Stress management, mindfulness, and peer support needs among adolescent and young adult cancer survivors: a qualitative interview study

IntroductionAdolescent and young adult cancer survivors (AYA-CS) make up a distinct, growing oncology patient population that uniquely contends with the challenge of navigating cancer survivorship alongside the typical developmental tasks of emerging adulthood (EA). Though past research has found high levels of psychological distress, anxiety, and depression in this population, AYA-CS remain understudied. Little is known about their personal strategies for coping with stress and their experiences applying evidence-based coping strategies.MethodsTo fill this gap, we conducted in-depth qualitative semi-structured interviews with AYA-CS (N = 19), all at least one-year post-treatment, to explore their day-to-day stressors, stress management techniques, and use of mindfulness. Interviews lasted approximately one hour each and were conducted via Zoom videoconferencing.ResultsThrough thematic analysis, three major themes emerged: The fluid salience of survivorship for identity and experience; Applying self-management and accountability to maintain stress-reducing habits; and Implicit mutual understanding among AYA-CS. These, with their corresponding subthemes, reflect the dynamic and nuanced ways in which participants, as AYA-CS in EA, construct and understand their identities and lives during survivorship. While the role of survivorship in identity and stress varied, all participants relied on family and friends for social support and to remain accountable to their personal coping strategies, most commonly exercise. Many participants had been previously introduced to mindfulness by their treatment teams, though only four continued to independently use it in their own lives. Finally, more than half agreed that meeting other AYA-CS, which was rare for them, could promote an instant bond and connection that would not otherwise be possible with those their age who had no cancer history.DiscussionThese findings may be used to inform future intervention development targeted at the specific needs of AYA-CS, who, in this study, demonstrated interest in connecting with peers to share lived experiences and support one another through the unique combination of survivorship and EA. These findings suggest that future peer-supported interventions should be explored and tested.