Clinical Psychology Department, William James College, Newton, Massachusetts, USA.
J Adolesc Young Adult Oncol. 2020 Aug;9(4):528-533. doi: 10.1089/jayao.2019.0159. Epub 2020 Apr 7.
Little is known about how survivors of adolescent and young adult (AYA) cancers navigate the process of communicating their cancer history to those at work/school. The purpose of this study was to evaluate the factors impacting workplace/school disclosure decisions among AYA survivors and strategies used for self-disclosure. Two hypotheses were tested: (1) survivors would be significantly less likely to disclose their cancer history and more likely to avoid cancer-related topics at work/school versus with friends/acquaintances; (2) survivors' satisfaction with previous cancer-related self-disclosures at work/school would mediate the relationship between the reactions of others to those disclosures and the likelihood of future work/school disclosures. Online survey data, including a measure of self-disclosure adapted from the Nebraska Outness Scale, were collected from 120 survivors (age = 15 to 39 years at diagnosis, 19 to 45 years when surveyed). Data were analyzed descriptively and study hypotheses were evaluated using paired -tests (Hypothesis 1) and multiple regression with bootstrapping (Hypothesis 2). Both hypotheses were supported: participants were less likely to self-disclose at work/school than to friends/acquaintances ( < 0.001) and satisfaction with previous self-disclosure at work/school mediated the relationship between reactions to previous disclosures and likelihood of future disclosures (95% confidence interval = 0.39-0.81). Descriptive analyses indicated that participants were guided by a variety of factors when making disclosure decisions (e.g., anticipated reactions) and used a range of strategies for disclosures (e.g., humor). AYA survivors are cautious in their approach to workplace/school disclosure. Employers and school administrators should create supportive and inclusive environments that facilitate self-disclosure for survivors who wish to self-disclose.
青少年和年轻成人（AYA）癌症幸存者在向工作/学校中的人传达其癌症病史的过程中知之甚少。本研究的目的是评估影响 AYA 幸存者工作/学校披露决策的因素，以及用于自我披露的策略。测试了两个假设：（1）幸存者在工作/学校中与朋友/熟人相比，更不可能透露其癌症病史，更有可能避免与癌症相关的话题；（2）幸存者对工作/学校中以前的癌症相关自我披露的满意度将调解他人对这些披露的反应与未来工作/学校披露的可能性之间的关系。从 120 名幸存者（诊断时年龄为 15 至 39 岁，调查时年龄为 19 至 45 岁）收集了包括从内布拉斯加州公开量表改编的自我披露量表在内的在线调查数据。使用描述性分析和使用 bootstrap 的多元回归分析（假设 2）对数据进行了分析。两个假设都得到了支持：与朋友/熟人相比，参与者在工作/学校中更不愿意自我披露（ < 0.001），并且对以前在工作/学校中的自我披露的满意度调解了以前披露的反应与未来披露的可能性之间的关系（95％置信区间= 0.39-0.81）。描述性分析表明，参与者在做出披露决策时受到多种因素的指导（例如，预期的反应），并使用了一系列披露策略（例如，幽默）。AYA 幸存者在处理工作/学校披露时非常谨慎。雇主和学校管理人员应营造支持性和包容性的环境，为希望自我披露的幸存者提供便利。
