"I just feel alone and by myself": how adolescents experience loneliness when their parent has cancer.
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BACKGROUND: Parental cancer is a distressing experience for young people which is associated with an increased risk of behavioural and emotional issues as well as depression and anxiety. Systematic review evidence indicates that young people experiencing parental cancer report profound feelings of loneliness. Despite this evidence, there is a lack of dedicated focus given to adolescent loneliness when a parent has cancer. This study aimed to better understand adolescent’s subjective lived experience of loneliness when their parent has cancer and considers factors which might influence their experience. METHODS: Nine qualitative interviews were conducted with young people aged 18 to 19 years old who self-identified as lonely when their parent had cancer. The sample included four women and five men. The interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. RESULTS: Young people reported several facets of loneliness including temporal loneliness, affective loneliness, relational loneliness, existential loneliness and feeling like a changed person as a result of parental cancer. Young people’s loneliness was exacerbated by constrained communication with their parent and missing who their parent was prior to cancer. Normal family life had to shrink around the parent’s cancer diagnosis which left young people feeling lonely. Young people hid the pain of parental cancer from their friends. Even in cases where young people were keen to socialise, caring responsibilities limited their time to do so. Young people reported that discussing parental cancer with peers with similar lived experience and socialising with selected trusted friends was helpful when their parent had cancer. Loneliness could also be alleviated by getting support from trusted adults and techniques such as journalling to support emotional processing and catharsis. CONCLUSIONS: Adolescents experiencing parental cancer report intrapersonal loneliness and interpersonal loneliness across their peer group and family life. Healthcare professionals should identify if patients have young dependent children early on so they can support parents to provide age-appropriate information about cancer to their young people and signpost parents to relevant support for their children. This study has provided a strong foundation to begin developing a theoretical model of loneliness in adolescents experiencing parental cancer.