Providing developmentally appropriate psychosocial care to adolescent and young adult cancer survivors

Abstract

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

Do Current Cancer Follow-Up Care Practices Meet the Needs of Young Adult Cancer Survivors in Canada? A Aualitative Inquiry

“…Thompson et al proposed a model of cfc that includes a transitional care plan, monitoring for recurrence and late effects, and assistance with getting back to "normal" 17 . Other authors have identified the need for financial assistance for young adult cancer survivors 18,19 .…”

Empowerment in adolescents and young adults with cancer: Relationship with health‐related quality of life

“…Although many AYA patients have developed decision‐making skills regarding their own health or life goals,22 others will still look to others to help them with decision making and indeed they may return to a state of dependency when faced with cancer 23. Health‐related information should be delivered in a manner that is appropriate to the age of the patient because this is critical in helping AYA individuals learn to cope with their disease and navigate the health care system 24. The capacity to handle new situations is closely related to the concept of coping.…”

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

“…185 AYA men and women go through developmental stages marked by rapid changes in cognitive and emotional growth, and these issues need to be considered while delivering developmentally appropriate psychosocial and supportive care to AYA patients. 186 Few measurement tools have been developed to better understand health-related quality of life in AYA patients with cancer. 6 Palmer et al 187 developed an AYA Oncology Psychosocial Screening Tool to assist clinicians in supporting psychosocial coping during active treatment and promoting healthy post-treatment survivorship in AYA patients.…”

“…Reinforcing relationships with family, peers, and health professionals is an important aspect of life for AYA patients. 186,212 Although some studies have identified family support and cohesiveness as important contributors to a survivor's adjustment, others have identified the important role played by same-aged peers (healthy peers as well as other AYA cancer survivors) in helping AYA patients cope with cancer and overcome feelings of loneliness. 11,186 In one study, AYA patients with cancer (16-22 years of age) identified social support (including family members, friends, healthcare providers, and other patients) as their major coping strategy.…”