Psychosocial Impact of Childhood Cancer Survivorship: Experiences of Adolescent and Young Adult Survivors and Their Families

OBJECTIVE: To analyze the psychosocial impact of childhood cancer survivorship from the perspectives of survivors and their family members. METHODS: This qualitative interpretive study followed COREQ guidelines and used purposive sampling with a hybrid recruitment strategy to include adolescent and young adult survivors of childhood cancer and their family members in Brazil. Participants completed individual online, semistructured interviews. Interviews were audio-recorded, fully transcribed, and analyzed using reflexive thematic analysis supported by MAXQDA software. RESULTS: Thirty participants were included: 19 survivors (aged 14-28 years) and 11 parents. Four themes were identified: first, the persistent shadow of prejudice, shaping survivors' interactions and relationships; second, stigma in education and employment, with barriers to recruitment, job retention, and school performance linked to late effects and follow-up; third, social reintegration and feelings of inadequacy, marked by insecurity, isolation, and challenges in intimate relationships; and fourth, family support, overprotection, and judgments, where encouragement coexisted with restrictions to autonomy. Together, these subthemes formed a broader theme underscoring the psychosocial repercussions of survivorship. CONCLUSIONS: Survivorship after childhood cancer is not only a clinical trajectory but also a deeply social and familial phenomenon. Prejudice, stigma, and ambivalent family support continue to shape survivors' lives, limiting educational, occupational, and social opportunities. IMPLICATIONS FOR NURSING PRACTICE: Findings highlight the need for survivorship care addressing psychosocial well-being, with strengthened family support, and social and occupational reintegration are essential components of long-term follow-up, particularly in low- and middle-income countries where survivorship care remains limited.