Adolescents with cancer felt supported by connecting with others in similar circumstances through a teen support group
Ms J Cassano, McMaster Children’s Hospital, Hamilton, Ontario, Canada;
What are adolescents’ perceptions of a teen support group for cancer?
Purposeful sample of 11 adolescents 14–20 years of age (mean age 16 y, 55% men) who had cancer and were part of a teen support group.
Adolescents participated in individual interviews lasting 20–45 minutes. Interviews were tape recorded, transcribed, coded, and analysed for themes; field notes were also analysed. To increase trustworthiness, researchers analysed data individually and then had group discussions to arrive at a common meaning of the data.
2 themes described adolescents’ perceptions of a teen support group for cancer: (1) satisfying elements and (2) challenges. (1) Satisfying elements involved 3 subthemes. (a) Talking to others who “just know.” Adolescents with cancer felt an instant connection and comfort level with same-age peers who had similar experiences. They found it easier to discuss cancer-related topics within the group than with friends who did not have cancer. Discussions provided support when adolescents were on treatment because they did not have to explain medical terms. Although men felt understanding and support from both support-group and healthy peers, women felt that healthy peers were neither understanding nor supportive. (b) Sharing experiences and having fun as a normal teen. The support group provided opportunities to have fun and socialise with same-age peers during treatment; it allowed the choice of whether or not to talk about cancer and to shift between light (sports and music) and serious (treatments and hospital experiences) conversations. Participants enjoyed the combination of activity and talking because it enabled them to feel like a normal teenager and forget problems. They also expressed a need to be away from their families so that they could spend time with peers instead. (c) Inspiring—giving and receiving. Adolescents on treatment were inspired by adolescents who had completed therapy, gone on to postsecondary school, and were living healthy lives. Adolescents off treatment found it rewarding to give back to the group by sharing their positive experiences with those who were still on treatment, reunite with friends, and experience the group connection. (2) Challenges involved 2 subthemes. (a) Level of activity for events. Adolescents recognised that some of their peers were physically challenged (eg, mobility, fatigue, and pain) and suggested that group events should be balanced between activity and non-activity. (b) Dealing with the death of a group member. Adolescents had different perspectives on dealing with the death of a group member (ie, whether to inform the group of a death) because they did not know how different individuals would react to death.
Adolescents with cancer felt supported by connecting with others in similar circumstances and participating in normal activities in a teen support group.
Cassano J, Nagel K, O’Mara L. Talking with others who “just know”: perceptions of adolescents with cancer who participate in a teen group. J Pediatr Oncol Nurs 2008;25:193–9.
The study by Cassano et al offers insight into the perceptions and needs of teens with cancer with respect to support groups. The most striking finding related to doing normal activities. Other studies allude to the drive for normalcy in patients with cancer, but none have focused on the effect of planned activities as part of support group work nor identified this specific aspect as essential to feeling normal.1 2 The title of the article, “Talking with others who ‘just know,’” states the most important effect of the teen support group. Healthcare professionals “know” cancer through a different lens; parents know cancer as a source of fear for their child; and siblings understand it in terms of diverted attention and protection of their sibling. Peers with cancer “just know” the issues, even when cancers differ. Perceptions of understanding and support of usual friendship networks differed by sex, with young men perceiving more and appropriate support from friends than young women. Participants also commented on the need to “give back” to the support group when they were no longer on treatment.
Areas for further research and refinement of findings include examining age-specific perceptions, needs, and differences, for example, in terms of discussions of death and other specific topics. One would also expect a desire for different activities in teens who are 14–20 years of age. It could be that the need to give back overrode the need for age-appropriate activities. Further research might also address the effect of sex, culture, and treatment status or prognosis on discussions of the death of peers and reactions to diagnosis. Teens in rural and remote areas are understudied in terms of these issues and how they receive support within their communities.
From a practice perspective, the study provides insights that could be integrated into the care of teens with cancer, specifically by treating them as “normal,” whether that involves allowing the freedom to be active, speak with others, or discuss death and other important issues on their own terms. Sensitivity to the specific support needs of young women is important as healthcare professionals may play a supportive or educative role in helping family and friends understand what is going on and dealing with the results of discussions.