Background: To an adolescent or young adult (AYA), a diagnosis of cancer poses unique challenges to personal and social development: interrupting social relationships, halting the move towards independence, and postponing achievement of educational and occupational goals. Isolation, side effects of treatment, dependence upon family members, and changes in body image lead to an interruption of identity development and often results in emotional symptoms including anxiety and depression. The goal of this research was to measure the psychosocial services utilized by AYAs in a pediatric program at a comprehensive cancer center.
The Pediatric Psychosocial Support team at a comprehensive cancer center in the United States collected data on services (emotional coping, family conference, social services, medical education, psychosocial screening, socialization, school, symptom management) rendered by the psychosocial team (psychiatry, psychology, clinical social work, child life, palliative care, chaplain) to all patients over a 2 month period. Quantity and types of services utilized were examined contrasting the Pediatric (0 to 15) and AYA (16+) age groups.
A total of 1403 encounters were collected amongst 149 unique patients. Services were provided to 56 AYA patients with an average of 14 encounters per patient. Services were provided to 97 pediatric patients with 6 encounters on average. AYAs had a significantly higher number of encounters per patient than Pediatric patients. (p<.05). The top interventions provided to AYAs were emotional/coping support (44.7%), school (15.3%), socialization (15.1%), and social services (15%). The top interventions for pediatrics were emotional coping (57.3%), socialization/developmental activities (17.3%) and school (9.9). While AYAs required slightly less emotional/coping support, they needed more support in the area of social service (financial assistance, accessing resources, and advocacy). Finally, AYAs received emotional/coping resources primary from Clinical Social Work professionals, while Pediatric patients received emotional and coping support primarily from Child Life Specialists.
The results suggest that AYA oncology patients continue to need outside support to address the needs that arise from a cancer diagnosis. AYA patients like pediatric patients, need support in the area of coping, socialization, and schooling. Unlike pediatric patients, however, they have many more concerns with regards to navigating financial, resource, and advocacy concerns than pediatric patients and their families.