Negative Psychological Sequelae in Adolescent and Young Adult Survivors of Pediatric Cancer: A Qualitative Analysis

Introduction.Survivors of pediatric cancer are at risk of developing negative psychological effects including posttraumatic stress symptoms 1,2 which may inhibit engagement in guidelinebased care. [3]4][5] Limited work has examined the relationship between these effects and health behaviors in this population.The present study sought to explore this relationship.Methods.This study is part of a larger project involving 51 adolescent and young adult survivors of pediatric cancer (mean age 28.6 years, 66.7% female) who received care at a Midwestern children's hospital or adult-focused academic center from 2015 to 2023.Eleven survivors participated in semi-structured interviews asking about their experience.Data were analyzed using Braun and Clarke's six-step framework.Themes related to the negative psychological impacts of survivorship were identified for this study.Results.Survivors reported significant psychological sequelae of their cancer experience, including post-traumatic stress symptoms (PTSS) of hypervigilance, and avoidance of traumatic reminders (e.g., the hospital).Survivors reported frustration with late effects from cancer, which reduced engagement in health behaviors, such as diet and exercise.A small subset of survivors felt unaffected by their diagnosis over time. Conclusions.Similar to previous studies, this study showed that pediatric cancer survivors exhibit negative psychological late effects of cancer treatment, including PTSS.The current study found that these symptoms may inhibit survivors from engaging in positive health behaviors.Survivors may benefit from trauma-informed healthcare to improve long-term outcomes.Future research may further investigate the connection between PTSS and health behaviors.