"Defining a new normal": An exploration of psychosocial adjustment in young adult survivors of adolescent cancer
Psycho-oncology has been limited by inconsistent definitions of adjustment, leading to inconsistent information about the correlates of adjustment among adult survivors of pediatric cancer. Further, adolescent survivors are seldom broken out for special analysis, even though there are vast medical and developmental differences between those diagnosed during adolescence and those diagnosed at a younger age. The current study utilized a mixed method approach examine adjustment with 7 female and 5 male survivors of cancer who were diagnosed during adolescence. Thematic analysis revealed that adjustment is the process of changing one's perspective or redefining oneself as one works to determine a role for cancer in one's life. Using the Stress Illness Vulnerability Model (Kornblith, 1998) as a guiding framework, the current study found that concerns about uncertainty and physical functioning, along with developmental challenges, served as the key stressors facing survivors. The presence or absence of social support, individual characteristics (i.e., optimism, coping), positive relationships with the medical system, economic resources, and concurrent stressors were some of the most salient factors for survivors when thinking about adjustment. Additionally, psychosocial interventions could interact with any of these mediating variables to ameliorate the stressors associated with the cancer experience. Developmental differences in the experience of cancer also emerged, with those diagnosed during later adolescence being more likely to report challenges with intimate relationships, infertility, and college/graduation, while survivors diagnosed at a younger age were more likely to report accessibility of the school environment, conflict with parents, and difficulties developing a sense of social and psychological self as additional sources of stress. Gender differences in the experience of cancer also emerged, with women reporting additional challenges and different coping strategies. Quantitatively, those diagnosed at a younger age and males scored higher on purpose in life measures and measures of psychosocial functioning. Results from the current study suggest that the Stress Illness Vulnerability Model be expanded to recognize the developmental challenges that interact with the cancer experience. Implications for future research and programming are discussed. ^
Kristen J Quinlan,
""Defining a new normal": An exploration of psychosocial adjustment in young adult survivors of adolescent cancer"
Dissertations and Master's Theses (Campus Access).