Perceptions of stress in adolescent and young adult (AYA) cancer patients and survivors in Kansas City, KS, and Copenhagen, Denmark: A pilot study.

Abstract

186 Background: Adolescent and Young Adult (AYA) Oncology is a developing field of medicine with unique challenges in the clinical setting. People at this stage of life face many difficulties, which may be compounded by lack of insurance coverage and barriers in accessing health care resources. The goal of this pilot study is to examine how stress levels and psychosocial well-being are affected by healthcare system, insurance status, and other AYA-specific factors. Methods: 38 AYA patients ages 15-30 who have received, or are currently receiving treatment for an oncology diagnosis completed an online survey and 10-item interview, with 29 patients at University of Kansas Medical Center, Kansas City, United States, and 9 patients at Rigshospitalet, Copenhagen, Denmark. Survey measures included the Perceived Stress Scale (PSS) standardized tool, and questions relating to patient concerns, resources utilized, and general thoughts on healthcare. Results: Differences in quantitative stress levels were not significant between the two study sites. In Kansas City, female gender was identified as a significant variable for increased PSS values. In addition, Kansas City patients expressed increased reported practical concerns, such as the role of social workers, transportation, insurance, and disruptions in work and school life due to treatment. Danish patients expressed more positive practical concern statements, citing Danish government resources such as physical therapy and psychiatry services. Qualitative data for both sites placed highest emphasis on the connection that AYA patients have with their healthcare team. Both U.S. and Danish patients reported diverse concerns and positive experiences. Conclusions: AYA oncology patients are a diverse group who have not yet been sufficiently studied, and face many struggles that are unique to this age group. More research on a broad scale is needed, as the data collected in this study suggest results that may prove significant with more time available and larger patient sample sizes. The first author of this abstract has been selected as a semifinalist by the Fulbright commission to expand this pilot project in 2017-2018.