A qualitative study of adolescent cancer survivors perspectives on social support from healthy peers – A RESPECT study

Background Adolescents’ psychosocial development is generally influenced by their peers. Those facing hospital‐based cancer treatment are particularly challenged as they are isolated from their social network and lack sufficient coping resources. Aim This study explores the adolescent cancer survivor's perceptions and experiences with healthy classmate socialization support efforts via hospital co‐admittance, from diagnosis to reinstatement in school, as an intervention of the RESPECT (REhabilitation including Social and Physical Activity and Education in Children and Teenagers with cancer) Study. Design A phenomenological, descriptive study. Methods Using variation sampling, 14 adolescents (aged 14–19), who completed the RESPECT intervention (April 2016–July 2017), participated in qualitative, in‐depth, semi‐structured interviews that were thematically analysed. Findings Four themes emerged: (a) Ambassadors as liaison persons; (b) Ambassadors as promoters of normalization and identity continuity; (c) Ambassadors as ‘behind the scenes’ friends; and (d) feelings of vulnerability and inferiority. Ambassadors reinstated a sense of normalcy in the adolescents’ daily life. They supported identity construction and served as liaison persons who buffered loneliness and social isolation as well as bridging a continued sense of belonging to one's school peer network. In contrast with other peers, ambassadors understood cancer‐related issues, knowledge which they partially gained witnessing the impact of treatment‐related side effects on their hospitalized classmates. However, the consequence of this trade‐off was an asymmetry in their relationship, with the adolescents requiring a certain level of safeguard from their ambassadors to maintain equal power in the relationship. Conclusion The ambassadors enhanced the adolescents’ ability to cope with their altered social position during treatment and to psychosocially reinstate it on their return to school. Impact Future interventions should offer opportunities for healthy peers to be educated in what it means to live with cancer. Future programs to sustain socialization in adolescents with cancer should involve healthy peers for the entirety of the treatment period. 摘要 背景 通常而言, 青少年的社会心理发展会受到同龄人的影响。医院内部接受抗癌治疗的患者面临高度挑战, 原因在于, 其远离社交网络, 应对资源不足。 目的 本研究探讨青少年癌症生还者从诊断到复学的过程中, 透过同期入院的健康同学提供的社会化支持而获得的认知与经验, 并将此作为癌症儿童和青少年的康复, 包括社交、体育活动及教育 (RESPECT) 研究的一项干预措施。 设计 一项现象学及描述性研究。 方法 变异抽样, 筛选14名完成RESPECT干预 (2016年4月‐2017年7月) 的青少年 (14‐19