Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia;; School of Psychology, The University of New South Wales, Sydney, Australia; School of Women's and Children's Health, The University of New South Wales, Sydney, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia;; School of Women's and Children's Health, The University of New South Wales, Sydney, Australia.
Transl Pediatr. 2013 Oct;2(4):167-97. doi: 10.3978/j.issn.2224-4336.2013.10.06.
Adolescents and young adults (AYAs) with cancer must simultaneously navigate the challenges associated with their cancer experience, whilst striving to achieve a number of important developmental milestones at the cusp of adulthood. The disruption caused by their cancer experience at this critical life-stage is assumed to be responsible for significant distress among AYAs living with cancer. The quality and severity of psychological outcomes among AYAs remain poorly documented, however. This review examined the existing literature on psychological outcomes among AYAs living with cancer. All psychological outcomes (both distress and positive adjustment) were included, and AYAs were included across the cancer trajectory, ranging from newly-diagnosed patients, to long-term cancer survivors. Four key research questions were addressed. Section 1 answered the question, "What is the nature and prevalence of distress (and other psychological outcomes) among AYAs living with cancer?" and documented rates of clinical distress, as well as evidence for the trajectory of this distress over time. Section 2 examined the individual, cancer/treatment-related and socio-demographic factors that have been identified as predictors of these outcomes in this existing literature. Section 3 examined current theoretical models relevant to explaining psychological outcomes among AYAs, including developmental models, socio-cognitive and family-systems models, stress-coping frameworks, and cognitive appraisal models (including trauma and meaning making models). The mechanisms implicated in each model were discussed, as was the existing evidence for each model. Converging evidence implicating the potential role of autobiographical memory and future thinking systems in how AYAs process and integrate their cancer experience into their current sense of self and future goals are highlighted. Finally, Section 4 addressed the future of psycho-oncology in understanding and conceptualizing psychological outcomes among AYAs living with cancer, by discussing recent empirical advancements in adjacent, non-oncology fields that might improve our understanding of psychological outcomes in AYAs living with cancer. Included in these were models of memory and future thinking drawn from the broader psychology literature that identify important mechanisms involved in adjustment, as well as experimental paradigms for the study of these mechanisms within analogue, non-cancer AYA samples.
青少年和青年癌症患者（AYAs）在临近成年之际，不仅要应对癌症带来的挑战，还要努力实现多个重要的发展里程碑。在这个关键的人生阶段，癌症带来的困扰被认为是癌症患者中存在大量焦虑和抑郁的原因。然而，AYAs 癌症患者的心理结果的质量和严重程度仍未得到充分记录。本综述探讨了 AYA 癌症患者的心理结果的现有文献。纳入了所有的心理结果（包括痛苦和积极适应），并纳入了癌症病程中的 AYA，从新诊断的患者到长期癌症幸存者。本综述回答了四个关键的研究问题。第 1 部分回答了“患有癌症的 AYA 中有哪些心理困扰（和其他心理结果）？”这一问题，并记录了临床痛苦的发生率，以及随着时间推移痛苦的轨迹。第 2 部分研究了在现有文献中被确定为这些结果预测因素的个体、癌症/治疗相关和社会人口统计学因素。第 3 部分检查了目前与解释 AYA 心理结果相关的理论模型，包括发展模型、社会认知和家庭系统模型、应激应对框架以及认知评估模型（包括创伤和意义建构模型）。讨论了每个模型中涉及的机制，以及每个模型的现有证据。强调了自传体记忆和未来思维系统在 AYA 如何处理和将癌症经历融入当前自我意识和未来目标中的潜在作用的综合证据。最后，第 4 部分通过讨论相邻非肿瘤学领域的最近实证进展，讨论了理解和概念化癌症患者心理结果的心理肿瘤学的未来，这些进展可能会提高我们对癌症患者心理结果的理解。其中包括从更广泛的心理学文献中提取的记忆和未来思维模型，这些模型确定了与适应相关的重要机制，以及在模拟非癌症 AYA 样本中研究这些机制的实验范例。
