A Systematic Review of Qualitative Research Describing Psychosocial Challenges in Adolescents and Young Adults Affected by Cancer: Implications for Healthcare Provider Practice.
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OBJECTIVES: Psychosocial challenges among adolescents and young adults with cancer are distinct and diverse. While researchers have collated these challenges to inform tailored support strategies and interventions, healthcare providers continue to report uncertainty and difficulty delivering psychosocial cancer care in this cohort. A growing body of qualitative research captures adolescents and young adults' voices and elaborates on the challenges faced, yet this evidence remains fragmented. Synthesizing adolescents and young adults' lived experiences could generate actionable insights and better equip healthcare providers to provide the care that is needed and wanted by adolescents and young adults. The purpose of this systematic review was to synthesize qualitative evidence covering the psychosocial challenges experienced among adolescents and young adults affected by cancer with a focus on informing recommendations for healthcare providers caring for this population. METHODS: This review was guided by Joanna Briggs Institute methodology for systematic reviews of qualitative evidence. Three electronic databases were searched for qualitative studies published between 2006 and 2024 that reported on psychosocial challenges among adolescents and young adults with cancer. Two researchers screened citations against predefined eligibility criteria, conducted quality appraisal, and extracted data using a standardized template. Data were analyzed using a meta-aggregation approach. RESULTS: In total, 7,762 references were identified and 56 articles were included. Four themes (with additional subthemes) were identified and organized into domains: physical, psychological, interpersonal, and daily living. Synthesized data highlighted that adolescents and young adults with cancer experience a loss of control across domains, leading to withdrawal and distress throughout the cancer continuum. CONCLUSIONS: Findings afford an integrated and nuanced understanding of the psychosocial challenges adolescents and young adults affected by cancer experience-in their own words-and seek to better equip healthcare providers to address the psychosocial sequelae of this population. IMPLICATIONS FOR NURSING PRACTICE: Nurses can empower adolescents and young adults by promoting clear communication about side effects and consequences of cancer and treatment, involving adolescents and young adults in shared decision making, and adopting a strengths-based approach in care.