Do negative emotions expressed during follow-up consultations with adolescent survivors of childhood cancer reflect late effects?

Anneli V Mellblom; Ellen Ruud; Jon Håvard Loge; Hanne C Lie

doi:10.1016/j.pec.2017.06.008

Do negative emotions expressed during follow-up consultations with adolescent survivors of childhood cancer reflect late effects?

Patient Educ Couns. 2017 Nov;100(11):2098-2101. doi: 10.1016/j.pec.2017.06.008. Epub 2017 Jun 19.

Authors

Anneli V Mellblom¹, Ellen Ruud², Jon Håvard Loge³, Hanne C Lie⁴

Affiliations

¹ Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Pediatric Medicine, Women and Children's Unit, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: anneli.mellblom@medisin.uio.no.
² Department of Pediatric Medicine, Women and Children's Unit, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway. Electronic address: elruud@ous-hf.no.
³ Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway; Regional Advisory Unit for Palliative Care, Dept. of Oncology, Oslo University Hospital (OUS), Oslo, Norway. Electronic address: j.h.loge@medisin.uio.no.
⁴ Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Pediatric Medicine, Women and Children's Unit, Oslo University Hospital, Rikshospitalet, Oslo, Norway; National Resource Centre for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, Oslo, Norway. Electronic address: h.c.lie@medisin.uio.no.

PMID: 28641990
DOI: 10.1016/j.pec.2017.06.008

Abstract

Objective: To explore whether negative emotions expressed by adolescent cancer survivors during follow-up consultations were associated with potential late effects (persisting disease or treatment-related health problems).

Methods: We video-recorded 66 follow-up consultations between 10 pediatricians and 66 adolescent survivors of leukemia, lymphoma or stem-cell transplantations. In transcripts of the recordings, we identified utterances coded as both 1) expressions of negative emotions (VR-CoDES), and 2) late effect-related discussions. Principles of thematic content analysis were used to investigate associations between the two.

Results: Of the 66 video-recorded consultations, 22 consultations contained 56 (49%) utterances coded as both emotional concerns and discussions of potential late effects. Negative emotions were most commonly associated with late effects such as fatigue ("I'm struggling with not having energy"), psychosocial distress ("When I touch this (scar) I become nauseous"), pain ("I'm wondering how long I am going to have this pain?"), and treatment-related effects on physical appearance ("Am I growing?").

Conclusions: Negative emotions expressed by adolescent cancer survivors during follow-up consultations were frequently associated with potential late effects. These late effects were not the medically most serious ones, but reflected issues affecting the adolescents' daily life.

Practice implication: Eliciting and exploring patients' emotional concerns serve as means to obtain clinically relevant information regarding potential late effect and to provide emotional support.

Keywords: Clinical communication; Follow-up care; Late effects; Survivorship.

MeSH terms

Adolescent
Emotions*
Female
Humans
Male
Neoplasms / psychology*
Neoplasms / therapy
Psychology, Adolescent*
Referral and Consultation*
Survivors / psychology*
Video Recording