{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:47:44Z","timestamp":1782712064289,"version":"3.54.5"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pediatric malignant bone tumors impose substantial physical and psychosocial burdens that may compromise health-related quality of life (HRQOL) for both children and caregivers. Family resilience may be protective, yet dyadic evidence in pediatric bone tumor care remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted at Shanghai General Hospital between May 2023 and July 2024. A total of 134 pediatric patients with malignant bone tumors and their primary caregivers were recruited. Family resilience was assessed using the Chinese version of the Family Resilience Assessment Scale (FRAS). Child health-related quality of life (HRQOL) was assessed using the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module (child self-report and caregiver proxy-report). Demographic and clinical data were collected from medical records and caregiver reports. Statistical analyses included descriptive statistics, Pearson correlations, and multilevel linear modeling in an Actor\u2013Partner Interdependence Model (APIM) framework, performed using IBM SPSS Statistics version 21.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Child HRQOL self-reports were available for 95 children, and caregiver proxy-reports were available for all children (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f134). Family resilience was positively correlated with child self-reported HRQOL (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.661,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and caregiver proxy-reported child HRQOL (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.615,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and child self-reported and caregiver proxy-reported HRQOL were highly correlated among paired cases (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.899,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001;\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f95). In adjusted multilevel models, family resilience predicted higher child HRQOL in both the self-report model (\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f0.646,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001;\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f95) and the proxy-report model (\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f0.627,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001;\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f134).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Family resilience was independently associated with HRQOL in pediatric malignant bone tumor dyads. Given the cross-sectional design, causality cannot be inferred; however, family resilience may represent a clinically relevant psychosocial correlate of HRQOL and a potential focus for supportive care. Longitudinal and interventional studies are warranted to clarify directionality and evaluate resilience-oriented supportive approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1720767","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:38:55Z","timestamp":1782711535000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Family resilience and health-related quality of life in children with malignant bone tumors: implications for pediatric oncology nursing"],"prefix":"10.3389","volume":"17","author":[{"given":"Wei","family":"Dai","sequence":"first","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Shanghai Jiao Tong University School of Nursing","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuqing","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixuan","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka Yan","family":"Ho","sequence":"additional","affiliation":[{"name":"The Hong Kong Polytechnic University","place":["Hong Kong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Shanghai Jiao Tong University School of Nursing","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"258","DOI":"10.30476\/IJCBNM.2019.73893.0","article-title":"Caregiver burden and its associated factors in caregivers of children and adolescents with chronic conditions","volume":"7","author":"Adib-Hajbaghery","year":"2019","journal-title":"Int J Community Based Nurs Midwifery."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"46","DOI":"10.33545\/comed.2025.v8.i1.A.370","article-title":"The role of family support in enhancing adherence and management in adolescents with type 1 diabetes: a review article","volume":"8","author":"Alshehri","year":"2025","journal-title":"Int. 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