الفهرس 
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Abstract
Childhood leukemia affect the psychological wellbeing of the parents, as parents face psychological, physical, social and financial challenges as the result of diagnosing their child. Hence, resilience involves the characteristics of self-efficacy, ability to recover from traumatic stress that enables parents to adapt to the adversity and overcome these challenges. Parents who show resilience enhance their psychological wellbeing, which psychological wellbeing is the pleasant feelings, satisfaction with life and the optimum performance in individual and social life, in spite of the diagnosis of their child with leukemia.
Aim of the study:
This study aimed at assessing resilience and psychological wellbeing among parents of child with leukemia through answering the following question:
1. What are levels of resilience among parents of child with leukemia?
2. To what extent having child with leukemia affecting the psychological wellbeing of parents?
Research design:
A descriptive design was utilized in this study.
Research setting:
The study was conducted in children’s cancer hospital in Egypt 57357 at the inpatient wards.
Subjects of the study:
The sample of present study included 93 parents of child with leukemia who agreed to participate in the study and fulfilled the following criteria:
Inclusion criteria for child with leukemia:
1- Age of child is between 1 to 18years old.
2- Sex: Both sexes (males and females).
3- Child diagnosed with leukemia at least from one month.
Inclusion criteria for parents of child with leukemia
1. Primary caregiver.
2. Stay with the child in the same household.
3. Age of parents is between 25 to 50 years old.
4. Caring for child with leukemia at least six months.
Exclusion criteria for parents of child with leukemia:
1. Have another person in the family diagnosed with chronic illness.
2. Have psychological disorder.
Tools of data collection:
1- Interviewing Socio-demographic questionnaire consisted of two parts (Appendix I)
It was designed by the researcher, based on reviewing related literatures, written in Arabic language to assess all the related socio-demographic characteristics of parents caring for child with leukemia and socio-demographic characteristics of child with leukemia.
a- First part (Socio Demographic data for parents):
This part includes socio demographic characteristics of parents of child with leukemia such as:
name, sex, age, place of residence, marital status, educational level, income per month, number of children, having an assistant in child care, the job, number of hours of care provided to the child, child psychosocial needs, activities that increase the ability of parents to care for their child.
b- Second part (Socio demographic data of the child):
This part includes socio demographic characteristics of child with leukemia such as:
Name, sex, age, age at detection of the disease, period of treatment of disease, ranking of child between siblings, presence of physical or psychological disorders, preferred activities for the child.
2- Connor-Davidson Resilience scale (Appendix II)
The scale was originally developed by Connor-Davidson (2003) and adapted by the researcher to assess resilience among parents of child with leukemia. The scale consisted of 25 items classified into 5 sections:
1- Personnel competence (8 questions).
2- Tolerance of negative effects and strengthening against stress (7 questions).
3- Positive acceptance of change (5 questions).
4- Self-control (3 questions).
5- Spiritual influence (2 questions).
Scoring system:
Each item was rated on a five point on Likert scale ranged from 1-5. The answers of each question converted to numerical data.
3- Ryff’s Psychological Wellbeing Scale (Appendix IV):
The scale was originally developed by Ryff (1989) and adapted by the researcher to assess psychological wellbeing among parents of child with leukemia. The scale consisted of 42 items which classified into six subscales including: autonomy, environmental mastery, personal growth, positive relations with others, self-acceptance and purpose in life. Each subscale consisted of seven items.
Scoring system:
Each item was rated on six point Likert scale ranged from (1-6). The answer of each question converted to numerical data.
The study findings were as follows:
• The highest proportion of parents caregivers were housewives mothers in age group 25 ˂ 30, (79.6%) were married, and (59.1%) of parents were resident in urban area. Concerning to level of education, (33.3%) of them studied at universities, (67.7%) hadn’t enough monthly income.
• The highest proportion of the psychological needs for the child from parent’s perspective was staying with him most of the time.
• The great proportion of child with leukemia in the study was males, in age less than five years and they were the youngest children between their siblings.
• As regard with resilience the highest proportion of parents were perceived that their previous successes increase their ability to challenge their child’s disease were rarely true for them, meanwhile half of parents will do their best to treat the child regardless of the result as regard tolerance of negative effects and strengthening against stress.
• Concerning to resilience half of parents were seeing the positive side of things was rarely true for them. Meanwhile, one quarter of them mentioned that they try to recover psychologically after their child’s illness was true nearly all of the time in response to the positive acceptance of change. About half of parents were perceived that they have a goal in life and they were trying to achieve it was rarely true for them. Parents believed that god help them is true all the time with percentage (45.2%).
• Parents had low level of personal competence, positive acceptance of change& self-control. They represent (50.5%), (47.3%) & (48.4%) respectively. Meanwhile, they had high level (47.3%) concerning spiritual influence. Finally, (57.0%) of parents had moderate level regard tolerance of negative effects and strengthening against stress.
• Half of parents with percentage (50.5%) had moderate level of resilience.
• There was significance between level of resilience and socio-demographic characteristics among parents of child with leukemia regarding monthly income & number of hours for caring the child.
• Concerning autonomy the highest percent of parents (39.8%) were slightly disagreed that they do not care what others think about them. Meanwhile, (43.0%) of parents slightly disagreed that they find it easy to arrange their life in a satisfactory way for them as regard to environmental mastery.
• Regarding personal growth, (33.3%) of parents strongly disagreed that they lived an ideal life even with the conditions of their child’s illness, (40.9%) & (35.5%) disagreed that they prefer new situations that require them to change their usual ways of doing things & they were interested in activities that suit their needs respectively. About positive relations sub items, (36.6%) of parents slightly disagreed that they had many friends who help them solve their problems.
• Regarding psychological wellbeing the highest proportion of parents slightly disagreed that they know their direction and purpose in life & they have more to achieve in life as regard to purpose in life sub items. About self-acceptance sub items (39.8%) & (37.6%) of parents slightly disagreed that they feel satisfied about what they got in their lives & they feel confident and positive about themselves.
• The highest proportion of parents had low level regard components of psychological wellbeing.
• Half of parents with percent had moderate level of psychological wellbeing.
• There was no statistical significant association between psychological wellbeing of parents with leukemic child and their socio-demographic characteristics at P-value > 0.05.
• Level of resilience among parents of child with leukemia is positively highly correlated with their level of psychological wellbeing.
In conclusion, the current study concluded that the highest proportion of parents caregivers have moderate level of resilience and psychological wellbeing. There was a significant relation between resilience and psychological wellbeing among parents of child with leukemia. There was a positive highly statistical significant association between resilience and psychological wellbeing sub items among parents of child with leukemia at P-value < 0.001.
Based upon the results of the present study, the following recommendations were suggested:
1. Development of stress management and resilience training programs to decrease stress and enhance resilience among parents of child with leukemia.
2. Assessing the factors that influencing resilience among parents of child with cancer.
3. Establishment of counseling clinic to enhance resilience among parents of child with leukemia.
4. Future research to assess burdens, resilience and psychological wellbeing among parents of a child with leukemia in the hospice care.