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Adolescent and Young Adult Survivors of Childhood Brain Tumors: Life After Treatment in Their Own Words

Hobbie, Wendy L. MSN, CRNP, FAAN; Ogle, Sue MSN, CRNP; Reilly, Maureen BSN, RN; Barakat, Lamia PhD; Lucas, Matthew S. PhD; Ginsberg, Jill P. MD; Fisher, Michael J. MD; Volpe, Ellen M. PhD; Deatrick, Janet A. PhD, FAAN

doi: 10.1097/NCC.0000000000000266
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Background: To date, there are few studies that examine the perspectives of older survivors of childhood brain tumors who are living with their families in terms of their sense of self and their role in their families.

Objective: The aim of this study was to describe how adolescent and young adult survivors of childhood brain tumors describe their health-related quality of life, that is, their physical, emotional, and social functioning.

Methods: This qualitative descriptive study included a purposive sample of 41 adolescent and young adult survivors of a childhood brain tumor who live with their families. Home interviews were conducted using a semistructured interview guide. Directed content analytic techniques were used to analyze data using health-related quality of life as a framework.

Results: This group of brain tumor survivors described their everyday lives in terms of their physical health, neurocognitive functioning, emotional health, social functioning, and self-care abilities. Overall, survivors struggle for normalcy in the face of changed functioning due to their cancer and the (late) effects of their treatment.

Conclusions: Neurocognitive issues seemed most compelling in the narratives. The importance of families went beyond the resources, structure, and support for functioning. Their families provided the recognition that they were important beings and their existence mattered to someone.

Implications for Practice: The value and complexity of care coordination were highlighted by the multifaceted needs of the survivors. Advocacy for appropriate and timely educational, vocational, and social support is critical as part of comprehensive cancer survivorship care.

Author Affiliations: Department of Nursing (Mss Hobbie, Ogle, and Reilly), Division of Oncology (Drs Barakat, Ginsberg, and Fisher), The Children’s Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania University of Pennsylvania, School of Nursing (Ms Hobbie and Dr Deatrick), and Temple University School of Medicine (Dr Lucas), Philadelphia, Pennsylvania; and School of Nursing, University of Buffalo, New York (Dr Volpe).

All phases of this study were supported by a National Institutes of Health grant (RO1 NR009651) to J.A.D. (principal investigator) and a grant from the Oncology Nursing Society and the American Brain Tumor Foundation to J.A.D. (principal investigator). Research training support was provided by the National Institutes of Health (F31NR013091 [to M.S.L. and E.M.V.]) and the American Cancer Society (122552-DSCN-10-089 [to M.S.L.]).

Ms Hobbie is a consultant for National Insitute of Nursing Research and received royalties from Springer Publishing and O’Reilly Media, Inc. Dr Fisher was member of the speaker’s bureau of NYU School of Medicine and Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware. All other authors have no conflicts of interest to disclose.

Correspondence: Wendy L. Hobbie, MSN, CRNP, FAAN, The Children’s Hospital of Philadelphia, 10th Flr, Colket Bldg, Rm 10305, Philadelphia PA 19104 (hobbie@email.chop.edu).

Accepted for publication March 9, 2015.

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