Findings on how adolescents cope with cancer--a matter of methodology?

Integrative Literature Review on Psychological Distress and Coping Strategies Among Survivors of Adolescent Cancer

PROBLEM IDENTIFICATION

Cancer survivors, particularly those diagnosed in adolescence, are faced with physical, mental, and emotional stressors associated with the disease and its treatment. These stressors add to the demand placed on survivors' already taxed coping skills. This article reviews the literature on psychological distress experienced by survivors diagnosed with cancer during adolescence and the coping strategies they employed.

LITERATURE SEARCH

Three electronic databases (CINAHL®, PsycINFO®, PubMed®) were searched, and 19 studies were selected. Garrard's matrix method guided this integrative review.

DATA EVALUATION

Gough's weight of evidence framework was used to evaluate each study.

SYNTHESIS

Analysis revealed important findings about the types of coping strategies used by adolescents during and after cancer treatment and the impact of each on levels of psychological distress.

IMPLICATIONS FOR PRACTICE

Healthcare providers, who regularly assess for negative thoughts and unmet needs among survivors, may identify symptoms of psychological distress, intervene early, and facilitate better outcomes for their patients. Patient-centered interventions aimed at coping with psychological distress are most helpful.

Supporting the psychological needs of teenagers and young adults during cancer treatment: a literature review

BACKGROUND

The developmental period of the teenage years and young adulthood can be a challenging time for most. Experiencing a diagnosis of cancer during this time inevitably presents further challenges and concerns. Identifying such issues can help to provide better ways of understanding the patients' experience and their needs, offering nurses insight to enhance care and support for teenagers and young adults (TYAs) undergoing cancer treatments.

AIM

To explore the literature regarding the psychological issues faced by TYAs during cancer treatment to inform nursing practice.

METHOD

A systematic search of electronic databases was conducted using predetermined search terms which yielded relevant articles. Applying an inclusion and exclusion criteria identified six articles that were deemed appropriate to explore the focus question.

RESULTS

A thematic analysis identified three main themes and five sub-themes: anxieties about treatment, concerns regarding the impact on life (feeling restricted and different, the benefits of being sick, facing uncertainty) and coping strategies (positive thinking and problem solving, support).

CONCLUSION

Teenagers and young adults face a unique set of psychological concerns and challenges during cancer treatment, resulting in the development of specific coping strategies. These strategies should be promoted by nurses, ensuring patients are supported throughout their cancer journey.

Children and adolescents coping with cancer: self- and parent reports of coping and anxiety/depression

OBJECTIVE

The diagnosis and treatment of cancer present children and adolescents with significant stress. However, research on the ways that children and adolescents cope with cancer-related stress has not yielded clear findings on the efficacy of different coping strategies, and has been limited by reliance primarily on self-reports of both coping and distress. To address this gap, the current study used a control-based model of coping to examine self- and parent reports of child/adolescent coping and symptoms of anxiety and depression in a sample of children with cancer.

METHOD

Children and adolescents (5 to 17 years old) and their parents were recruited near the time of a child's diagnosis or relapse of cancer (M = 1.30 months postdiagnosis). Child self-reports (n = 153), mother reports (n = 297), and father reports (n = 161) of children's coping and symptoms of anxiety/depression were obtained.

RESULTS

Bivariate correlations revealed significant associations for secondary control coping (efforts to adapt to source of stress; e.g., acceptance, cognitive reappraisal) and disengagement coping (e.g., avoidance, denial) with anxiety/depression within and across informants. Linear multiple regression analyses indicated that secondary control coping accounted for unique variance in symptoms of anxiety/depression both within and across informants.

CONCLUSIONS

Secondary control coping appears important for children and adolescents during early phases of treatment for cancer, and it may serve as an important target for future interventions to enhance adjustment in these children.

Cancer during adolescence: negative and positive consequences reported three and four years after diagnosis

Persons diagnosed with cancer during adolescence have reported negative and positive cancer-related consequences two years after diagnosis. The overall aim was to longitudinally describe negative and positive cancer-related consequences reported by the same persons three and four years after diagnosis. A secondary aim was to explore whether reports of using vs. not using certain coping strategies shortly after diagnosis are related to reporting or not reporting certain consequences four years after diagnosis. Thirty-two participants answered questions about coping strategies shortly after diagnosis and negative and positive consequences three and four years after diagnosis. Answers about consequences were analysed with content analysis, potential relations between coping strategies and consequences were analysed by Fisher's exact test. The great majority reported negative and positive consequences three and four years after diagnosis and the findings indicate stability over time with regard to perceived consequences during the extended phase of survival. Findings reveal a potential relation between seeking information shortly after diagnosis and reporting a more positive view of life four years after diagnosis and not using fighting spirit shortly after diagnosis and not reporting good self-esteem and good relations four years after diagnosis. It is concluded that concomitant negative and positive cancer-related consequences appear stable over time in the extended phase of survival and that dialectical forces of negative and positive as well as distress and growth often go hand-in-hand after a trauma such as cancer during adolescence.