained variance between 9.4 percent and 31.9 percent that include the informative and emotional support, parental distress, and coping. This study contributes to the understanding of psychosocial outcomes of childhood cancer survivors and its correlates.

Social support during childhood cancer treatment enhances quality of life at survival / El apoyo social durante el cáncer infantil favorece la calidad de vida en periodo de supervivencia

Introducción: La calidad de vida en relación a la salud (CVRS) en cáncer se ha relacionado con distintos factores de riesgo y protección tales como el apoyo social percibido (ASP) y el afrontamiento. Sin embargo, la investigación acerca de los efectos de dichos factores sobre la CVRS de supervivientes pediátricos sigue siendo no concluyente. Objetivo: Describir y explorar la relación entre CVRS en periodo de supervivencia y factores presentes durante el periodo de hospitalización (ASP y afrontamiento). Métodos: Diseño transversal. 41 supervivientes de cáncer infanto-juvenil respondieron medidas de CVRS en referencia al periodo actual de supervivencia, así como medidas de ASP y afrontamiento en relación al periodo de hospitalización. Resultados: La función discriminante obtenida logró clasificar correctamente al 78% de la muestra. Los supervivientes con mayores puntuaciones en CVRS, fueron aquellos que, en los peores momentos durante su hospitalización, percibieron un apoyo emocional satisfactorio (por parte del personal de enfermería) y no desplegaron un gran número de recursos de afrontamiento para hacer frente al evento estresante (sólo la estrategia de afrontamiento de acción social mostró relación estadísticamente significativa con CVRS). Conclusiones e implicaciones: Considerando estos resultados, parece adecuado el llevar a cabo intervenciones de tipo psicoeducativo destinadas a fortalecer la red de apoyo social, sobre todo por parte del personal sanitario (enfermería). Estos resultados ponen de manifiesto la importancia de considerar todas las oportunidades para abordar las necesidades emocionales de los pacientes durante su hospitalización, ya que se ha observado que esto puede tener un efecto positivo perdurable en periodo de supervivencia

Background: Health-related quality of life (HRQoL) in cancer has been related to several protective and risk factors such as perceived social support (PSS) and coping. However, their effects on HRQoL once patients are in survivorship have not been fully described in pediatric samples. Objective: To describe and explore the relationship between HRQoL in survivorship and some factors (PSS, coping) present while active treatment. Methods: Cross-sectional study. Forty-one pediatric cancer survivors answered HRQoL measures referred to survivorship, as well as PSS and coping measures referred to treatment period. Results: The discriminant function obtained succeeds to correctly classify 78% of the sample. Survivors who showed high HRQoL were those who, in the hardest moment while hospitalization, perceived satisfactory emotional support (from nurses) and did not deploy a wide range of active coping resources to cope with stressful events (only social action coping strategy showed a significant relationship with HRQoL). Conclusions and implications: Considering these outcomes, educational and counseling interventions to strengthen patients’ social networks and supportive relationships are recommended, specially, among health providers (nurses). These results highlight the importance of not overlooking opportunities to address the emotional needs of patients while hospitalization, since a positive and endurable effect has been observed at survivorship

Perceived positive and negative consequences after surviving cancer and their relation to quality of life.

Surviving childhood cancer has multiple implications on both physical and psychological domains of the individual. However, its study and possible effects on health-related quality of life (HRQoL) outcomes of adolescent survivors has been understudied. The objective of this study was twofold; to assess positive and negative cancer-related consequences (psychosocial and physical) in a sample of adolescent cancer survivors and to explore their relationship with HRQoL outcomes. Forty-one participants answered two questions about positive and negative consequences in the aftermath of cancer and filled in the KIDSCREEN-52 self-reported version. Data were analysed using mixed methods approach. Overall, 87.8% of the studied sample identified positive consequences and 63.4% negative consequences in survivorship. Four positive categories and five negative categories with regard to cancer-related consequences were found. Changed perspectives in life narratives seem to be the positive consequence more related to HRQoL (physical well-being, mood & emotions, autonomy, social support & peers), followed by useful life experience (physical well-being, autonomy, social support & peers). Psychological impact was the most referred negative consequence with a significant detrimental effect on social support and peers HRQoL dimension. Even if the majority of survivors reported benefit finding in the aftermath of cancer, concomitant positive and negative consequences have been found. However, findings only reveal a significant relationship between positive narratives and HRQoL, and negative consequences do not seem to have a significant influence on overall HRQoL in survivorship.

Making sense of resilience: A review from the field of paediatric psycho-oncology and a proposal of a model for its study / Explicando la resiliencia: una revisión desde la psico-oncología pediátrica y una propuesta de modelo para su estudio

The present article is intended to review the concept of resilience from the scope of pediatric psycho-oncology. The origin of resilience, its different definitions and its adequacy applied to serious physical illness such as cancer will be analyzed. Likewise, differences between resilience and other concepts commonly associated or confused with it such as posttraumatic growth or benefit finding will be discussed

En el presente artículo se pretende hacer una revisión del concepto de resiliencia desde el ámbito de la psico-oncología pediátrica. Se analizará su origen, sus distintas definiciones y adecuación de la misma aplicada al ámbito de las enfermedades físicas graves como el cáncer. También se tratará de diferenciar la resiliencia de otros conceptos como el crecimiento postraumático o el benefit finding, comúnmente asociados o confundidos con ésta. Por último, se plantea una propuesta de modelo integrador de resiliencia en cáncer infanto-juvenil