title: A Grounded Theory Investigation into the Psychosexual Unmet Needs of Adolescent and Young Adult Cancer Survivors.
abstract: For many adolescents and young adults (AYAs) with cancer, psychosexual well-being is compromised due to the onset of illness at a vulnerable stage of sexual development. To date, prior studies have focused on the psychosexual well-being of older adult survivors, largely ignoring AYAs. Furthermore, the few studies investigating AYA psychosexual well-being have been prematurely quantitative in nature, limited by a lack of in-depth exploration regarding the unique psychosexual experiences of AYA survivors. Qualitative research is required to better identify and understand the unique complexities surrounding psychosexual needs among AYAs with cancer.
  
  
  
  Semi-structured interviews were conducted with 11 AYA cancer survivors (aged 15-45 years at the time of diagnosis). Transcripts were coded using a grounded theory methodology.
  
  
  
  Constant comparison data analysis gave rise to the Pathways to Problems model, denoting the pathways to psychosexual unmet needs among AYA survivors. Participants experienced identity conflict, whereby an incongruity occurred between their chronological age and their self-perceived age. The experience of identity conflict, combined with changes to intimate relationships, shifts in priorities, physicians' assumptions, and inadequate support, contributed to the onset of psychosexual unmet needs. Six areas of psychosexual unmet needs were identified: fertility concerns, sexual communication, dealing with side effects, dating and disclosure, relating to other AYAs, and reconciling identity conflict.
  
  
  
  The present findings provide evidence for shared and unique psychosexual unmet needs among AYA survivors. Practical implications include the need for validation and incorporation of unique AYA unmet needs into screening tools and care plans, as well as peer support.
authors.affiliation: 1 Department of Psychology/Science, The University of Sydney , Sydney, Australia .
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Dobinson
authors.affiliation: 2 Department of Psychology, Hunter College, City University of New York , New York.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Hoyt
authors.affiliation: 1 Department of Psychology/Science, The University of Sydney , Sydney, Australia .
authors.forename: Zac E
authors.initials: ZE
authors.lastname: Seidler
authors.affiliation: 3 Department of Media and Communications, The University of Technology , Sydney, Australia .|4 Project Management, Cancer Council New South Wales , Sydney, Australia .
authors.forename: Amelia L
authors.initials: AL
authors.lastname: Beaumont
authors.affiliation: 5 Department of Psychology, Rush University Medical Center , Chicago, Illinois.
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Hullmann
authors.affiliation: 1 Department of Psychology/Science, The University of Sydney , Sydney, Australia .|5 Department of Psychology, Rush University Medical Center , Chicago, Illinois.
authors.forename: Catalina R
authors.initials: CR
authors.lastname: Lawsin
mesh_terms: D000293:Adolescent; D000328:Adult; D000073116:Cancer Survivors / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D020018:Sexual Dysfunctions, Psychological / Q000523:psychology*; D055815:Young Adult
keywords: identity; psychosexual; qualitative; sexuality; survivorship