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Prof. Dr. Gabriela Topa
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Home > Archives > Vol. 11 No. 1 (2026): Publishing > Research Articles
ESP-4268

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2026-01-26

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Vol. 11 No. 1 (2026): Publishing

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Research Articles

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Copyright (c) 2026 Xiao Liu, Paramjit Singh Jamir Singh

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Xiao Liu, & Paramjit Singh Jamir Singh. (2026). Environmental determinants of family resilience in pediatric leukemia: A longitudinal mixed-methods study . Environment and Social Psychology, 11(1), ESP-4268. https://doi.org/10.59429/esp.v11i1.4268
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Environmental determinants of family resilience in pediatric leukemia: A longitudinal mixed-methods study

Xiao Liu

Department of Social Work, School of Social Sciences, Universiti Sains Malaysia, Minden, Penang, 11800, Malaysia; Dongfang College, Shandong University of Finance and Economics, Taian, Shandong, 271000, China

Paramjit Singh Jamir Singh

Department of Social Work, School of Social Sciences, Universiti Sains Malaysia, Minden, Penang, 11800, Malaysia


DOI: https://doi.org/10.59429/esp.v11i1.4268


Keywords: childhood leukemia; family resilience; environmental factors; psychosocial adaptation; mixed-methods research; ecological systems theory


Abstract

This study explores from the perspective of the social ecosystem how multi-level environmental factors shape the psychosocial adaptation process of families with children diagnosed with leukemia in China. Employing a longitudinal mixed-methods design, the study utilized tracking data from the China Family Panel Studies (CFPS) from 2014 to 2020, including 187 observation points from 58 families. The analysis integrated narrative analysis, thematic analysis, and growth curve modeling to examine family adaptation trajectories and their environmental determinants. The results identified three environment-driven adaptation trajectories: rapid recovery type (28.1%), gradual adaptation type (51.7%), and persistent predicament type (20.2%). Medical insurance type emerged as the strongest environmental predictor, explaining 31.5% of the variance in depression trajectories (β=-3.45, p<0.001), with families covered by employee medical insurance demonstrating psychological recovery speeds 2.3 times faster than those under the New Rural Cooperative Medical Scheme. Environmental factors collectively explained 67% of the variance in family adaptation outcomes, revealing the systematic effects of medical environment, policy environment, community environment, and cultural environment. The research integrates Bronfenbrenner's ecosystem theory with Walsh's family resilience model to construct an integrated framework of "Family Resilience in the Environment." The findings indicate that unequal distribution of environmental resources is the fundamental cause of family adaptation differentiation. Multi-level environmental interventions are urgently needed to promote psychosocial adaptation and health equity for families affected by childhood leukemia, including increasing medical insurance reimbursement rates, optimizing the medical environment, building community support networks, and promoting cultural de-stigmatization.


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