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Trying to Feel Normal Again

Early Survivorship for Adolescent Cancer Survivors

Walker, Amy J., PhD, RN; Lewis, Frances M., PhD, RN; Lin, Yuting, MSN; Zahlis, Ellen, MS, RN; Rosenberg, Abby R., MD, MS, MA

doi: 10.1097/NCC.0000000000000629
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Background Despite knowing the potential medical consequences of cancer treatment, little is known about how adolescents cognitively and emotionally frame, process, and manage in the early survivorship period.

Objective The specific aims were to describe the worries, perceived challenges, and ways of dealing with these issues for adolescent cancer survivors in the early period of survivorship.

Methods Twenty-nine adolescent survivors (12–18 years) completed a semistructured interview. Inductive coding methods adapted from grounded theory were used to analyze the data.

Results Seven domains and 18 categories organized the adolescent's experience with early posttreatment survivorship. The domains included getting back to school; relationships with parents, siblings, friends; feeling changed by the experience; and concerns about relapse.

Conclusions This study contributes to our understanding of survivors' relationships with parents, siblings, and friends and survivors' models of the illness. Future studies are needed to understand how parents can help adolescents assume greater responsibility for their care, to understand what it is like for friends to have a peer with cancer and what behaviors by healthcare providers contribute to feelings of abandonment later in survivorship, and to better understand adolescent survivors' models of the illness and survivorship.

Implications for Practice Study results suggest that nurses are in an ideal position to begin and to continue discussions with adolescent survivors about the adolescent's view of medical follow- up, its purpose and importance, and ways in which the adolescent can begin, early on, to engage in planning their own health during survivorship.

Author Affiliations: Department of Family and Child Nursing, University of Washington, Seattle (Drs Walker and Lewis and Mss Lin and Zahlis); Department of Pediatrics, University of Washington School of Medicine and Cancer & Blood Disorders Center, Seattle Children's Hospital (Dr Rosenberg); and Public Health Sciences and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington (Dr Lewis).

Research reported in this study was supported by grants from the National Cancer Institute, National Institutes of Health under award R03 CA 186 910. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors have no conflicts of interest to disclose.

Correspondence: Amy J. Walker, PhD, RN, Department of Family and Child Nursing, University of Washington, Box 357262, Seattle, WA 98195 (walkeraj@uw.edu).

Accepted for publication April 23, 2018.

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