Assigning healthy classmates to accompany patients with cancer in their peer group to hospital visits had a positive impact on the patients’ social and emotional wellbeing.
Healthy classmates accompanying adolescent patients with cancer during their hospital treatments was proven to be a beneficial source of psychosocial support, according to recent findings from the RESPECT study published in the Journal of Advanced Nursing.
According to the authors, adolescents with cancer often face an extra layer of challenges during their treatment, aside from physical issues. These can include emotional suffering such as loneliness, depression, anxiety and low self-esteem, as well as social isolation, low academic performance and difficulty maintaining or developing friendships. This is important to address because adolescence is an important stage of cognitive, emotional and social development.
Cancer treatments, the authors added, tend to be intensive and lengthy, impeding on patients’ normal opportunities for social interaction and putting them at the risk of disrupting normal maturation processes and fragmenting or delaying their developmental skills.
“Hence, exploring new ways of how adolescents receive and perceive social support from this target group is fundamental in developing appropriate social support systems suited to the specific needs of adolescents during cancer treatment,” the authors wrote.
To explore the potential benefit of connections between adolescent patients with cancer and healthy classmates, the researchers co-admitted the classmates (two per patient), who were considered “ambassadors,” with the patients (aged 6-18) during visits to the Department of Pediatric and Adolescent Medicine at the University Hospital in Copenhagen. The ambassadors also received an educational session on cancer and cancer treatment. Patients were also introduced to a physical activity component to determine whether it would have a beneficial effect.
The researchers conducted semi-structured interviews of the patients using open-ended questions around the themes of the ambassadors’ co-admittance to the hospital, the adolescent patients’ relationships with their ambassadors and other friends during/after treatment as well as during their return to school.
The majority of the adolescent patients’ experiences with their ambassadors were positive. They reported feeling more of a sense of belonging to their school peer group, more connected to normalcy and more optimistic about life after treatment. They also emphasized the importance of their ambassadors in facilitating their reentry to school and reintegration to peer groups. The patients appreciated having a friend who had a mutual understanding of their cancer, treatment and sufferings. The ambassadors also provided a safe and welcoming presence to go to for help if they were having trouble resuming typical tasks. However, this extra support did not entirely solve the issue.
“In contrast, the adolescents felt that their non-ambassador classmates showed hesitancy in approaching them and, in general, the adolescents found it difficult to reinstate themselves in school life,” the authors wrote.
The patients also reported that their ambassadors’ presence was therapeutic at times and helped them feel more “normal” in situations deemed abnormal.
“Through their friendship and sharing age-relevant activities, the ambassadors permitted the adolescents to reassume their teenager identity rather than sustaining their image as just a (patient with cancer),” the authors wrote.
One downside to the presence of the ambassadors was feelings of vulnerability and dependance for the patients. In situations where the patient became very ill due to side effects, they were embarrassed to be in front of a peer and felt “helpless to maintain any self-integrity and self-control.” However, it was expressed that the benefits outweighed these negative feelings.
“These findings speak to the quality of supportive relationships that exist among classmates and calls for facilitated interventions to maintain consistent social support from friends during treatment and in survivorship,” the authors emphasized.
They added that it’s important for further research to continue exploring this source of support for adolescent patients with cancer.
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