Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
School of Women's and Children's Health, UNSW Sydney, NSW, Australia.
Psychooncology. 2018 Feb;27(2):532-538. doi: 10.1002/pon.4525. Epub 2017 Sep 11.
Cancer in adolescents and young adults (AYAs) can interrupt important developmental milestones. Absence from school and time lost from work, together with the physical impacts of treatment on energy and cognition, can disrupt educational and vocational goals. The purpose of this paper is to report on AYA cancer survivors' experiences of reintegration into school and/or work and to describe perceived changes in their educational and vocational goals.
Adolescents and young adults recruited from 7 hospitals in Australia, aged 15 to 26 years and ≤24 months posttreatment, were interviewed using the psychosocial adjustment to illness scale. Responses were analysed to determine the extent of, and explanations for, cancer's effect on school/work.
Forty-two AYA cancer survivors (50% female) participated. Compared with their previous vocational functioning, 12 (28.6%) were scored as experiencing mild impairment, 14 (33.3%) moderate impairment, and 3 (7.1%) marked impairment. Adolescents and young adults described difficulties reintegrating to school/work as a result of cognitive impacts such as concentration problems and physical impacts of their treatment, including fatigue. Despite these reported difficulties, the majority indicated that their vocation goals were of equal or greater importance than before diagnosis (26/42; 62%), and most AYAs did not see their performance as compromised (23/42; 55%). Many survivors described a positive shift in life goals and priorities. The theme of goal conflict emerged where AYAs reported compromised abilities to achieve their goals.
The physical and cognitive impacts of treatment can make returning to school/work challenging for AYA cancer survivors. Adolescents and young adults experiencing difficulties may benefit from additional supports to facilitate meaningful engagement with their chosen educational/vocational goals.
青少年和年轻成年人（AYAs）的癌症可能会中断重要的发展里程碑。缺课和工作时间损失，加上治疗对能量和认知的身体影响，可能会打乱教育和职业目标。本文的目的是报告 AYA 癌症幸存者重新融入学校和/或工作的经验，并描述他们对教育和职业目标的看法的变化。
从澳大利亚 7 家医院招募的 15 至 26 岁且≤24 个月治疗后青少年和年轻成年人，使用疾病心理社会适应量表进行访谈。分析反应以确定癌症对学校/工作的影响程度和原因。
42 名 AYA 癌症幸存者（50%为女性）参与了研究。与他们以前的职业功能相比，12 名（28.6%）被评为轻度受损，14 名（33.3%）中度受损，3 名（7.1%）严重受损。青少年和年轻成年人描述了因认知问题（如注意力集中问题）和治疗的身体影响（如疲劳）而难以重新融入学校/工作。尽管存在这些报告的困难，但大多数人表示，他们的职业目标与诊断前同等重要或更重要（26/42；62%），大多数 AYAs 并不认为自己的表现受到影响（23/42；55%）。许多幸存者描述了生活目标和优先事项的积极转变。出现目标冲突的主题，即 AYA 报告说他们实现目标的能力受到了损害。
治疗的身体和认知影响可能使 AYA 癌症幸存者重返学校/工作具有挑战性。有困难的青少年和年轻成年人可能会受益于额外的支持，以促进他们与所选教育/职业目标的有意义参与。
