Exploring the impact of cancer on adolescents' and young adults' relational worlds

Abstract Background: Adolescent and young adult cancer survivors (referred to as “survivors” hereafter) experience their transition from childhood to adulthood alongside a cancer experience. Limited research has qualitatively assessed Australian survivors' perspectives of impacts on relationships and social engagement, which are an important context for experiencing social relationships and building identity. There is also limited literature on extended family relationships and the early survivorship period in this population. Therefore, we investigated the impact of cancer on (1) family relationships and (2) friendships. Methods: We interviewed 43 survivors aged 15–26 years at treatment completion, who were aged 11–25 years at diagnosis. We used the Psychosocial Adjustment to Illness Scale , a psychometrically sound qualitative tool used to assess psychosocial adjustment, as a framework for the semistructured interview. The Domestic Environment , Extended Family Relationships , and Social Environment domains were analyzed using the Miles and Huberman qualitative analysis method. Results: We found themes of both disruption and continuity in family relationships. Survivors' appreciation of support and strengthened relationships contrasted with frustration at reduced independence. Expectations of extended family and relationship changes were very different to immediate family. Survivors also described physical, mental health, social, and geographical barriers to family relationships and friendships. They reported using communication technology and social media to partially overcome some barriers. Conclusions: Survivors experience diverse impacts on relationships, which persist into survivorship. Psychosocial assessment, education and intervention for survivors, and social networks that acknowledges and responds to support these impacts are likely to promote positive adjustment.