title: Adolescents' and parents' experiences of managing the psychosocial impact of appearance change during cancer treatment.
abstract: Using combined qualitative data from multiple case study interviews and an online survey, this study explored the impact of appearance change on 22 adolescents receiving cancer treatment aged 13 to 18 years and six of their parents. Data were analyzed using template analysis. Appearance changes were a major concern. Adolescents typically struggled to adapt to new experiences and concerns related to this highly sensitive issue. Many felt anxious and self-conscious and were reluctant to reveal appearance changes in public. These feelings were compounded by the negative reactions of others (e.g., staring, teasing, and inappropriate questioning), which sometimes lead to avoidance of social activity and threats of noncompliance. Parents of these children felt ill-prepared to manage appearance-related anxieties. Adolescents wanted support to develop the practical and social skills necessary to maintain a "normal" appearance and manage the negative responses of others. However, some adolescents showed resilience and, with support from friends and family, developed strategies to manage their altered appearance and its social consequences. These strategies are explored, which can inform interventions to support adolescents and parents.
authors.affiliation: University of the West of England, Frenchay, Bristol, UK. Heidi3.williamson@uwe.ac.uk
authors.forename: Heidi
authors.initials: H
authors.lastname: Williamson
authors.forename: Diana
authors.initials: D
authors.lastname: Harcourt
authors.forename: Emma
authors.initials: E
authors.lastname: Halliwell
authors.forename: Hannah
authors.initials: H
authors.lastname: Frith
authors.forename: Melissa
authors.initials: M
authors.lastname: Wallace
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D001294:Attitude to Health; D001828:Body Image; D004739:England; D005260:Female; D033062:Friends / Q000523:psychology; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D015404:Nursing Methodology Research; D010290:Parents / Q000523:psychology*; D010379:Peer Group; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000523:psychology* / Q000628:therapy; D000297:Psychology, Adolescent; D036301:Qualitative Research; D055500:Resilience, Psychological; D020377:Self Efficacy; D012919:Social Behavior; D012944:Social Support; D011795:Surveys and Questionnaires