Beyond Resilience to Human Flourishing

The ANS article we are currently featuring is titled “Beyond Resilience: A Concept Analysis of Human Flourishing in Adolescents and Young Adults With Cancer” authored by Eunji Cho, MSN, RN and Sharron L. Docherty, PhD, PNP, FAAN. While the article is featured you can download and read it at no cost, and we invite you to return here to share your comments and questions. This is the message that Ms. Cho sent about this work:

This paper is a part of my doctoral dissertation about human flourishing in adolescents and young adults (AYAs) with cancer, exploring positive growth and the maximum potential of young cancer survivors who were diagnosed with cancer during adolescence. Being diagnosed with cancer during adolescence is a life-challenging experience. AYAs with cancer confront the unique developmental tasks of their age groups while dealing with a range of challenges related to cancer and its treatment. Despite the unexpected, challenging impact of cancer, a unique cohort of AYAs with cancer has shown exceptionally positive growth across the turbulent period of cancer treatment and entry into survivorship. This small group of AYAs shows the ability to move beyond the period of distress and suffering to emerge and live a high-quality life. They find meaning in their cancer experience, perceive the world positively, and use adversity as an opportunity to improve relationships with others and to aid others in suffering. Understanding these positive outliers may inform how healthcare professionals can provide adequate, age-appropriate care for this vulnerable population that is so full of potential.

Our study examines the unique attributes of those special AYAs with cancer and their maximum favorable growth and development by applying a developing concept, human flourishing. Human flourishing, a life-long process to achieve “uniqueness, dignity, diversity, freedom, happiness, and holistic well-being of the individual” (National League for Nursing, 2014, p. 1), can work as an excellent target for healthcare that addresses the unique needs of this population. However, the concept of human flourishing has received scant attention in the field of pediatric and young adult oncology, and has been applied in a very limited fashion to AYAs with cancer. The primary aim of this study is to conduct an evolutionary concept analysis to describe the history and current usage of human flourishing in various disciplines, and analyze human flourishing and its related concepts in the AYA oncology literature.
We present three antecedents (i.e., the situational conditions that precede the concept); seven attributes (i.e., the critical characteristics of the concept); and three consequences (i.e., the outcomes, conditions, or situations that follow the concept). The figure below  shows a metaphor of an apple tree, describing the characteristics of human flourishing in this population.

In this study, we can describe human flourishing in AYAs with cancer as the highest positive state that AYAs can attain, and also a continuous, life-long, self-driven process and methods for reaching this heightened state. As human flourishing is a process that continues throughout life, the consequences can become antecedents as well as attributes of human flourishing in the ongoing process. The individual characteristics and resources that have been fortified during an AYA’s past encounter triggering events such as cancer diagnosis. The direct and indirect experiences associated with cancer diagnosis and treatment during the unique developmental period create a strong foundation and new opportunities for growth. By achieving positive intrapersonal changes and interacting and engaging with others or with the external environment, a flourishing AYA positively influences others (and even trigger flourishing in others), lives a truly owned life, and achieves ongoing harmonious development with their environment.

National League for Nursing (2014) claimed that nurses can guide individuals’ journey of self-actualization and fulfillment and help them to recover or develop pathways to human flourishing by providing individualized, holistic, culturally tailored, relationship-focused care. It is evident that this concept can be applied as a health care goal for a range of populations with health care challenges, including AYAs with cancer. Our next studies will focus on further exploration of human flourishing in this population and develop various methods to apply this concept to nursing practice, education, and policy.