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Cancer during Adolescence: Coping Shortly after Diagnosis and Psychosocial Function during the Acute and Extended Phase of Survival
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Psychosocial oncology and supportive care.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In this thesis coping shortly after diagnosis and psychosocial function during the acute and extended phase of survival was investigated for individuals struck by cancer during adolescence. Sixty-one participants were recruited and data were collected from four to eight weeks (T1) up to four years (T7) after diagnosis. Study I: the aim was to describe how participants (n=56) cope with cancer-related distress in response to closed and open-ended questions. In response to closed-ended questions, the majority reported emotion-focused strategies, and in response to open-ended questions they reported meaning-based and problem-focused strategies. Study II: the aim was to investigate nurses’ and physicians’ ability to identify which coping strategies participants (n=48) use. Neither nurses nor physicians were successful in identifying which strategies participants used, although physicians were somewhat better. Study III: the aim was to identify participants’ (n=61) psychosocial states. Three states were identified: poor (A), average (B), and good (C). From 18 months after diagnosis more participants than expected by chance were in state C. At T7 77% were in State C and 15% in State A. Female gender, divorced parents, and using distracting to cope was related to State A and B. Study IV: the aim was to describe negative and positive cancer-related consequences reported (n=32) three and four years after diagnosis and to establish whether using certain strategies at T1 was related to reports of certain consequences at T7. The majority reported negative and positive consequences and a relation between using distracting to cope at T1 and reporting bodily concerns at T7 was established. In conclusion: it is difficult for nurses and physicians to identify how adolescents recently diagnosed with cancer cope with distress; the majority of individuals diagnosed with cancer during adolescence experience a state of good psychosocial function during the extended phase of survival, and distress and personal growth often go hand in hand after cancer during adolescence.  

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2011. , 62 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 693
Keyword [en]
adolescents, cancer, coping, psychosocial, consequences
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:uu:diva-157094ISBN: 978-91-554-8131-5 (print)OAI: oai:DiVA.org:uu-157094DiVA: diva2:435368
Public defence
2011-09-30, Auditorium Minus, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2011-09-09 Created: 2011-08-16 Last updated: 2012-03-15Bibliographically approved
List of papers
1. Findings on how adolescents cope with cancer: a matter of methodology?
Open this publication in new window or tab >>Findings on how adolescents cope with cancer: a matter of methodology?
2011 (English)In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 20, no 10, 1053-1060 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: The various conclusions drawn from previous studies on how adolescents cope with cancer might partly be explained by methodological issues. The aim was to explore how adolescents recently diagnosed with cancer report that they cope with disease- and treatment-related distress in response to closed- and open-ended questions, respectively.Methods: Adolescents diagnosed with cancer 4-8 weeks ago (N=56) answered closed- and open-ended questions over the telephone about which coping strategies they use to cope with physical concerns, personal changes, feelings of alienation, and worries.Results: In response to closed-ended questions, most adolescents reported using emotion-focused coping (Accepting and Minimising) while, in response to open-ended questions, meaning-based (i.e. Positive thinking) and problem-focused (i.e. Problem solving) coping were most often mentioned. A majority reported using Minimising and Seeking support in response to closed-ended questions, but very few adolescents mentioned using these strategies in response to open-ended questions.Conclusions: Adolescents' reports of how they cope with disease- and treatment-related distress vary depending on antecedent closed- and open-ended questions. Responses to closed-ended questions appear to be more indifferent to aspects of distress than responses to open-ended questions. Strategies representing meaning-based coping should be included in future studies investigating how adolescents recently diagnosed with cancer cope with disease- and treatment-related distress.

Keyword
adolescents, cancer, coping, methodology, oncology
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-130825 (URN)10.1002/pon.1809 (DOI)000295880900004 ()20669336 (PubMedID)
Note

Article first published online: 28 JUL 2010

Available from: 2010-09-14 Created: 2010-09-14 Last updated: 2017-12-12
2. Are nurses and physicians able to assess which strategies adolescents recently diagnosed with cancer use to cope with disease- and treatment-related distress?
Open this publication in new window or tab >>Are nurses and physicians able to assess which strategies adolescents recently diagnosed with cancer use to cope with disease- and treatment-related distress?
Show others...
2011 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 19, no 5, 605-611 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: It was examined whether nurses and physicians are able to identify whether adolescents with cancer have used certain strategies to cope with disease- and treatment-related distress. METHOD: Adolescents (N = 48) were asked whether they had used a number of strategies to cope with disease- and treatment-related distress and, if so, the extent to which they had used these. Nurses and physicians were asked to answer the same questions on behalf of a certain adolescent. RESULTS: Nurses overestimate the extent to which adolescents use strategies to cope with distress, and neither nurses nor physicians, physicians somewhat more, are successful in identifying the extent to which certain adolescents use strategies. CONCLUSION: Health-care staff's possibilities to assess how patients cope with disease- and treatment-related distress should be increased. A number of changes in education and the organization of clinical care, especially with regard to assessing patients' needs, are suggested.

Keyword
adolescents, cancer, coping, distress, nurses, physicians
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-130830 (URN)10.1007/s00520-010-0859-0 (DOI)000289105600004 ()20349092 (PubMedID)
Available from: 2010-09-14 Created: 2010-09-14 Last updated: 2017-12-12
3. Longitudinally derived psychosocial states among individuals diagnosed with cancer during adolescence up to four years after diagnosis
Open this publication in new window or tab >>Longitudinally derived psychosocial states among individuals diagnosed with cancer during adolescence up to four years after diagnosis
2011 (English)Article in journal (Refereed) Submitted
Keyword
Adolescents, Cancer, Cluster analysis, Oncology, Psychosocial
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-157092 (URN)
Available from: 2011-08-18 Created: 2011-08-16 Last updated: 2012-01-04Bibliographically approved
4. Cancer during adolescence: negative and positive consequences reported three and four years after diagnosis
Open this publication in new window or tab >>Cancer during adolescence: negative and positive consequences reported three and four years after diagnosis
Show others...
2011 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 6, no 12, e29001- p.Article in journal (Refereed) Published
Abstract [en]

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.

Keyword
Adolescents, Cancer, Consequences, Oncology, Survivor
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-157093 (URN)10.1371/journal.pone.0029001 (DOI)000298369100138 ()
Available from: 2011-08-18 Created: 2011-08-16 Last updated: 2017-12-08Bibliographically approved

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