To foster healing among adolescents and young adults with cancer: what helps? What hurts?

ABSTRACT

PURPOSE: The physical and emotional well-being of adolescents and young adults with cancer (AYA) rests on the ability of all concerned to promote helpful forms of care and reduce hurtful forms. The purpose of this study was to identify aspects of behavior that may promote or inhibit healthy psychosocial adjustment for this age-defined population. METHOD: Seventeen young adult cancer survivors participated in focus groups to discuss what people said or did that they found helpful or hurtful. Inductive and deductive techniques of coding and analysis of these qualitative data were performed. RESULTS: Survivors reported being the recipients of positive and negative communications and behaviors of an informational, practical, interpersonal, and/or emotional character. Most common were comments and actions in the interpersonal realm. More helpful than hurtful comments were reported, except in the informational category, where the "bad news" about cancer and the style of information-sharing created hurt. CONCLUSION: How people communicate information, tasks, and feelings to AYA patients and survivors affects how they experience their illness and think about themselves and their current and future situations. All parties-doctors, other medical providers, family members, and friends-need to attend to the manner as well as content of their communications and interactions with AYAs and to the social and emotional context within which communication and interaction occurs. Specific recommendations for the care of AYA cancer patients are offered, emphasizing the importance of attending to the cognitive capabilities and unique developmental challenges associated with adolescence and young adulthood.