Family communication and courageous coping in Korean adolescents and young adults: a cross-sectional study.

Objective: Adolescents and young adults (AYAs) with cancer are a vulnerable population during a critical developmental transition that can benefit from the adoption of courageous coping. Parental support is crucial in enhancing adjustment and coping skills. The linkage between parent-adolescent communication (PAC) and the use of courageous coping (UCC), however, remains unclear. This study examined the association between PAC and UCC and possible mediators of this relationship among Korean AYAs with cancer.

Methods: In this cross-sectional, correlational study, self-report data were collected from 144 AYAs aged 11-26 years. A path analytic approach was employed using a hierarchical regression model to test for the direct relationship between PAC and UCC and the indirect effects of a proposed primary mediator (family cohesion) and two intermediary mediators (uncertainty of illness, hope) on PAC-UCC relationship.

Results: The mean age of the sample was 17 years (SD = 3.8), with 42% currently receiving cancer treatment. Greater PAC was significantly associated with increased UCC (mother figure: p = .0024, father figure: p  = .0042). Increased family cohesion significantly mediated the PAC-UCC relationship, indicated by a diminished PAC-UCC relationship after controlling for family cohesion (mother: p = .2753; father: p = .8107). Mediated mediation models indicated that increased hope stemming from decreased uncertainty was the mechanism through which family cohesion impacted the PAC-UCC relationship.

Conclusions: Findings underscore that greater PAC can facilitate UCC among Korean AYAs with cancer and provide insights for therapeutic parent-child communication. Results further demonstrate the complex mediating role of fostering family cohesion, reducing uncertainty, and fostering hope can play in the PAC-UCC relationship.