Contributors and Inhibitors of Resilience Among Adolescents and Young Adults with Cancer

Abstract

Purpose: Self-perceived resilience may enable coping and mitigate poor psychosocial outcomes among adolescent and young adult (AYA) patients with cancer. In order to inform the development of resilience-promoting interventions, we aimed to: (1) describe AYA patient-reported resilience and (2) identify AYA patient-reported contributors and inhibitors of resilience. Methods: The "Resilience in Adolescents and Young Adults with Cancer" study was a prospective longitudinal mixed-methods study. Consecutive Caucasian patients aged 14-25 years old enrolled 14-60 days following their diagnosis of cancer and completed one-on-one semi-structured interviews both at the time of enrollment and 3-6 months later. Constant comparative analyses identified salient themes describing modifiable contributors and inhibitors to patient-perceived resilience. Results: Seventeen patients (85% of those approached) enrolled in the study. The mean age was 17 years (SD=2.6) and 53% were female. All patient definitions of resilience inferred an ability to handle adversity. Five themes emerged as predominant contributors or inhibitors of resilience: (1) stress and coping; (2) goals, purpose, and planning; (3) optimism; (4) gratitude and meaning; and (5) connection and belonging. Merged analyses suggested that AYA resilience was a balance that may be enabled by promoting certain skills. Conclusion: AYA patients with cancer perceive resilience as a balance. Learned skills in stress management, goal-setting, and benefit-finding may empower AYAs during their cancer experience, in turn improving long-term psychosocial outcomes.

Keywords: coping; meaning-making; psychosocial outcomes; resilience; stress; survivorship.

FIG. 1.

Flow diagram of patient approach, enrollment, and completion of study interviews.

FIG. 2.

The balance between adolescent and young adult cancer patients' self-reported contributing and inhibiting factors of resilience. Potential interventions could translate these into teachable skills or programmatic support aimed at tipping the scales toward resilience.