The psychosocial experiences of long -term survivors of childhood cancer across the lifespan.

Advances in medical treatment for childhood cancer have resulted in dramatically increased survival rates, and a growing population of long-term survivors (LTS). As a result, their psychosocial issues and service needs have become increasingly important topics in social work and health care. Existing research has been limited by its focus on short-term survivorship, its atheoretical nature, and its reliance upon biomedical models of disease and dysfunction, which assume primarily negative psychosocial after-effects. In a series of manuscripts, this inquiry explores the ways in which cancer survivorship intersects with lifespan developmental issues and how cancer may lead to positive psychosocial outcomes, including transformational change, or thriving. Findings are based on qualitative and quantitative data. Using a sample of survivors randomly selected from the medical records of a major midwestern cancer center, survey data were collected from 190 LTS of childhood cancer in 1998--1999. Subsequently, in-depth interviews were conducted with 23 LTS of childhood cancer (aged 17--29) in May--November, 2000. The survey questionnaires and the interviews focused on the effects of cancer on survivors' lives in four domains of well-being: physical, psychological, social, and spiritual. Data were analyzed using factor analyses, t-tests, and inductive qualitative methods. This inquiry is composed of three manuscripts. The first manuscript, Embracing Uncertainty, suggests that one of the key factors involved in psychosocial well-being after cancer is how survivors relate to and negotiate existential uncertainty. The second manuscript, Evidence and Correlates of Psychosocial Thriving, explores the possibility of positive change, growth, and transformation resulting from cancer. The final manuscript, Clinical Vs. Statistical Analyses of Thriving, compares quantitative and qualitative assessments of well-being to explore the role/s that different methodologies play in understanding LTS's psychosocial experiences. Together, the manuscripts provide a template for understanding the range of possible outcomes in long-term survivorship of childhood cancer and the processes that lead to psychosocial thriving. This body of work suggests that processes of coping, healing, and development are intimately related and that meaning making is crucial to long-term psychosocial well-being. This work suggests that, in the aftermath of a trauma such as childhood cancer, many outcomes are possible, including thriving.Ph.D.Developmental psychologyPsychologySocial SciencesSocial psychologySocial workSociologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/132733/2/3058028.pd