Date of Award


Degree Name

Doctor of Nursing Science

Dissertation Committee

Louise M. Rauckhorst, EdD, RN, Chair; Mary Jo Clark, PhD, RN; Geraldine V. Padilla, PhD


Cancer survivors, health-related quality of life, nursing, Oncology, resourcefulness, self-esteem, social support


Increased survival and advances in oncology research demand that health professionals attend to the gap in knowledge regarding health-related quality of life (HRQL) variables associated with the unique sequelae of cancer in the long-term (LT) cancer survivor. Research in this area may direct the development of effective interventions to increase the HRQL of LT cancer survivors. The study's purpose was to describe the relationships between self-esteem, learned resourcefulness, and social support to HRQL as well as their predictive value to HRQL for LT cancer survivors. A quantitative, descriptive, correlational, and noninterventional design was used to describe the relationship of self-esteem, learned resourcefulness, social support, and HRQL for LT cancer survivors. Data from six mail-back, self-report instruments were collected from a purposive sample of 456 eligible cancer survivors from two cancer data bases (24.3% response rate). Descriptive, correlational, and regression statistics were computed. Study findings revealed: (a)a strongly positive relationship between self-esteem and HRQL (r = .69, p value .00), (b)a moderately strong inverse relationship between learned resourcefulness and HRQL (r = -.32, p value .01), and (c)only the total loss component of social support had a statistically significant inverse relationship with HRQL (r = -.38; p value .00). Together self-esteem, learned resourcefulness, and the loss component of social support explained over half the variance (R2 =.53) of HRQL with self-esteem accounting for 52% of the predictive value. Study findings have implications for nursing research, education and practice. A major implication is the need for assessment and research designed to test interventions aimed at supporting and improving self-esteem for LT cancer survivors. Anticipating and buffering losses of social support may increase HRQL. A survivorship, age- and stage-appropriate (acute vs. long- term) knowledge base is needed for quality care of LT cancer survivors. Further research in this area may include: (a)study replication with a more diverse sample, (b)testing to refine the study's conceptual model, and (c)path analysis to test the study's conceptual framework or other frameworks related to the process of living as survivors. Lastly, a need exists for broader education about the unique, ongoing concerns of LT cancer survivors.

Document Type

Dissertation: Open Access



Included in

Nursing Commons