Investigating the psychosocial outcomes of young adult survivors of childhood and adolescent cancer

Abstract

While several studies report survivors of childhood and adolescent cancer to have affected outcomes in areas such as health-related quality of life, psychological health, education, employment and relationships, other studies report positive findings. Inconsistencies in the measures and methods used across studies hinder our ability to draw conclusions from the research and there is also a lack of measures which are designed specifically to capture the concerns of these survivors. In addition, survivors' subjective perceptions have been identified as potentially crucial risk factors for poorer psychosocial outcomes, but receive less attention than traditional risk factors involving disease and demographics. The research for this thesis employed a mixed methods design, in the form of an exploratory sequential design, with the purpose of providing a comprehensive investigation of the psychosocial outcomes of young adult survivors of childhood and adolescent cancer. The first study aimed to qualitatively explore survivors' own perceptions of the impact of cancer and the influence it has had on their lives. The second study aimed to quantitatively investigate the outcomes and concepts identified in the qualitative study, and in a review of the literature, in a larger sample of survivors. In both studies, the survivors own views, experiences and concerns were of central importance. Overall, survivors reported high levels of achievement and functioning. However, it was evident that a minority of survivors may benefit from further support and information with regards to fertility, education, employment, concerns about the impact of cancer and future health. Results of the questionnaire study indicate that survivors' views, as assessed by the Impact of Cancer for Childhood Cancer Survivors scale, may be associated with health-related quality of life and distress outcomes. Results suggest that overall the mixed methods study enabled a comprehensive investigation of psychosocial outcomes. The research indicates that health professionals should monitor the psychosocial health of even long-term survivors of childhood and adolescent cancer.