Close relationships among young adult survivors of childhood cancer: A quantitative and qualitative analysis
The growing body of research focusing on the long-term sequelae of diagnosis and treatment for childhood cancer suggests that while the majority of survivors are not at increased risk for psychopathology, many experience persistent problems in other domains that greatly affect quality of life (QoL). Social well-being, a construct that includes the development and maintenance of interpersonal relationships and issues of affection and sexuality, has been somewhat neglected in the late-effects literature. As such, a multi-method, developmentally sensitive study was conducted (1) to assess whether childhood cancer survivors experience difficulties in their close relationships during young adulthood, (2) to characterize the nature of these difficulties, (3) to identify who may be at risk for long-term social sequelae, and (4) to document survivors? own perceptions of their interpersonal relationships.
Sixty young adult (18-25years old) survivors of childhood cancer and 60 controls without a history of chronic illness completed an online assessment of their friendship and romantic relationships. In addition, a subsample of 18 female survivors participated in a follow-up qualitative interview. Quantitative analyses revealed that relative to controls, survivors were involved in fewer romantic relationships over the past five years and reported being significantly more distressed at the dissolution of those relationships. High trait anxiety, male gender, an older age of diagnosis, and higher treatment intensity emerged as significant risk factors for a host of relationship difficulties within the survivor sample, including lower relationship satisfaction, lower levels of reported intimacy, greater fear of intimacy, more conflict, and more distress at break-up. Finally, qualitative findings highlighted relationship issues not captured by the quantitative measures, including cautiousness with personal self-disclosure, self-consciousness as a result of treatment-related physical changes and medical sequelae, and concerns about fertility. In light of the inconsistencies between quantitative and qualitative findings, this study emphasizes the need for more sophisticated measures of survivors? social QoL. Limitations of the study (related to sampling and measurement) are discussed, and a number of future directions are suggested.