Lauren C Heathcote1, Nele Loecher1, Pamela Simon2, Sheri L Spunt3, Abbie Jordan4, Perri R Tutelman5, Sarah Cunningham1, Lidia Schapira6, Laura E Simons1. 1. Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA. 2. Department of Pediatric Hematology-Oncology, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA. 3. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA. 4. Department of Psychology & Centre for Pain Research, University of Bath, Bath, UK. 5. Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada. 6. Department of Medical Oncology, Stanford University School of Medicine, Stanford, CA, USA.
Abstract
OBJECTIVE: Somatic symptoms capture attention, demand interpretation, and promote health behaviors. Symptom appraisal is particularly impactful within uncertain health contexts such as cancer survivorship. Yet, little is known about how individuals make sense of somatic symptoms within uncertain health contexts, nor how this process guides health behaviors. DESIGN: 25 adolescent and young adult survivors of childhood cancer completed semi-structured interviews regarding how they appraise and respond to changing somatic sensations within the uncertain context of survivorship. MAIN OUTCOME MEASURES: Interviews were transcribed verbatim and subjected to a hybrid deductive-inductive thematic analysis, guided by the Cancer Threat Interpretation model. RESULTS: We constructed three themes. Symptoms as signals of bodily threat (theme 1) captured that participants described commonly interpreting and worrying about everyday sensations as indicating cancer recurrence or new illness. Playing detective with bodily signals (theme 2) captured participants' felt need to employ cognitive and behavioral strategies to determine whether somatic sensations indicated a credible health threat. These two themes are qualified by the final theme, Living with symptom-related uncertainty (theme 3), which captured participants' recognition that post-cancer symptoms are wily and influenced by psychological factors such as anxiety. CONCLUSIONS: These data highlight that making sense of everday somatic sensations can be particularly challenging following an experience of cancer. There is a need for novel symptom management approaches that target how somatic sensations are appraised and responded to as signals of bodily threat.
OBJECTIVE: Somatic symptoms capture attention, demand interpretation, and promote health behaviors. Symptom appraisal is particularly impactful within uncertain health contexts such as cancer survivorship. Yet, little is known about how individuals make sense of somatic symptoms within uncertain health contexts, nor how this process guides health behaviors. DESIGN: 25 adolescent and young adult survivors of childhood cancer completed semi-structured interviews regarding how they appraise and respond to changing somatic sensations within the uncertain context of survivorship. MAIN OUTCOME MEASURES: Interviews were transcribed verbatim and subjected to a hybrid deductive-inductive thematic analysis, guided by the Cancer Threat Interpretation model. RESULTS: We constructed three themes. Symptoms as signals of bodily threat (theme 1) captured that participants described commonly interpreting and worrying about everyday sensations as indicating cancer recurrence or new illness. Playing detective with bodily signals (theme 2) captured participants' felt need to employ cognitive and behavioral strategies to determine whether somatic sensations indicated a credible health threat. These two themes are qualified by the final theme, Living with symptom-related uncertainty (theme 3), which captured participants' recognition that post-cancer symptoms are wily and influenced by psychological factors such as anxiety. CONCLUSIONS: These data highlight that making sense of everday somatic sensations can be particularly challenging following an experience of cancer. There is a need for novel symptom management approaches that target how somatic sensations are appraised and responded to as signals of bodily threat.
Entities:
Keywords:
Symptom; adolescent and young adult; cancer survivors; qualitative; somatic
Authors: Lauren C Heathcote; Sarah J Cunningham; Sarah N Webster; Vivek Tanna; Elia Mattke; Nele Loecher; Sheri L Spunt; Pamela Simon; Gary Dahl; Marta Walentynowicz; Elizabeth Murnane; Perri R Tutelman; Lidia Schapira; Laura E Simons; Claudia Mueller Journal: Psychooncology Date: 2022-04-25 Impact factor: 3.955
Authors: An De Groef; Mira Meeus; Lauren C Heathcote; Louise Wiles; Mark Catley; Anna Vogelzang; Ian Olver; William B Runciman; Peter Hibbert; Lore Dams; Bart Morlion; G Lorimer Moseley Journal: J Cancer Surviv Date: 2022-03-11 Impact factor: 4.442