1 Department of Pediatrics and Adolescent Medicine, Center of Pediatric Oncology, Copenhagen University Hospital Rigshospitalet , Copenhagen, Denmark .
2 The University Hospitals' Centre for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet , Copenhagen, Denmark .
J Adolesc Young Adult Oncol. 2018 Aug;7(4):445-452. doi: 10.1089/jayao.2017.0128. Epub 2018 Mar 13.
An insufficient transition to normal life after cancer treatment in adolescent and young adults (AYAs) may lead to decreased occupational and educational opportunities throughout a survivor's lifespan. Key informant interviews were used to access unique knowledge of the healthcare, educational, and social systems.
We used key informant interviews with professionals representing disciplines from healthcare, educational, and social systems (n = 15). Informants were recruited through purposive sampling and snowball sampling. Interviews were analyzed thematically using Malterud's Systematic Text Condensation and verified by member checking.
We found four major themes: the impact of late effects, navigating the system, social reintegration, and the drive of youth. Although legal frameworks are often in place to assist AYA cancer survivors, navigating the public, educational, and social systems is a complex task and many AYAs do not have the required skill set or energy. Furthermore, AYA survivors often feel different from their peers and misunderstood by their surroundings, which may hinder reintegration into normal social life.
In Scandinavia, healthcare and education are free of charge with equal access for all, primarily funded by government taxes. Therefore, insurance status and tuition fees should not constitute barriers for returning to education and work. However, this study finds that the public and educational systems are complex to navigate, and that AYAs face trouble mobilizing the energy to receive needed support.
青少年和年轻成年人（AYA）在癌症治疗后，如果不能顺利过渡到正常生活，可能会在其整个生存期内减少职业和教育机会。本研究采用关键知情人访谈的方法，以获取医疗保健、教育和社会系统的独特知识。
我们对来自医疗保健、教育和社会系统的专业人员（n=15）进行了关键知情人访谈。通过目的性抽样和滚雪球抽样招募知情人。使用 Malterud 的系统文本浓缩法对访谈进行主题分析，并通过成员检查进行验证。
我们发现了四个主要主题：晚期效应的影响、系统导航、社会融合和青年的动力。尽管法律框架通常旨在帮助 AYA 癌症幸存者，但导航公共、教育和社会系统是一项复杂的任务，许多 AYA 没有所需的技能和精力。此外，AYA 幸存者常常感到与同龄人不同，被周围的人误解，这可能会阻碍他们融入正常的社会生活。
在斯堪的纳维亚，医疗保健和教育是免费的，所有人都可以平等地获得，主要由政府税收资助。因此，保险状况和学费不应成为重返教育和工作的障碍。然而，本研究发现，公共和教育系统错综复杂，AYA 面临着调动所需支持的精力的困难。
