Psychological factors impacting transition from paediatric to adult care by childhood cancer survivors

Leeat Granek, Paul C. Nathan, Zahava R.S. Rosenberg-Yunger, Norma D'Agostino, Leila Amin, Ronald D. Barr, Mark L. Greenberg, David Hodgson, Katherine Boydell, Anne F. Klassen

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Purpose: Childhood cancer survivors require life-long care focused on the specific late effects that may arise from their cancer and its treatment. In many centers, survivors are required to transition from follow-up care in a paediatric cancer center, to care provided in an adult care setting. The purpose of this study was to identify the psychological factors involved in this transition to adult care long-term follow-up clinics. Methods: Qualitative interviews were conducted with ten paediatric survivors still in paediatric care, as well as 28 adult survivors of whom 11 had transitioned successfully to adult care (attended three long-term follow-up (LTFU) appointments consecutively); ten who failed to transition (attended at least one LTFU appointment as an adult, but were inconsistent with subsequent attendance); and seven who had never transitioned (did not attend any LTFU care as an adult). Line-by-line coding was used to establish categories and themes. Constant comparison was used to examine relationships within and across codes and categories. Results: Two overall categories and four subthemes were identified: (1) Identification with being a cancer survivor included the subthemes of 'cancer identity' and 'cancer a thing of the past' and; (2) Emotional components included the subthemes of 'fear and anxiety' and 'gratitude and gaining perspective'. The analysis revealed that the same factor could act as either a motivator or a hindrance to successful transition in different survivors (e. g., fear of recurrence of cancer might be a barrier or a facilitator depending on the survivor's life experience). Conclusions: Psychological factors are an important consideration when preparing cancer survivors for transition to adult long-term follow-up care. Identifying and addressing the individual psychological needs of childhood cancer survivors may improve the likelihood of their successful transition to adult care.

Original languageEnglish
Pages (from-to)260-269
Number of pages10
JournalJournal of Cancer Survivorship
Issue number3
StatePublished - 1 Jul 2012
Externally publishedYes


  • Adolescents
  • Cancer survivor
  • Long-term follow-up care
  • Qualitative research

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)


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