Structuring of identity in adolescents with cancer: coping strategies and psychosocial impact and another project in conjunction USP/UP: health and citizenship: gaps and needs in health reproductive and maternal child care

Abstract

State of the art: cancer in adolescence is an especially critical experience. Having a neoplasic disease at this age hardens the construction of personal identity, affecting socialization, and hinders the development of sexual identity. Young people have to manage the demands of the confrontation with a vital threat and suffering associated with the disease and its treatments, along with the challenges and expected developmental crises for their age. The adaptation to cancer is an ongoing, dynamic and flexible process along which adolescents and their families learn to fit emotionally, to solve problems and to control events associated to the disease. Thus, young people and families need to acquire psychosocial adjustment and resilience skills to facilitate the management of diagnosis and of continuous bodily changes - alopecia, asthenia, thinness or swelling of the body, amputations - helping them to deal with aggression therapeutic. Adolescents' response to the impact of treatments depend on their age, maturity, ability to respond to stress involving the mourning of body image, family environment, potential changes in socio-economic status, challenges or demands related to religion and culture of belonging, and management of family reaction to the disease. These responses may be transient or continued in time. The psychological impact of cancer can be more devastating during adolescence than at any other stage of life, since the illness and therapeutic responses, mainly aggressive, difficult the construction of self-image and self-esteem. Teen cancer also implies loss of freedom and autonomy in habits and lifestyles, compromising the construction of identity not only by the losses associated with the change in familiar role, but especially at school, with possible fears of rejection by friends due to not participating in social activities as often as before. General objective: To investigate psychosocial impact and coping strategies in the structuring of identity in adolescents with cancer. Specific objectives: - To investigate possible implications of the disease during the psychodynamic development and structuring of adolescents' identity; - To investigate the psychosocial meanings inherent to the experience of cancer for participants' family members; - To systematize the elements listed and analyzed in a Manual of Good Practices that may be subsequently disseminated to health professionals in order to provide another instrument for enrichment of their medical and therapeutic, preventive, educational and psychotherapeutic action. Methodology: qualitative analysis based on semi-structured interviews to be conducted with parents and health professionals. Life stories of teenagers suffering from neoplasic disease will also be made, and then analyzed through content analysis technique. According to the research objectives, the following instruments will be applied: the AIDA (Assessment of Identity Development in Adolescent, Tardivo et al.,2013); the FACT-G, version 4 (Functional Assessment of Cancer Therapy General, Cella et al, 1993.), The Reduced Scale Mental Adjustment to Cancer MINIMAC (Watson et al., 1988) and the Scale Coping With Health Injuries and Problems Scale CHIP (Endler and Parker, 1998).Universe: Adolescents aged 12-18 years with cancer, living in the city of São Paulo who are receiving treatment in A.C. Camargo Hospital and Cancer Institute of São Paulo Octavio Frias de Oliveira. Expectations: to face cancer treatments, teenagers use different coping strategies. Knowing these strategies can help to provide better quality of life for these patients. This study aims to present a theoretical review of the changes occurring in the development process of adolescence regarding biological, psychological and social aspects; to display and comprehend the cancer illness process in teenagers and to discuss their coping strategies for overcoming the difficulties arising from this experience. (AU)