With survival rates increasing dramatically in pediatric cancer, concern has increasingly focused on the psychosocial aspects of the cancer experience. Clearly, the experience of a cancer diagnosis and treatment of cancer places high demands on the coping of adolescents. Research has shown social support to be effective in decreasing stress and enhancing coping in adolescents facing such demands. A review and critical analysis of studies of social support in adolescent cancer survivors was conducted. The seventeen studies were mainly descriptive and exploratory in nature with social support examined for a number of outcome variables in eight of the studies. Findings from this review indicate that support from parents (especially the mother) and friends were extremely important and that the adolescents were satisfied with family support. Support from friends was described as less satisfactory. Methodological concerns of the reviewed studies include small samples and a lack of consistency in the instruments used to assess social support. Future studies of social support for adolescent cancer survivors should include larger samples to determine gender, age group, and ethnic differences and to allow the examination of social support theoretical models specific to the developmental and chronic illness situation of these adolescents.

Adolescents with cancer (AWC) have poorer treatment outcomes as well as higher incidence and mortality rates than do younger children, and they face additional challenges related to normal developmental issues of adolescence. Although research has shown that information on the cancer experience improves outcomes by decreasing uncertainty and increasing perceived support, little is known about the types of information AWC need and want. This study describes how AWC rate the importance of specific cancer-related information, analyzes gender and age group differences, and compares 2 different time-since-diagnosis groups of AWC. The sample consisted of adolescents with newly diagnosed cancer (n = 74) and those 1 to 3 years from diagnosis (n = 39). The Information Preferences of Adolescents (IPA) Scale was used to measure the adolescents' information needs. Both samples of AWC rated the need for information as high. There were no significant differences by age, but females had significantly higher total scores for both groups and for many item means in the newly diagnosed group. Qualitative analysis of the additional write-in items generated 4 themes: treatment/side effects, uncertainty, social issues, and personal/emotional issues.

Uncertainty is important to consider far beyond the treatment period, particularly assessment of information needs and acknowledgment of inherent uncertainty throughout cancer survivorship.

Purpose-This concept analysis clarifies "assuming responsibility for self-care" by adolescents with type 1 diabetes. Methods-Walker and Avant's (2005) methodology guided the analysis.Results-Assuming responsibility for self-care was defined as a process specific to diabetes within the context of development. It is daily, gradual, individualized to person, and unique to task. The goal is ownership that involves autonomy in behaviors and decision-making.Practice Implications-Adolescents with type 1 diabetes need to be assessed for assuming responsibility for self-care. This achievement has implications for adolescents' diabetes management, short-and long-term health, and psychosocial quality of life. KeywordsAdolescents; assuming responsibility; concept analysis; diabetes; nursing A major developmental task for adolescents as they transition to young adulthood is assuming responsibility for themselves (Arnett, 1998(Arnett, , 2000Arnett & Galambos, 2003). Achievement of this developmental task in relation to their diabetes care is critical for the approximately 186,300 children and adolescents with diabetes in the United States (National Diabetes Information Clearinghouse, 2008) since these young people will eventually leave their parents' homes. There is not a good understanding of this developmental task, which may be related to the use of different conceptual and operational definitions. Some authors conceptualize and measure adolescents' responsibility for diabetes care as a parent's, adolescent's, or shared role (Anderson, Auslander, Jung, Miller, & Santiago, 1990;Beveridge, Berg, Wiebe, & Palmer, 2006;Holmes et al., 2006;Leonard, Skay, & Rheinberger, 1998) and others as the degree of self-care autonomy the adolescent has (Drotar & Ievers, 1994;Hanna, Juarez, Lenss, & Guthrie, 2003;Miller & Drotar, 2003). In addition, the concept of assuming responsibility is sometimes confused with a related term -management. Some view and measure responsibility for selfcare as distinct from management, compliance, or adherence (Anderson, Brackett, Ho, & Laffel, 1999;Cook, Herold, Edidin, & Briars, 2002;Holmes et al., 2006;La Greca, 1998;Miller & Drotar, 2007;Reid, Dubow, Carey, & Dura, 1994;. However, responsibility for self-care and self-management are also used interchangeably (Schilling, Grey, & Knafl, 2002a). These focuses on role or on management (as well as on compliance or adherence) are all limiting because they do not Author contact: kathanna@iupui.edu, with a copy to the Editor: roxie.foster@UCDenver.edu. NIH Public AccessAuthor Manuscript J Spec Pediatr Nurs. Author manuscript; available in PMC 2011 April 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscriptoffer an understanding of this developmental task -specifically, how these young people become the managers of their own care.The purpose of this article is to report the findings of a concept analysis of "assuming responsibility for self-care" by adolescents with type 1 diabetes with the intent to clarify this concept. Clarity i...

Nurses need to provide an opportunity for women to discuss problems they are experiencing relative to sexuality, intimacy, and body image.