The Role of Hope and Social Support in Adolescent/Young Adult (AYA) Patients Coping with Cancer Treatment

Approximately 70,000 adolescents/young-adults (AYAs; ages 15-39) are diagnosed with cancer annually in the United States (NCI, 2015). This psychosocially at-risk group is less studied and understood than other age cohorts, and experience disparities in access to developmentally-informed treatment. Hope interventions have demonstrated promising outcomes in a wide range of populations; however, no hope interventions have been studied in AYA cancer patients. To develop such interventions, additional research was needed to clarify the hope's role in AYAs' coping with cancer. Study aims were to: 1) determine how AYAs cope with cancer treatment and 2) explain hope's role (defined by Snyder, 1994) in their coping. Participants included 10 AYA cancer patients undergoing treatment at Children's Health (M=18.9 years) and 10 caregivers (M=45.6 years). Demographic variables were collected from the medical record. Participants scored within the normal to high range on measures of hope, depression/anxiety/stress, quality of life, and social support, Participants also completed a semi-structured interview. Qualitative analysis was guided by principles of grounded theory (Glaser & Strauss, 1967) and utilized the constant comparative approach. Guided by study aims, qualitative analysis generated three primary sections: 1) AYAs cancer experience, 2) hope, and 3) opinions/recommendations. Findings describe the in-depth AYA cancer experience and suggest AYAs utilize multiple coping strategies, both independently and by incorporating others. Results propose AYAs utilize an avoidance, rumination, and acceptance process during treatment, which can be enhanced by social supports. Similarly, others have the ability to provide additional coping resources for this population. Concurrent coding suggested hope theory and social supports are instrumental in AYAs coping with cancer, as much of the self- and other-coping findings described agency and pathways thinking. Others have the unique opportunity to increase hope levels through generating additional agency/pathways for AYA patients and assisting with pre-existing self-coping mechanisms. Thus, hope theory is one of inclusivity, bridging multiple coping theories and intervention techniques. Hope theory is a framework to guide clinicians, families, peers, friends, and others through future interventions and support strategies to improve coping for AYA cancer patients. Study results also include recommendations, directly from AYA patients, for social supports and AYA patients.