Human Flourishing in Adolescents and Young Adults with Cancer

Abstract

Survivorship of adolescents and young adults with cancer (AYAC) has for the last decade been a critical issue in pediatric oncology. Some studies have emphasized the importance of a positive health approach for AYAC, enhancing strengths and resources necessary to successfully address life-long challenges during and after treatment. Human flourishing (HF), a life-long process to achieve “uniqueness, dignity, diversity, freedom, happiness, and holistic well-being of the individual” (National League for Nursing, 2014, p. 1), can work as an excellent target for health care that addresses the unique needs of AYAC. However, the concept of HF has received scant attention in the field of pediatric and young adult oncology and has been applied in a very limited fashion to AYAC. Thus, this dissertation explored the concept of HF in AYAC and developed a concept-based targeted intervention using a Multiphase Optimization Strategy (MOST) Framework.To gain a better understanding of the concept of HF in the context of AYAC, we conducted three different studies: (1) a concept analysis of HF in AYAC; (2) an exploratory study of HF in AYAC from pediatric oncology professionals’ perspectives (N=17), and; (3) a prototype intervention development and single case feasibility and acceptability study. We found critical attributes of HF in AYAC and developed a preliminary conceptual model. Based on the findings of two previous studies, a literature review, and individual/focus group discussions with experts, we developed a dyadic storytelling intervention between a nurse and a patient. To test this intervention’s feasibility and acceptability, we applied the prototype intervention to a single dyad of an adolescent with cancer and a pediatric oncology nurse. Data suggest that the intervention is feasible and acceptable. We will revise the program and conduct a large-scale pilot study as a next step.The findings from this dissertation study explore and contribute to the knowledge generation surrounding the critical attributes of HF in AYAC and develop a preliminary conceptual framework. Additionally, this study represents a very early step in the translation of knowledge on HF to nursing care for AYAC. As we continue to develop the intervention in the future, we will explore diverse participants’ experiences and perspectives of flourishing while undergoing cancer treatment.