A qualitative study of adolescent cancer survivors perspectives on social support from healthy peers – A RESPECT study

• Published in: Journal of advanced nursing Vol. 77; no. 4; pp. 1911 - 1920
• Main Authors: Ingersgaard, Marianne Vie, Fridh, Martin Kaj, Thorsteinsson, Troels, Adamsen, Lis, Schmiegelow, Kjeld, Bækgaard Larsen, Hanne
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-04-2021
• Subjects: Activities of daily living; Adolescents; Belonging; Cancer; Classmates; Coping; Friendship; Hospitalized; Identity; Intervention; Liaison; Loneliness; Medical diagnosis; Normalization; Nursing; paediatric; Pediatrics; Peers; Physical activity; Power; psychosocial aspects; Psychosocial factors; qualitative; Qualitative research; Rehabilitation; school; Side effects; Social interaction; Social isolation; Social support; Socialization; Survivor; survivorship; Teenagers; social support; survivorship; psychosocial aspects; adolescents; qualitative; school; peers; social interaction; cancer; nursing; paediatric
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/jan.14732

Background
Adolescents’ psychosocial development is generally influenced by their peers. Those facing hospital‐based cancer treatment are particularly challenged as they are isolated from their social network and lack sufficient coping resources.
Aim
This study explores the adolescent cancer survivor's perceptions and experiences with healthy classmate socialization support efforts via hospital co‐admittance, from diagnosis to reinstatement in school, as an intervention of the RESPECT (REhabilitation including Social and Physical Activity and Education in Children and Teenagers with cancer) Study.
Design
A phenomenological, descriptive study.
Methods
Using variation sampling, 14 adolescents (aged 14–19), who completed the RESPECT intervention (April 2016–July 2017), participated in qualitative, in‐depth, semi‐structured interviews that were thematically analysed.
Findings
Four themes emerged: (a) Ambassadors as liaison persons; (b) Ambassadors as promoters of normalization and identity continuity; (c) Ambassadors as ‘behind the scenes’ friends; and (d) feelings of vulnerability and inferiority. Ambassadors reinstated a sense of normalcy in the adolescents’ daily life. They supported identity construction and served as liaison persons who buffered loneliness and social isolation as well as bridging a continued sense of belonging to one's school peer network. In contrast with other peers, ambassadors understood cancer‐related issues, knowledge which they partially gained witnessing the impact of treatment‐related side effects on their hospitalized classmates. However, the consequence of this trade‐off was an asymmetry in their relationship, with the adolescents requiring a certain level of safeguard from their ambassadors to maintain equal power in the relationship.
Conclusion
The ambassadors enhanced the adolescents’ ability to cope with their altered social position during treatment and to psychosocially reinstate it on their return to school.
Impact
Future interventions should offer opportunities for healthy peers to be educated in what it means to live with cancer. Future programs to sustain socialization in adolescents with cancer should involve healthy peers for the entirety of the treatment period.
摘要
背景
通常而言, 青少年的社会心理发展会受到同龄人的影响。医院内部接受抗癌治疗的患者面临高度挑战, 原因在于, 其远离社交网络, 应对资源不足。
目的
本研究探讨青少年癌症生还者从诊断到复学的过程中, 透过同期入院的健康同学提供的社会化支持而获得的认知与经验, 并将此作为癌症儿童和青少年的康复, 包括社交、体育活动及教育 (RESPECT) 研究的一项干预措施。
设计
一项现象学及描述性研究。
方法
变异抽样, 筛选14名完成RESPECT干预 (2016年4月‐2017年7月) 的青少年 (14‐19岁) 参与定性、深入、半结构化访谈, 并进行主题分析。
调查结果
共产生四大主题: (a) 大使作为联系人; (b) 大使作为生活常态恢复和身份持续性的推动者; (c) 大使作为“幕后”友人; 以及 (d) 脆弱和自卑感。大使确保青少年日常生活恢复常态。其支持身份建构, 充当联系人, 为孤独感和社会孤立感的来袭提供缓冲, 并建立对校园内同龄人的持续归属感。相比其他同龄人, 大使更了解癌症相关问题, 并目睹治疗相关副作用对住院同学的影响。然而, 这种权衡致使关系不对等, 青少年需要大使给与一定程度的保护, 以便维持平等关系。
结论
大使提高了青少年在治疗期间应对社会地位改变的能力, 并在其重返学校后对其心理社会地位进行恢复。
影响
未来, 应采取干预措施, 以便为健康同龄人提供机会, 帮助其了解癌症意味着什么。应维持执行癌症青少年社会化的项目, 且该项目应涵盖整个治疗过程中的健康同龄人。