The experiences of physical appearance and body-related changes in teenage and young adult (TYA) cancer survivors. Body image changes experienced by teenage and young adult (TYA) cancer survivors: a qualitative systematic review and thematic synthesis; and, Physical appearance evaluation, comparisons and wellbeing among teenage and young adult (TYA) cancer survivors: a moderated mediation model

OBJECTIVE: The current portfolio aimed to develop a more nuanced understanding of teenage and young adult (TYA) cancer survivors’ experience of physical appearance and body-related changes post-treatment. The first chapter presents a systematic review that synthesised existing qualitative literature on TYA survivors’ understanding and perspective of body image and appearance changes following treatment for cancer. The second chapter outlines an original research project that was designed to explore the relationships between physical appearance comparisons, appearance evaluation (e.g. valence) and overall wellbeing, as well as whether these associations differed between TYA cancer survivors and the general TYA population. METHODS: For the systematic review, an electronic search across five databases identified nine studies that met inclusion criteria. The included studies were quality assessed and then analysed using thematic synthesis. The original research project used a cross-sectional design. Participants completed an online questionnaire consisting of four measures. Moderated mediation (Model 59) analyses were conducted using the PROCESS macro for SPSS. RESULTS: In the systematic review, two analytical themes were identified: (1) Striving for social safety and (2) Navigating an unfamiliar body. Overall, the themes captured the social, identity and restorative processes that TYA survivors described post-treatment. In the original research study, the strength of the mediation for both the direction (e.g. upward vs downward) and effect (e.g. more positive vs more negative) of social, as well as temporal, comparisons differed significantly between the groups. CONCLUSION: Findings across both the systematic review and original research project suggest that physical appearance changes and evaluations are multi-faceted components to TYA cancer survivors’ experience post-treatment. Overall, results highlight the inclusion of body image and appearance as crucial post-treatment follow-up and support the development of specialised, TYA-targeted interventions