Facing the cancer-related life threat as adolescent and young adult (AYA) after initial diagnosis: A qualitative interview study

TL;DR

This study explores how young adults cope with the life-threatening nature of cancer shortly after diagnosis, highlighting their emotional challenges and the importance of support.

Contribution

The study provides new qualitative insights into AYAs' coping strategies and relational dynamics after a cancer diagnosis.

Findings

AYAs often feel a conflict between their mortality and youthful invincibility.

Hope was identified as the most important coping strategy among participants.

Healthcare professionals' attitudes and communication significantly impact AYAs' experiences.

Abstract

The aim of this study was to identify coping strategies, challenges, and needs regarding the life-threatening nature of cancer from the perspective of adolescents and young adults (AYAs) shortly after their initial diagnosis.

We conducted a qualitative interview study in Germany with AYAs from 18 to 39 years of age, 4–12 weeks after initial diagnosis. The interviews were transcribed verbatim, and the transcripts were analyzed using Framework Analysis.

Eighteen patients (7 females, 11 males, 27.2 ± 5.3 years) were included. The sudden confrontation with their mortality due to a potentially life-threatening illness stood in contrast to the feeling of youthful invincibility. One of the AYAs’ biggest concerns was burdening their relatives with the disease and the associated life threat. Many AYAs wanted to support their next of kin whilst at the same time having a great need for support from them. While there were inter-individual differences in how AYAs dealt with mortality, the most important coping strategy was hope. The attitude of healthcare professionals (HCPs), age-appropriate, individualized education, and treatment progress were important factors in this.

Even after a recent initial diagnosis, the topic of mortality can be pertinent for AYAs. Often, a unique relationship dynamic between AYAs and their relatives arises which requires further research. HCPs play a central supporting role. Helpful conversations require appropriate timing, a strong doctor-patient relationship, and a sincere, encouraging approach. Further studies, e.g., using a longitudinal or quantitative approach, are needed.

Trial registration number: DRKS00030276, 13.09.2022