Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.
Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
Psychooncology. 2023 Sep;32(9):1363-1371. doi: 10.1002/pon.6186. Epub 2023 Jun 28.
Developmental disruption contributes to poor psychosocial outcomes among adolescents and young adults (AYAs) with cancer, though indicators of AYAs' developmental status are not well understood. In this study, we describe perceived adult status as a novel developmental indicator and examine its associations with social milestones achievements and health-related quality of life (HRQoL).
For this secondary analysis, AYAs with cancer were recruited using a 2 (on/off treatment) × 2 [emerging adults (EAs) 18-25 years-old, young adults (YAs) 26-39 years-old] stratified sampling design through an online research panel. Surveys assessed perceived adult status (i.e., self-perception of the extent to which one has reached adulthood), social milestones (marital, child-rearing, employment, educational status), demographic and treatment characteristics, and HRQoL. Generalized linear models tested associations between perceived adult status, social milestones, and HRQoL.
AYAs (N = 383; M = 27.2, SD = 6.0) were majority male (56%) and treated with radiation without chemotherapy (37%). Most EAs (60%) perceived they had reached adulthood in some ways; most YAs (65%) perceived they had reached adulthood. EAs who perceived they had reached adulthood were more likely to be married, raising a child, and working than EAs who did not perceive they had reached adulthood. Among EAs, lower perceived adult status was associated with lower HRQoL when accounting for social milestones. Among YAs, perceived adult status was not associated with social milestones and neither perceived adult status nor social milestones were associated with HRQoL.
Perceived adult status may be a useful developmental indicator for EAs with cancer. Findings highlight unique developmental needs of EAs and utility of patient perspectives for understanding developmental outcomes.
发育障碍会导致癌症青少年和年轻成人（AYA）出现较差的心理社会结局，但 AYA 发育状况的指标尚未得到充分理解。本研究描述了感知成人身份作为一种新的发育指标，并探讨了其与社会里程碑成就和健康相关生活质量（HRQoL）的关系。
本二次分析通过在线研究小组，采用 2（治疗中/治疗结束）×2（成年早期 18-25 岁，年轻成人 26-39 岁）分层抽样设计招募癌症 AYA。调查评估了感知成人身份（即一个人达到成人身份的程度的自我认知）、社会里程碑（婚姻、育儿、就业、教育状况）、人口统计学和治疗特征以及 HRQoL。广义线性模型检验了感知成人身份、社会里程碑和 HRQoL 之间的关系。
AYA（N=383；M=27.2，SD=6.0）中男性占多数（56%），未接受化疗仅接受放疗（37%）。大多数成年早期患者（60%）认为他们在某些方面已经成年；大多数年轻成人（65%）认为他们已经成年。认为自己已经成年的成年早期患者比认为自己没有成年的成年早期患者更有可能结婚、养育孩子和工作。在成年早期患者中，考虑到社会里程碑，感知成人身份较低与 HRQoL 较低相关。在年轻成人中，感知成人身份与社会里程碑无关，感知成人身份和社会里程碑均与 HRQoL 无关。
感知成人身份可能是癌症成年早期患者有用的发育指标。研究结果突出了成年早期患者独特的发育需求以及患者观点对理解发育结局的重要性。
