Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship.
Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship.
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DOI：
10.1200/edbk_279787
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发表时间：
2020-03-01
期刊：
影响因子：
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通讯作者：
Rosenberg, Abby R
中科院分区：
文献类型：
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作者：
Perez, Giselle K;Salsman, John M;Rosenberg, Abby R
在过去十年中，对患有癌症的青少年和年轻人的研究蓬勃发展，突出了这一弱势群体独特的医疗和社会心理需求。青春期和青年期的癌症诊断与AYAs的发展轨迹相交，偏离了关键的身体，社会和情感发展。青少年面临着这些突然的生活变化，需要与他们年龄相适应的信息和资源来抵消这些挑战。需要更加重视解决美国青少年协会对生殖健康和性健康、经济安全和独立、情感福祉、社会支持和临终关怀的具体关切。如果这些独特的需求得不到满足，这可能会对青少年的医疗保健参与和整体生活质量产生不利影响，增加他们患癌症相关疾病和早期死亡的风险。特别是，治疗期间做出的卫生保健决定对AYA患者未来的健康有重要影响。通过预测和解决这一年龄组可能面临的挑战，肿瘤临床医生可以很好地解决AYA患者的担忧。在本文中，我们探讨了影响AYAs生活质量的几个核心主题，这些主题可能具有挑战性。从诊断的那一刻开始，通过癌症治疗和治疗后的生存，直到生命的终结，每个部分都强调了受癌症经历影响的以发展为中心的关键生命领域。具体地说，我们将讨论资源、工具和策略来引导这些具有挑战性的对话。采取降低风险的方法，邀请双向沟通，并促进转介到适合年龄的资源，将有助于消除这些经历的污名，反过来，将支持为这一弱势群体提供富有同情心和有效的年龄协调护理。
Research on adolescents and young adults (AYAs) with cancer has flourished over the past decade, underscoring the unique medical and psychosocial needs of this vulnerable group. A cancer diagnosis during adolescence and young adulthood intersects with the developmental trajectory of AYAs, derailing critical physical, social, and emotional development. AYAs face these abrupt life changes needing age-appropriate information and resources to offset these challenges. Greater attention is needed to address AYA-specific concerns on reproductive and sexual health, financial security and independence, emotional well-being, social support, and end-of-life care. If these unique needs are unaddressed, this can adversely affect AYAs' health care engagement and overall quality of life, increasing their risk for cancer-related morbidity and early mortality. In particular, health care decisions made during treatment have important implications for AYA patients' future health. Oncology clinicians are well positioned to address AYA patients' concerns by anticipating and addressing the challenges this age group is likely to face. In this paper, we explore several core topics that affect AYAs' quality of life and that can be challenging to address. Starting from the moment of diagnosis, through cancer treatment and post-treatment survivorship, and into end of life, each section highlights critical developmental-centric life domains that are affected by the cancer experience. Specifically, we discuss resources, tools, and strategies to navigate these challenging conversations. Taking a risk-reduction approach that invites two-way communication and facilitates referral to age-appropriate resources would help destigmatize these experiences and, in turn, would support the provision of compassionate and effective age-concordant care to this vulnerable group.