Cancer survivorship and identity: what about the role of oncology social workers?

With cancer survival rates rapidly increasing over time, more people are living into the survivorship stage of their cancer experience. Furthermore, the experience of cancer may impact individuals long after treatment has ceased. This paper presents the results of a mapping review implemented to explore key themes in the literature related to issues with identity following the completion of cancer treatment. The review included 22 studies including quantitative, qualitative, mixed method, and review studies as well as conceptual papers. Findings revealed key descriptions post-cancer treatment identities, literature focused on dominant discourses and counter-discourses around cancer survivorship, and key themes focused on identity management and the roles of Oncology Social Workers in supporting identity issues in postcancer treatment. This review presents a 'map' of current research on identity and cancer survivorship, helping to identify major gaps in the literature, direct future research, and inform practice.

"Others Like Me". An Approach to the Use of the Internet and Social Networks in Adolescents and Young Adults Diagnosed with Cancer

The purpose of this study is to improve comprehension about how adolescents and young adults (AYA) diagnosed with cancer use the Internet and social networks to seek information about their illness and to establish relationships between them. A group of 20 AYA patients and survivors of cancer (ages 14 to 29) were interviewed from a qualitative approach. Most of the respondents (N = 16) sought information about their disease on the Internet. They looked for information using search engines (mainly Google) and general concepts as their own cancer name. In general, they did not share the information obtained with their parents or professional healthcare providers. The interviewees think that the information is difficult to understand because of jargon and that it is not aimed at a young audience. All (N = 20) have presence in social networking sites. AYAs with cancer are starting to create content themselves: three started a blog in order to explain their experience to others like them. The study shows that is necessary to increase efforts on adapting content to these age groups in order to help them learn more about their own disease. This may contribute to increment their adherence to treatment and to maintain surveillance of potential consequences and health problems post-treatment.

"A Tribe Apart": Sexuality and Cancer in Adolescence

This qualitative study employed hermeneutic phenomenology and narrative inquiry to examine the topic of sexuality and adolescents with cancer from the perspectives of survivors who had experienced cancer as adolescents. This investigation examined the potentially sensitive, disquieting, and often taboo issue of sexuality in the interest of optimizing wellness in young people, and, ultimately, in the health of adults. Understanding the adolescent body as a sensitive, sexual, and developing self can enrich our understanding of adolescent cancer and promote best health care and practices, examining ways that we might mitigate the long-term effects of arrested or delayed development of sexual identity. In this article, we discuss phase 1 of the study, which used hermeneutics as the method of inquiry. Findings included a general experience of adolescents having a sense of "losing themselves" while at the same time finding themselves in a new light. Other findings include the connection between sexuality, self, and identity; the unique "tribe" of adolescents with cancer; the necessity for sexuality to take a backseat to cancer; the changing mirror images from self and others; sexuality and fertility; and, ultimately, that sexuality is a relational experience.

Activities of Daily Living in Survivors of Childhood Brain Tumor

OBJECTIVE. This cross-sectional, descriptive study evaluated the performance in activities of daily living (ADLs) of youth and young adult survivors of childhood brain tumor (BT) and explored associations with health-related quality of life (HRQoL).

METHOD. Thirty-six participants were examined using the Assessment of Motor and Process Skills to evaluate their quality of ADL task performance and the Medical Outcomes Study 12-Item Short-Form Health Survey (SF–12) to evaluate HRQoL.

RESULTS. Participants had significantly lower performance in ADLs compared with age norms (p < .05), and their functional level was positively associated with the SF–12 Physical (r 2 = .5) and Mental (r 2 = .3) scales.

CONCLUSION. Participants had significant limitations in both motor and process skills, which affected their performance in ADLs. Study results emphasize the importance of long-term follow-up and rehabilitation services aimed at improving the functional level and HRQoL of BT survivors.

Medication adherence skills training for African-American breast cancer survivors: the effects on health literacy, medication adherence, and self-efficacy

There are gaps in research regarding medication adherence, self-efficacy in proper medication adherence, and health literacy among breast cancer survivors. This pilot randomized controlled study was conducted to provide information addressing health literacy with respect to medication adherence and self-efficacy in African American breast cancer survivors. The study sample consisted of an intervention group (n = 24) of medication adherence skills training (MST) and a control group (n = 24), with a total sample population of 48 participants. The MST workshop was a collaborative intervention between pharmacy and social work and was designed to address issues that may be encountered while taking multiple medications for various acute and chronic conditions, increase participant confidence in accessing necessary resources for improved medication usage, and enhance personal self-efficacy regarding health care. A statistically significant relationship was detected between initial health literacy and medication adherence, as well as initial health literacy and self-efficacy. These findings indicated that individuals with higher health literacy were more likely to have higher levels of self-efficacy and were more likely to adhere to medication instructions. Analysis of the intervention and treatment groups did not show a statistically significant effect on health literacy, medication adherence, or self-efficacy from pre-test to post-test.

A national study of the provision of oncology sperm banking services among Canadian fertility clinics

The purpose of this study was to survey the current state of oncology sperm banking services provided by fertility clinics across Canada. A total of 78 Canadian fertility facilities were invited to complete a questionnaire related to the availability, accessibility, affordability and utilisation of sperm banking services for cancer patients. The total response rate was 59%, with 20 (69%) in vitro fertilisation clinics and 26 (53%) other fertility centres returning the survey. A total of 24 responding facilities accepted oncology sperm banking referrals. The time frame to book the first banking appointment for 19 (79%) facilities was within 2 days. Inconsistent practice was found regarding the consent process for cancer patients who are of minority age. Eight (33%) facilities did not provide any subsidy and charged a standard banking fee regardless of patients' financial situations. Overall, the utilisation of oncology sperm banking services was low despite its availability and established efficacy, suggesting that Canadian cancer patients are notably underserved. The study has highlighted some important issues for further consideration in improving access to sperm banking services for cancer patients, especially for adolescents. Better collaboration between oncology and reproductive medicine to target healthcare providers would help to improve sperm banking rates.

Coping skills among African-American breast cancer survivors

Women with a diagnosis of breast cancer, particularly African-American women, face multiple barriers to survival. Although research exists regarding the unique barriers faced by African-American breast cancer survivors, there has been little research into the various coping needs or coping strategies used among African-American women. The purpose of this article is to provide information from an exploratory study of data investigating the coping skills of 30 African-American women diagnosed and treated for breast cancer. Quantitative data was collected via a self-report questionnaire based on the pretest of the Breast Cancer Survivors Toolbox. The study sample was evaluated to determine overall coping skills followed by an analysis of individual categories of coping skills (e.g., communication, information seeking, negotiating, social support systems, cultural norms). Although limited by the non-random sampling technique and self-report, the results of the study support the need for further research regarding the use of interventions and strategies tailored to improve coping skills used by this population.

Körperliche und psychosoziale Belastung bei Jugendlichen und jungen Erwachsenen mit einer Krebserkrankung

Zusammenfassung. Zielsetzung dieser Literaturanalyse ist die Erfassung des gegenwärtigen empirischen Erkenntnisstands zu den körperlichen und psychosozialen Belastungen bei Jugendlichen mit einer Krebserkrankung. Spezifische Fragestellungen beinhalten die Untersuchung der Art und der Auftretenshäufigkeit spezifischer Belastungen im körperlichen, psychischen und sozialen Bereich unter Berücksichtigung der krankheits- und behandlungsbezogenen Faktoren. Ziel ist es, den psychologischen und pädagogischen Unterstützungsbedarf sowie relevante Forschungsfragestellungen abzuleiten. Für den Suchzeitraum von 01/1986 bis 06/2009 konnten 33 Originalarbeiten in die Übersichtsarbeit einbezogen werden. Es wurden insgesamt 1751 Jugendliche mit einem Durchschnittsalter von 15.4 Jahren untersucht. Die Ergebnisse der Literaturanalyse zeigen, dass Jugendliche mit einer Krebserkrankung mit vielfältigen Belastungen konfrontiert sind, die alle elementaren Entwicklungsbereiche (physisch, psychisch, kognitiv und sozial) betreffen. Als besondere Belastungen zeigten sich in den Studien folgende Bereiche: die körperlichen Veränderungen, krebs- und behandlungsspezifische Erschöpfung (Fatigue) und die beeinträchtigte Lebensqualität, Ängste und Depression sowie ein verringertes Selbstwertgefühl, Sorgen, von den Freunden verlassen zu werden, Sorgen um verändertes Aussehen sowie darüber, die Schule zu versäumen. Als weiteres Ergebnis des Reviews kann festgehalten werden, dass für krebskranke Jugendliche der Aspekt Schule und Lernen einen großen Stellenwert einnimmt. Es besteht insgesamt ein großer Forschungsbedarf zu den psychosozialen und pädagogischen Unterstützungsbedürfnissen von jugendlichen Krebspatienten.

Tumor locus moderates anxiety symptoms in a pediatric neuro-oncologic sample

Despite the prevalence of pediatric Central Nervous System (CNS) solid tumors, little is understood about patients' disease-related anxiety experience. Data from 25 remitted pediatric CNS tumor patients posttreatment were collected. Significant symptoms of anxiety were reported by 32% of patients. MRI studies showed all anxious patients had right cortical tumors or left cerebellar tumors. Confound analyses suggest these results are not better accounted for by demographic, disease, or treatment variables. These results evidence the risk some pediatric neuro-oncologic patients face for developing significant anxiety symptoms.

Oncology social workers' perceptions of barriers to discussing fertility preservation with cancer patients

Infertility is a common result of cancer treatment; however, opportunities exist that allow patients to preserve their fertility prior to treatment. Evidence suggests health care providers, including social workers, do not consistently discuss this topic with patients. This study used a qualitative, cross-sectional design using a focus group and in-depth interviews to explore knowledge, attitudes, barriers, and behaviors related to social workers' discussion of fertility preservation with cancer patients. Factors that influence the discussion of fertility preservation among social workers include: (1) Knowledge (e.g., Fertility Preservation Resources); (2) Attitudes (e.g., Cost, Perceived Role, Comfort Level, Fertility Preservation Discussion Difficulty/Priority); (3) Barriers (e.g., Cost, Urgency to start Treatment/Time, Patient Factors, Physician Attitudes/Beliefs); (4) Behaviors; and (5) Suggestions. Results show social workers are not typically discussing fertility preservation methods with patients; however, they may be in an ideal position to facilitate the conversation between the physician and the patient. There is a strong need to develop educational interventions aimed at oncology social workers, to help facilitate discussions with patients.