Managing Late and Long-Term Effects Among Swedish Adolescents and Young Adults Affected by Cancer Following a Wilderness Intervention: Reconnecting with Self and Meaning Through Nature’s Unconditional Presence – A Qualitative Study

TL;DR

This study explores how young cancer survivors in Sweden use nature to manage long-term effects of cancer beyond structured programs, finding that nature helps them reconnect with themselves and find meaning.

Contribution

The study reveals how nature supports AYAs in managing late effects of cancer through personal, sustainable, and meaningful engagement beyond formal interventions.

Findings

Nature helps AYAs achieve inner balance through mindfulness and calmness.

Nature acts as a meaningful companion by sparking hope and providing a space free from obligations.

Engaging with nature offers a low-threshold, accessible approach to well-being and rehabilitation.

Abstract

Adolescents and Young Adults (AYAs) affected by cancer are at risk of experiencing late and long-term effects following cancer diagnosis and treatment. While structured interventions have demonstrated potential benefits for well-being during the intervention itself, little is known about how AYAs affected by cancer engage with and experience nature in their everyday lives beyond the formal program context. The aim of this study was to explore how a selected group of AYAs affected by cancer—who had participated in a nature-based intervention (the WAYA program)—experience nature and its role in supporting and managing late and long-term effects of cancer and its treatment, beyond the context of the program itself.

This qualitative study explored the experiences of nature following the WAYA intervention among AYAs affected by cancer. Data were collected by focus group interviews at a three-month follow-up, using participant-selected photographs as visual prompts to elicit reflection on how nature supports management of late and long-term effects of cancer. A photovoice-inspired approach guided discussion questions and facilitated individual and collective meaning-making. Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis.

The analysis of this study showed one theme: Reconnecting with self and meaning through nature’s unconditional presence—beyond human connection. The theme comprises the two categories Nature as a resource for inner balance and Nature as a meaningful companion, and five sub-categories: Managing by being mindful, Managing by experiencing rest and being calm, Experiencing metaphoric recognition, Sparking comfort, hope and positive emotions, and Nature as a space without obligations.

This study explored how AYAs affected by cancer engage with nature beyond formal programs, revealing its potential in better management of late and long-term effects. These findings can inform low-threshold, personal meaningful, and sustainable approaches to clinical practice, well-being, and rehabilitation for this vulnerable group.

Why was the study done?

Adolescents and young adults (AYAs) who have had cancer often experience late and long-term effects from their illness and treatment, such as fatigue, anxiety, and challenges in everyday life. While rehabilitation programs exist, we know less about how AYAs affected by cancer themselves use nature in their daily lives to manage these effects beyond structured programs.

What did the researchers do?

The researchers invited AYAs affected by cancer who had participated in an intervention called the Wilderness program for Adolescents and Young Adults affected by cancer (WAYA) to share their experiences of nature through focus group discussions, photographs, and personal reflections. The researchers analyzed this material to understand how young people describe the role of nature in coping with challenges after cancer.

What did the researchers find?

The study identified one main theme: Reconnecting with self and meaning through nature’s unconditional presence—beyond human connection. This theme included two main ways that nature helped:

• Nature as a resource for inner balance – by being mindful and by finding calm and rest.

• Nature as a meaningful companion – by recognizing metaphors in nature, sparking comfort, hope, and positive emotions, and by providing a space free from obligations.

What do the findings mean?

The study shows that nature can play an important role in supporting the well-being of this selected group of AYAs affected by cancer and helping them manage long-term effects in ways that feel personally meaningful and sustainable. These insights suggest that nature could be used as a low-threshold, flexible, and accessible part of rehabilitation and everyday coping strategies for AYAs affected by cancer and potentially for other groups with similar health challenges.

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