Ma Yuanshuo, Zhang Sulin, Yuan Meina, Xu Xinyi, Guo Yang, Zhao Jinping, Xue Tao, Lv Huicong, Hu Jie
School of Public Health, Hebei Medical University, Shijiazhuang, Hebei, 050017, China.
School of Nursing, Innovation Center of Humanistic Care and Health Management, Hebei Medical University, Shijiazhuang, Hebei, 050017, China.
J Cancer Surviv. 2025 Sep 4. doi: 10.1007/s11764-025-01888-0.
Guided by the COM-B model ("capability," "opportunity," "motivation," and "behavior"), this study explores the factors and potential mechanisms of social withdrawal in children with cancer.
The illness experiences shared by families of children with cancer on the internet provided a unique opportunity for this study. An interdisciplinary research team was formed, and a hybrid thematic analysis was conducted to examine 41 online illness narratives describing the experiences of children (≤ 18 years old) diagnosed with cancer.
This study identified seven themes: (1) Capability: physical problem and self-acceptance; (2) Motivation: stigma and self-esteem; (3) Opportunity: interpersonal interaction, parental parenting style, and social support. Analysis revealed that stigma indirectly influences social withdrawal through self-esteem; physical problem indirectly influences social withdrawal by affecting interpersonal interaction; and parental parenting style and social support further influence children's social withdrawal behaviors by affecting self-acceptance.
This study applied the COM-B model to pediatric oncology, revealing the multifaceted causes of social withdrawal in children with cancer. It highlights the need, beyond physical recovery, to foster psychological acceptance, build motivation, and expand social opportunities. Examples include integrated physical-social interventions, positive parenting, enhanced self-worth, and strengthened disease awareness and support networks to encourage active social engagement.
The findings are derived from authentic interview texts of children with cancer or their caregivers, providing practical reference value. This deepens understanding of the causes of social withdrawal in cancer survivors and informs more effective strategies to support their social reintegration.
本研究以COM-B模型（“能力”“机会”“动机”和“行为”）为指导，探讨癌症患儿社交退缩的影响因素及潜在机制。
癌症患儿家庭在互联网上分享的疾病经历为本研究提供了独特的机会。组建了一个跨学科研究团队，并进行了混合主题分析，以审视41篇描述18岁及以下癌症确诊患儿经历的在线疾病叙事。
本研究确定了七个主题：（1）能力：身体问题与自我接纳；（2）动机：耻辱感与自尊；（3）机会：人际互动、父母教养方式和社会支持。分析表明，耻辱感通过自尊间接影响社交退缩；身体问题通过影响人际互动间接影响社交退缩；父母教养方式和社会支持通过影响自我接纳进一步影响儿童的社交退缩行为。
本研究将COM-B模型应用于儿科肿瘤学，揭示了癌症患儿社交退缩的多方面原因。它强调了除身体康复外，培养心理接纳、建立动机和扩大社会机会的必要性。例如包括综合身体-社会干预、积极教养、增强自我价值以及加强疾病认知和支持网络，以鼓励积极的社会参与。
研究结果源自癌症患儿或其照顾者的真实访谈文本，具有实际参考价值。这加深了对癌症幸存者社交退缩原因的理解，并为支持他们重新融入社会的更有效策略提供了信息。
