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“完全变了一个人”:青少年和青年癌症治疗后重返教育的体验。

"A Different Person Entirely": Adolescent and Young Adults' Experiences Returning to Education after Cancer Treatment.

机构信息

School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.

Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.

出版信息

J Adolesc Young Adult Oncol. 2021 Oct;10(5):562-572. doi: 10.1089/jayao.2020.0168. Epub 2021 Mar 9.

Abstract

Adolescent and young adults (AYAs) establish their independent, adult identities as part of their psychosocial development, a process that is largely informed by educational experiences. Not only is a cancer diagnosis disruptive to this process but also AYA cancer survivors (AYACs) face barriers as they attempt to reintegrate into educational systems. This study explores the experiences of AYACs as they return to education, to identify these obstacles and the implications for care teams. In-depth semistructured interviews were conducted with AYACs ( = 8), 16-19 years of age at diagnosis and 18-27 years of age at time of interview. Interviews were transcribed verbatim and analyzed using the principles of Giorgi's phenomenological analysis. Four major themes were identified: AYACs suffer from debilitating late effects (theme 1) post-treatment as they adjust to a loss of normality and other fundamental losses (theme 2) associated with a cancer diagnosis, such as irrecoverable future plans. The educational systems (theme 3) to which they return can be both accommodating, capable of making allowances, and uncompromising, unable to adapt to AYAC survivors' needs. Appropriate mechanisms to facilitate resilience (theme 4) among AYACs are vital for successful return to education. This study supports previous findings that late effects and systemic barriers can hinder return to education, but further research focused on this age group is required. We believe that treating clinicians and specialist services can facilitate the return of AYACs to education by providing warning and comprehensive information about late effects, as early as possible before treatment completion, as well as effective information sharing with educational institutions.

摘要

青少年和年轻人(AYAs)在其心理社会发展过程中确立独立的成人身份,这一过程在很大程度上受到教育经历的影响。不仅癌症诊断会干扰这一过程,而且 AYA 癌症幸存者(AYACs)在试图重新融入教育系统时也会面临障碍。本研究探讨了 AYAC 重返教育的经历,以确定这些障碍及其对护理团队的影响。对 8 名年龄在 16-19 岁诊断时和 18-27 岁访谈时的 AYAC 进行了深入的半结构化访谈。访谈逐字记录并使用 Giorgi 现象学分析原则进行分析。确定了四个主要主题:AYAC 在治疗后会遭受衰弱的晚期影响(主题 1),因为他们需要适应正常状态的丧失和与癌症诊断相关的其他基本丧失(主题 2),例如不可挽回的未来计划。他们返回的教育系统(主题 3)既可以容纳,能够做出让步,也可以不妥协,无法适应 AYAC 幸存者的需求。为 AYAC 提供促进适应力的适当机制(主题 4)对于成功重返教育至关重要。本研究支持先前的研究结果,即晚期影响和系统性障碍可能会阻碍重返教育,但需要对这一年龄组进行进一步的研究。我们认为,治疗临床医生和专科服务可以通过在治疗完成前尽早提供关于晚期影响的警告和全面信息,并与教育机构有效共享信息,促进 AYAC 重返教育。

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