Motivations for cancer history disclosure among young adult cancer survivors
To gain an in-depth understanding of the motivations for cancer history disclosure and/or non-disclosure among young adult cancer survivors.
Using a constructivist grounded theory approach, semi-structured telephone interviews were conducted with breast and testicular cancer survivors diagnosed between the ages of 18 and 39 from across Canada.
Twenty-eight young adult cancer survivors (16 female; 12 male) participated in this study. Analysis of the interviews revealed two basic motivational systems for disclosure at play: approach-focused motivations geared towards a positive outcome (desire for understanding, acceptance, support and to promote cancer awareness) and avoidance-focused motivations which are geared towards avoiding a negative outcome (fear of discrimination/stigmatization, unwanted attention, pity, loss of privacy, and rejection). Those exhibiting approach-focused motivations were more likely to disclose than those expressing avoidance-focused motivations. Participants also described a series of situational/contextual factors (social/cultural context, relevance, situation/timing, person disclosing, audience/confidant, and time passed since cancer diagnosis) which had the potential to change or influence the disclosure decision despite overarching motivations to disclose or not.
Implications for Cancer Survivors
Gaining a better understanding of the cancer history disclosure decision processes of young adult cancer survivors can help them to better adapt and socially reintegrate back into their pre-cancer lives after the completion of treatment. Acknowledging and understanding the disclosure decision process and communication challenges faced by young cancer survivors can also be beneficial to healthcare professionals in the development and provision of better support interventions and informational resources to help improve psychosocial well-being after cancer.
KeywordsSelf-disclosure Young adult cancer Qualitative Constructivist grounded theory
This study was funded in part through a Social Sciences and Humanities Research Council of Canada (SSHRC) Doctoral Fellowship.
Compliance with ethical standards
Conflict of interest
The author declares that there are no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by the author.
Informed consent was obtained from all individual participants included in the study.
- 1.Fernandez C, Fraser GA, Freeman C, Grunfeld E, Gupta A, Mery LS. Schacter B, for the Canadian Task Force on Adolescents and Young Adults with Cancer. Principles and recommendations for the provision of healthcare in Canada to adolescent and young adult-aged cancer patients and survivors. J Adolesc Young Adult Oncol. 2011;1(1):53–9.CrossRefGoogle Scholar
- 4.Adolescent and Young Adult Oncology Progress Review Group. Closing the gap: research and imperatives for adolescents and young adults with cancer. 2006. https://www.cancer.gov/types/aya/research/ayao-august-2006.pdf Accessed 05 Jun 2018.
- 5.Miedema B, Easley J, Hamilton R. Young adults’ experiences with cancer: comments from patients and survivors. Can Fam Physician. 2006;52(11):1446–7.Google Scholar
- 22.Berg JH, Derlega VJ. Themes in the study of self-disclosure. In: Derlega VJ, Berg JH, editors. Self-disclosure: theory, research and therapy. New York and London: Plenum Press; 1987. p. 1–8.Google Scholar
- 23.Greene K. An integrated model of health disclosure decision-making. In: Afifi TD, Afifi WA, editors. Uncertainty and information regulation in interpersonal contexts: theories and applications. New York, NY: Routledge; 2009. p. 226–53.Google Scholar
- 25.Knapp ML, Vangelisti AL. Interpersonal communication and human relationships. 4th ed. Boston: Allyn & Bacon Press; 1999.Google Scholar
- 37.Charmaz K. Grounded theory: objectivist and constructivist methods. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. 2nd ed. Thousand Oaks, CA: Sage Publications; 2000. p. 509–35.Google Scholar
- 39.QSR International. NVivo Version 9 [Computer software]. 2010. http://www.qsrinternational.com/ Accessed on June 4, 2018.
- 40.Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. London: Sage Publications; 2006.Google Scholar
- 41.Afifi WA, Guerrero LK. Motivations underlying topic avoidance in close relationships. In: Bryant J, Zillman D, Petronio S, editors. LEA’S communication series: balancing the secrets of private disclosures, vol. 2000. Mahwah, NJ: Lawrence Erlbaum Associates; 2000. p. 165–80.Google Scholar
- 51.Leary MR, Cox CB. Belongingness motivation: a mainspring of social action. In: Shah J, Gardner W, editors. Handbook of motivation science. New York, NY: Guilford Press; 2008. p. 27–40.Google Scholar
- 55.Charmaz K. Good days, bad days: the self in chronic illness and time. New Brunswick, NJ: Rutgers University Press; 1991.Google Scholar
- 58.Jourard SM. Self-disclosure: an experimental analysis of the transparent self. New York: Wiley-Interscience; 1971.Google Scholar