Hebah A. Almulla, PhD, RN, is Assistant Professor, Imam Abdulrahman Bin Faisal University, College of Nursing, Dammam, Saudi Arabia.

Frances Marcus Lewis, PhD, RN, FAAN, is Professor, University of Washington School of Nursing, Seattle; and Public Health Sciences and Clinical Research Divisions, Fred Hutchinson Cancer Research, Seattle, Washington.

Monica L. Oxford, PhD, MSW, is Research Professor, University of Washington School of Nursing, Seattle.

Accepted for publication March 17, 2023.

The authors acknowledge the contributions of Min Li, PhD, for her statistical advice and Kristin A. Griffith, MS, for her help with data preparation. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01-CA-78424 (Lewis, PI), the Oncology Nursing Society Foundation Research Doctoral Scholarship, and an Imam Abdulrahman bin Faisal University Scholarship through the Saudi Arabian Cultural Mission. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

This study was approved by the institutional review board (File #99-2050-C). Informed consent and assent were obtained in writing from the participants.

This study conducted a secondary data analysis using a sample from a completed clinical trial (PI: Frances M. Lewis, Professor, Family and Child Nursing, University of Washington; ClinicalTrials.gov identifier: NCT00194571, other study ID numbers: 16636-C, trial number: 1R01CA078424-01A1, date of registration: September 19, 2005; https://clinicaltrials.gov/ct2/show/NCT00194571).

The authors have no conflicts of interest to disclose.

Corresponding author: Hebah A. Almulla, PhD, RN, Department of Fundamentals of Nursing, College of Nursing, Imam Abdulrahman Bin Faisal University, King Faisal Street, Dammam 34221, Saudi Arabia (e-mail: [email protected]).

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