To deliver developmentally appropriate psychosocial care, the key developmental tasks facing adolescents and young adults (AYA) need to be taken into consideration. These include establishing autonomy from parents; a personal set of values and identity; strong peer relationships, including intimate and sexual relationships; and obtaining adequate preparation to join the workforce. To minimize the amount of disruption caused by the cancer experience and to maximize the health-related quality of life of AYA patients, young individuals with cancer need opportunities to participate as much as possible in typical AYA activities and to master the developmental tasks of this life stage. Promoting a sense of normalcy is essential. To achieve this, the health care environment must be flexible and recognize the important role of peers. Informational and practical supports also are necessary for AYA to stay on track developmentally in the context of coping with cancer. Critical elements of effective AYA psychosocial services should include access to AYA-specific information and support resources, fertility and sexuality counseling, programs to maximize academic and vocational functioning, and financial support. In recent years, there has been growing recognition around the world that adolescent and young adults (AYA) who are diagnosed with and treated for cancer have distinctive psychosocial concerns that set them apart from pediatric and older adult populations. [1][2][3][4] In March 2010, the Canadian Task Force on Adolescent and Young Adults with Cancer held a workshop with various stakeholders, including AYA, to discuss priority issues in advancing oncologic care for this age-specific group. The current article focuses on ''how'' to address the health care needs of AYA patients (age 15-29 years). It includes comments and recommendations from AYA who participated in the workshop and reflects published literature suggesting important features of developmentally appropriate AYA psychosocial care. To deliver developmentally appropriate care, health care professionals caring for this population need to have an appreciation for ''emerging adulthood,'' 5 a phase in life when AYA are developing their own social and financial responsibilities; autonomy from parents; a personal set of values and identity; strong peer relationships, including intimate and sexual relationships; and obtaining adequate preparation to join the workforce. 5,6 To minimize the amount of disruption caused by the cancer experience and to maximize the health-related quality of life of AYA, young individuals with cancer need opportunities to participate as much as possible in typical AYA activities 3,6-8 and to master the developmental tasks of emergent adulthood. New and emerging resources for AYA focus on promoting a sense of normalcy. They emphasize the importance of flexibility in health care

The authors investigated longitudinally bereavement in mothers and fathers whose children died of cancer. Thirty-one parents were interviewed 6 and 18 months post-death. Analyses revealed parental differences and changes over time: (a) employment--fathers were more work-focused; (b) grief reactions--mothers expressed more intense grief reactions that lessened over time; (c) coping--mothers were more child-focused, fathers more task-focused; (d) relationship with bereaved siblings-mothers actively nurtured relationship with child; (e) spousal relationship--parents reported diversity in their relationship over time; and (f) relationship with extended family--mothers maintained contact with extended family more. Findings illustrate parental differences in bereavement over time that might be partly socially determined. These findings emphasize the need for tailoring bereavement support services in the family.

This study comprehensively explored parental bereavement and adjustment at 6 months post-loss due to childhood cancer. Interviews were conducted with 18 mothers and 13 fathers. Interviews were transcribed verbatim and analyzed based on qualitative methodology. A model describing early parental bereavement and adaptation emerged with 3 domains: (1) Perception of the Child, describing bereavement and adjustment prior to and after the loss; (2) Perception of Others, including relationships with partners, surviving children, and their social network; and (3) Perception of the World, exploring parents' perceived meanings of the experience in the context of their worldview. Domains are illustrated by quotes. Profiles of parental bereavement emerged.