A Developmental Science Approach to Informing Age Subgroups in Adolescent and Young Adult Cancer Research.
A Developmental Science Approach to Informing Age Subgroups in Adolescent and Young Adult Cancer Research.
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在青少年和年轻人癌症研究中告知年龄亚组的发展科学方法。
DOI：
10.1016/j.jadohealth.2023.04.014
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Salsman,JohnM
中科院分区：
文献类型：
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作者：
Siembida,ElizabethJ;Fladeboe,KaitlynM;Ip,Edward;Zebrack,Brad;Snyder,MalloryA;Salsman,JohnM
目的青春期和青壮年(Aya；确诊年龄15-39岁)癌症幸存者在发育上是异质性的，这一群体至少由三个不同的理论上知情的亚群组成：青少年、新兴成年人和年轻人。然而，在癌症特异性研究中描述这些亚组的有效性的循证建议是有限的。方法采用2x3分层抽样设计(On-vs.非治疗；15-17岁、18-25岁、26-39岁)和一项横断面调查。Ayas(N=572)完成了新兴成人维度问卷的三个子量表(身份探索、实验/可能性和其他聚焦)，我们使用回归树分析来确定平均子量表分数的明显变化，这些变化将指示独特的亚组。模型包括(A)实际年龄，(B)实际年龄+癌症相关变量，以及(C)实际年龄+社会人口学/心理社会变量作为每种发育测量的预测因素。结果接受积极治疗的Aya幸存者的推荐年龄范围与先前的研究一致：15-17岁的青少年，18-24岁的初出茅庐的成年人，25-39岁的年轻人。非治疗幸存者的模型提出了四个不同的亚组：15-17岁的青少年，18-23岁的新兴成年人，以及更年轻的(24-32岁)和更年长的年轻人(33-39岁)。没有社会人口学或心理社会变量有意义地改变这些建议。讨论我们的结果表明，三个发育亚组仍然适合接受治疗的幸存者，但第二个年轻成人亚组(年龄33-39岁)出现在非治疗幸存者。因此，发育中断可能更有可能发生或表现在治疗后的存活期。
PurposeAdolescent and young adult (AYA; diagnosed ages 15–39) cancer survivors are developmentally heterogenous, and this population consists of at least three distinct theoretically informed subgroups, as follows: adolescents, emerging adults, and young adults. However, there are limited evidence-based recommendations for delineating the validity of these subgroups in cancer-specific research. We sought to inform recommended chronological age ranges for each subgroup based on developmental processes.MethodsThe data were collected using a 2x3 stratified sampling design (on-vs. off-treatment; ages 15–17, 18–25, 26–39) and a cross-sectional survey. AYAs (N = 572) completed three subscales of the Inventory of Dimensions of Emerging Adulthood (identity exploration, experimentation/possibilities, and other-focused), and we used regression tree analyses to identify distinct shifts in mean subscale scores that would indicate unique subgroups. Models included (a) chronological age, (b) chronological age + cancer-related variables, and (c) chronological age + sociodemographic/psychosocial variables as predictors of each developmental measure.ResultsThe recommended age ranges for AYA survivors receiving active treatment were consistent with prior research as follows: adolescents ages 15–17, emerging adults ages 18–24, and young adults ages 25–39. Models for off-treatment survivors suggested four distinct subgroups: adolescents ages 15–17, emerging adults ages 18–23, and ‘younger’ (ages 24–32) and ‘older’ young adults (ages 33–39). No sociodemographic or psychosocial variables meaningfully shifted these recommendations.DiscussionOur results suggest that three developmental subgroups remain appropriate for on-treatment survivors, but a second young adult subgroup (ages 33–39) emerged for off-treatment survivors. Therefore, development disruptions may be more likely to occur or manifest in post-treatment survivorship.