Kudos to PhD student Heeyeon Son and her sponsor, Director for the PhD in Nursing Program Sharron Docherty, for the submission of her American Cancer Society (ACS) application entitled: "Family Communication in Pediatric Palliative Care in Korea." This proposal requests funds for a two-year period with a start date of July 1, 2020.

In Korea, cancer is the third leading cause of death in adolescents and young adults (AYAs, aged 11-26 years) and the incidence of cancer is increasing (1, 2). AYAs are a significant, yet neglected population who have characteristics relevant to the cancer experience that are unique when compared to children and adults (3, 4). Family plays a critical role in managing AYAs' illnesses across the cancer trajectory (5-7). Across the diverse functions of family as a source of support for AYAs with cancer, the quality of communication is critical to maintaining psychological well-being (3, 8). Family communication refers to the ability of family members to openly and clearly share their thoughts and feelings with one another regarding stressful situations (8, 9). Therefore, family communication between AYAs with cancer and their parents is an important way to improve coping for these AYAs with cancer to relieve their physical and psychological distresses and burdens (3), which are intensified after receiving a diagnosis of cancer (10-12). However, most existing studies have focused on the negative effects of poor family communication rather than presenting positive outcomes from engaging in family communication. Thus, the main purpose of this study is to examine the relationship between family communication and use of courageous coping in Korean AYAs with cancer.

The specific aims of this study are to:

AIM 1: Determine the relationship between family communication and courageous coping in Korean AYAs with cancer, covarying for AYA age, self-reported gender, treatment status, and symptom distress. H1: Better family communication will predict greater courageous coping in Korean AYA with cancer, after adjusting for covariates.

AIM 2: Determine whether family cohesion mediates the relationship between family communication and courageous coping in Korean AYAs with cancer, covarying for AYA age, self-reported gender, treatment status, and symptom distress. H2: Better family communication increases family cohesion, which mediates the impact of family communication on courageous coping after adjusting for covariates.

AIM 3: Determine whether perceived uncertainty in illness and/or hope mediate the relationship between family cohesion and courageous coping in Korean AYAs with cancer, covarying for AYA age, self-reported gender, treatment status, and symptom distress. H3: Decreased uncertainty in illness and increased hope will mediate the impact of increased cohesion on courageous coping, after adjusting for covariates.