Returning to school from the perspective of adolescent cancer survivors: a qualitative analysis

Authors

  • Carolliny Rossi de Faria Ichikawa Centro Universitário Faculdade de Medicina do ABC (FMABC), Santo André, São Paulo, Brasil. E-mail: carolliny.ichikawa@fmabc.net. https://orcid.org/0000-0003-3002-9448
  • Elaine Cristina Rodrigues Gesteira Faculdade de Enfermagem da Universidade Estadual de Campinas (FEnf-Unicamp), Campinas, São Paulo, Brasil. E-mail: elaine_gesteira@ufsj.edu.br. https://orcid.org/0000-0002-9153-5777
  • Camila Amara Borghi Universidade Municipal de São Caetano do Sul (USCS), São Paulo, São Paulo, Brasil. E-mail: camila.borghi@online.uscs.edu.br. https://orcid.org/0000-0002-3867-4604
  • Regina Szylit Universidade de São Paulo (USP), São Paulo, São Paulo, Brasil. E-mail: szylit@usp.br. https://orcid.org/0000-0002-9250-0250

DOI:

https://doi.org/10.5216/ree.v27.77644

Keywords:

Adolescent, Cancer Survivors, Return to School, Neoplasms, Pediatric Nursing

Abstract

Objectives: to understand the dynamics of returning to school from the perspective of adolescent cancer survivors. Methods: a qualitative study was conducted using symbolic interactionism as a framework. Fourteen adolescent cancer survivors undergoing outpatient treatment at a hospital specializing in childhood cancer in the city of São Paulo participated in the study. Semi-structured interviews were used, and thematic analysis was employed to analyze the data. Results: four themes were identified: Not telling anyone about having cancer; Suffering bullying at school; Facing prejudice; and Seeking normality. Adolescent cancer survivors face a series of personal challenges after completing treatment, including returning to school, due to difficulties caused by prejudice — either because of their physical appearance or the stigma of the disease itself. Conclusions: the dynamics of returning to school from the adolescents’ perspective reveal a mixture of difficulties faced, coping strategies, and the desire to get on with life like everyone else.

Downloads

Download data is not yet available.

References

1. Hydeman JA, Uwazurike OC, Adeyemi EI, Beaupin LK. Survivorship needs of adolescent and young adult cancer survivors: a concept mapping analysis. J Cancer Surviv. 2019 Jan 2;13:34-42. https://doi.org/10.1007/s11764-018-0725-5

2. Andrés-Jensen L, Larsen HB, Johansen C, Frandsen TL, Schmiegelow K, Wahlberg A. Everyday life challenges among adolescent and young adult survivors of childhood acute lymphoblastic leukemia: An indepth qualitative study. Psycho-Oncol. 2020 July 16;29(10):1630-7. https://doi.org/10.1002/pon.5480

3. Erdmann F, Frederiksen LE, Bonaventure A, Mader L, Hasle H, Robison LL, et al. Childhood cancer: survival, treatment modalities, late effects and improvements over time. Cancer Epidemiol. 2021 May 24;71(Pt B):101733. https://doi.org/10.1016/j.canep.2020.101733

4. American Cancer Society. Cancer Treatment & Survivorship: Facts & Figures 2019-2021 [Internet]. Atlanta (GA): American Cancer Society; 2019 [cited 2023 Dec 1]. 47 p. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-and-figures-2019-2021.pdf

5. Cousijn J, Luijten M, Ewing SWF. Adolescent resilience to addiction: a social plasticity hypothesis. Lancet Child Adolesc Health. 2017 Nov 17;2(1):69-78. https://doi.org/10.1016/S2352-4642(17)30148-7

6. Pringle J, Mills K, McAteer J, Jepson R, Hogg E, Anand N, et al. A systematic review of adolescent physiological development and its relationship with health-related behaviour: a protocol. Syst Rev. 2016 Jan 5;5:3. https://doi.org/10.1186/s13643-015-0173-5

7. Bradford NK, McDonald FEJ, Bibby H, Kok C, Patterson P. Psychological, functional and social outcomes in adolescent and young adult cancer survivors over time: A systematic review of longitudinal studies. Psycho-Oncology. 2022 June 22;31(9):1448-58. https://doi.org/10.1002/pon.5987

8. Sisk BA, Fasciano K, Block SD, Mack JW. Impact of cancer on school, work, and financial independence among adolescents and young adults. Cancer. 2020 July 13;126(19):4400-6. https://doi.org/10.1002/cncr.33081

9. Fardell JE, Wakefield CE, Patterson P, Lum A, Cohn RJ, Pini SA, et al. Narrative review of the educational, vocational, and financial needs of adolescents and young adults with cancer: recommendations for support and research. J Adolesc Young Adult Oncol. 2018 Apr 1;7(2):143-7. https://doi.org/10.1089/jayao.2017.0086

10. Pini S, Gardner P, Hugh-Jones S. How and why school is important to teenagers with cancer: outcomes from a photo-elicitation study. J Adolesc Young Adult Oncol. 2019 Apr 5;8(2):157-64. https://doi.org/10.1089/jayao.2018.0068

11. Otth M, Scheinemann K. Back to school - the teachers’ worries and needs having a childhood cancer patient or survivor in their class. Front Oncol. 2022 Nov 1;12:992584. https://doi.org/10.3389/fonc.2022.992584

12. Elsbernd A, Pedersen KJ, Boisen KA, Midtgaard J, Larsen HB. “On Your Own”: Adolescent and Young Adult Cancer Survivors’ Experience of Managing Return to Secondary or Higher Education in Denmark. J Adolesc Young Adult Oncol. 2018 Oct 5;7(5):618-25. https://doi.org/10.1089/jayao.2018.0058

13. Choquette A, Rennick JE, Lee V. Back to School After Cancer Treatment: Making Sense of the Adolescent Experience. Cancer Nurs. 2016 Oct 9;39(5):393-401. https://doi.org/10.1097/NCC.0000000000000301

14. Heaton J. Secondary analysis of qualitative data: An overview. Hist Soz Forsch. 2008;33(3):33-45. https://doi.org/10.12759/hsr.33.2008.3.33-45

15. Thorne S. Secondary analysis of qualitative research: Issues and implications. In: Morse JM, editor. Critical issues in qualitative research methods. 1st ed. Thousand Oaks: Sage; 1994. p. 263-79.

16. Thorne S. Interpretive description: Qualitative Research for Applied Practice. 1st ed. California: Left Coast Press; 2008.

17. Charon JM. Symbolic Interacionism: an introduction, an interpretation, an integration. 9th ed. Upper Saddle River: Pearson; 2007.

18. Boyatzis RE. Transforming qualitative information: thematic analysis and code development. Thousand Oaks: Sage; 1998.

19. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 Sept 14;19(6):349-57. https://doi.org/10.1093/intqhc/mzm042

20. Turcotte LM, Neglia JP, Reulen RC, Ronckers CM, Leewen FE, Morton LM, et al. Risk, Risk Factors, and Surveillance of Subsequent Malignant Neoplasms in Survivors of Childhood Cancer: A Review. J Clin Oncol. 2018 June 6;36(21):2145-52. https://doi.org/10.1200/JCO.2017.76.7764

21. Rick TJ, Lee J, Skendzel S, Verich K, Schempp A, Napurski C, et al. The development and flux of the University of Minnesota Survivorship Program: progress, challenges, and opportunities. J Cancer Surviv. 2024 Jan 31;18:42-52. https://doi.org/10.1007/s11764-023-01520-z

22. Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qual Methods. 2006 Mar;5(1):80-92. https://doi.org/10.1177/160940690600500107

23. Resolução Nº 466 do Conselho Nacional de Saúde, de 12 de dezembro de 2012 (BR) [Internet]. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União. 2012 Dec 12 [cited 2023 Dec 1]. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html

24. Oliveira RAA, Zago MMF, Thorne SE. Interaction between professionals and cancer survivors in the context of Brazilian and Canadian care. Rev. Latino-Am. Enfermagem. 2017;25:e2972. https://doi.org/10.1590/1518-8345.2253.2972

25. Wood SK. Transition to cancer survivorship: a concept analysis. ANS Adv Nurs Sci. 2018 Apr/June;41(2):145-60. https://doi.org/10.1097/ANS.0000000000000190

26. Ichikawa CRF, Szylit R, Cunha MLR, Rossato LM, Gesteira ECR. Transition from disease to survival: accounts of adolescents who have experienced cancer. Rev Latino-Am Enfermagem. 2022 Nov 28;30(spe):e3846. https://doi.org/10.1590/1518-8345.6302.3846

27. Cameron N, Ross K, Baken D, Bimler D. The psychosocial interactions of adolescent and young adult cancer survivors and the possible relationship with their development. Cancer Nurs. 2021;44(1):e23-33. https://doi.org/10.1097/NCC.0000000000000732

28. Lea S, Martins A, Fern LA, Bassett M, Cable M, Doig G, et al. The support and information needs of adolescents and young adults with cancer when active treatment ends. BMC Cancer. 2020 July 28;20:697. https://doi.org/10.1186/s12885-020-07197-2

29. Braga TRL, Mattos CX, Cabral IE. Participatory health education on school (re)inclusion of the adolescent cancer survivor. Rev Bras Enferm. 2021 Mar 24;74(1):e20200006. https://doi.org/10.1590/0034-7167-2020-0006

30. Annisa F, Allenidekania A, Chodidjah S. Do adolescent cancer survivors need health care and psychosocial services?: An Indonesian experience. Enferm Clin. 2018 Apr 9;28(Supl 1):41-5. https://doi.org/10.1016/S1130-8621(18)30034-2

31. Stergiou-Kita M, Qie X, Yau HK, Lindsay S. Stigma and work discrimination among cancer survivors: A scoping review and recommendations. Can J Occup Ther. 2017 June 13;84(3):178-88. https://doi.org/10.1177/0008417417701229

32. Kim Y. Exploration of life experiences of positive growth in long-term childhood cancer survivors. Eur J Oncol Nurs. 2017 Aug 31;30:60-6. https://doi.org/10.1016/j.ejon.2017.08.001

33. Nap-van der Vlist MM, Kars MC, van der Sprenkel EEB, Nijhof LN, Grootenhuis MA, van Geelen SM, et al. Daily life participation in childhood chronic disease: a qualitative study. Arch Dis Child. 2019 Nov 20;105(5):463-9. https://doi.org/10.1136/archdischild-2019-318062

34. Fox RS, Armstrong GE, Gaumond JS, Vigoureux TFD, Miller CH, Sanford SD, et al. Social isolation and social connectedness among young adult cancer survivors: A systematic review. Cancer. 2023 July 25;129(19):2946-65. https://doi.org/10.1002/cncr.34934

35. Rumor PCF, Heidemann ITSB, Souza JB, Manfrini GC, Souza JM. Programa Saúde na Escola: potencialidades e limites da articulação intersetorial para promoção da saúde infantil. Saúde debate. 2023 Feb 10;46(spe3):116-28. https://doi.org/10.1590/0103-11042022E308

36. Darabos K, Ford JS. Basically, You Had Cancer and Now You Don’t’’: Exploring the Meaning of Being a ‘‘Cancer Survivor’’ Among Adolescents and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol. 2020 Aug 4;9(4):534-9. https://doi.org/10.1089/jayao.2019.0176

37. Psihogios AM, Schwartz LA, Deatrick JA, Hoeve ESV, Anderson LM, Wartman EC, et al. Preferences for cancer survivorship care among adolescents and young adults who experienced healthcare transitions and their parents. J Cancer Surviv. 2019 July 4;13:620-31. https://doi.org/10.1007/s11764-019-00781-x

38. Belpame N, Kars MC, Deslypere E, Rober P, Van Hecke A, Verhaeghe S. Coping Strategies of Adolescent and Young Adult Survivors of Childhood Cancer: A Qualitative Study. Cancer Nurs. 2021 Dec 1;44(6):e395-403. https://doi.org/10.1097/NCC.0000000000000865

39. Parrillo E, Petchler C, Jacobson LA, Ruble K, Paré-Blagoev EJ, Nolan MT. Integrative review of school integration support following pediatric cancer. J Cancer Surviv. 2022 Nov 1;18:325-43. https://doi.org/10.1007/s11764-022-01276-y

40. Bolliger C, Way K, Michel G, Sodergren SC, Darlington AS; EORTC Quality of Life Group. Mapping and comparing the quality of life outcomes in childhood and adolescent and young adult cancer survivors: an umbrella review and future directions. Qual Life Res. 2025 Mar;34:633-56. https://doi.org/10.1007/s11136-024-03825-7

Published

2025-12-31

Issue

Section

Original Article