Social functioning among young adult cancer survivors upon transition from active treatment to survivorship care

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2018-05

Authors

Walsh, Casey Anne

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Abstract

During the transition process from active treatment to survivorship care young adult cancer survivors are facing the opportunities and challenges of social reintegration as they manage ongoing treatment effects. This study explores the social functioning of young adult cancer survivors during this critical transition process. Qualitative interviews were conducted with study participants (N=13; ages 17-25 at the time of cancer diagnosis) within approximately 6 months of the completion of active treatment and 3 months later. Participants completed supplemental self-report measures of social functioning at both time points. Applied thematic analysis was used to identify themes from participant interviews. Six key themes and twelve sub-themes emerged regarding participant interactions with their support system (“Being there”, “Staying strong”, & “Treat me the same”) and healthcare team (“Connection and relationship building” & “Seeking knowledge and engaging in advocacy”), as well as treatment effects (“Uncertainty, Loss, & Changes in Identity” & “Ups & Downs of Physical Symptoms”), coping strategies (“Keep busy” & “Keep a positive vibe”), support resources (“Support needs change over time”), and post-treatment experiences (“Trying new things to cope with losses” and “Managing expectations with realities”). On the supplemental self-report measures of social functioning, three participants (25% of the study sample (n=12) who completed questionnaires at both time points) experienced mild or moderate impairment in multiple domains of social functioning. There were no statistically significant differences between groups in participant T-scores at Time One and Time Two on any of the measures. Study participants often experienced reduced self-efficacy for managing social interactions during the transition from active treatment to survivorship care. Study participants who experienced more severe physical treatment effects, who had unaddressed mental health needs, and who were younger at the time of cancer diagnosis experienced more impairment in social functioning post-treatment. Findings from this study support screening for the social functioning of AYAs early and often in the care trajectory to identify patients who may need additional support and to provide referrals to age-appropriate resources as needed. Opportunities for AYAs to stay involved socially and professionally should be fostered throughout treatment and beyond

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