title: Trajectories of social isolation in adult survivors of childhood cancer.
abstract: OBJECTIVE
  Long-term childhood cancer survivors may be at increased risk for poor social outcomes as a result of their cancer treatment, as well as physical and psychological health problems. Yet, important challenges, namely social isolation, are not well understood. Moreover, survivors' perspectives of social isolation as well as the ways in which this might evolve through young adulthood have yet to be investigated. The purpose of this research was to describe the trajectories of social isolation experienced by adult survivors of a childhood cancer.
  
  
  METHODS
  Data from 30 in-depth interviews with survivors (9 to 38 years after diagnosis, currently 22 to 43 years of age, 60 % women) were analyzed using qualitative, constant comparative methods.
  
  
  RESULTS
  Experiences of social isolation evolved over time as survivors grew through childhood, adolescence and young adulthood. Eleven survivors never experienced social isolation after their cancer treatment, nor to the present day. Social isolation among 19 survivors followed one of three trajectories; (1) diminishing social isolation: it got somewhat better, (2) persistent social isolation: it never got better or (3) delayed social isolation: it hit me later on.
  
  
  CONCLUSIONS
  Knowledge of when social isolation begins and how it evolves over time for different survivors is an important consideration for the development of interventions that prevent or mitigate this challenge.
  
  
  CONCLUSIONS
  Assessing and addressing social outcomes, including isolation, might promote comprehensive long-term follow-up care for childhood cancer survivors.
authors.affiliation: School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada, fuchsia.howard@ubc.ca.
authors.forename: A Fuchsia
authors.initials: AF
authors.lastname: Howard
authors.forename: Jason
authors.initials: J
authors.lastname: Tan de Bibiana
authors.forename: Kirsten
authors.initials: K
authors.lastname: Smillie
authors.forename: Karen
authors.initials: K
authors.lastname: Goddard
authors.forename: Sheila
authors.initials: S
authors.lastname: Pritchard
authors.forename: Rob
authors.initials: R
authors.lastname: Olson
authors.forename: Arminee
authors.initials: A
authors.lastname: Kazanjian
mesh_terms: D000328:Adult; D017668:Age of Onset; D001294:Attitude to Health; D005260:Female; D005544:Forecasting; D065026:Hope; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008960:Models, Psychological; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D026684:Personal Autonomy; D036301:Qualitative Research; D012934:Social Isolation; D012938:Social Perception; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology*; D055815:Young Adult