Balancing Risk with Resilience: Using Holistic Psychosocial Screening and Assessment Tools Effectively with Adolescents and Young Adults with Cancer

  • Pandora PattersonEmail author
  • Frances Hardman
  • Jennifer Cheshire
  • Ursula Sansom-Daly


Holistic psychosocial assessment of adolescents and young adults (AYAs) with cancer is crucial to ensuring that these young people receive individualised support and care which is flexible, responsive, and tailored to their specific needs and resources. Repeated assessment across the cancer trajectory allows clinicians to monitor areas of strength and concern and adjust care in accordance with changes in the cancer situation. This chapter outlines the development and use of two such screening and assessment processes used with AYAs with cancer: the AYA Oncology Psychosocial Care Manual and Integrated Assessment Mapping. Four case studies are presented which illustrate how these processes may be adapted for individual AYAs, highlighting the benefits and challenges of adopting such approaches. This holistic approach to screening and assessment promotes a thorough exploration of the cancer experience from the young person’s perspective and identifies individual strengths as a means to building resilience. The familiarity that oncology nurses often have with their AYA patients and their cancer situation makes them particularly well-placed to facilitate these screening and assessment processes and lay the foundations for a positive and collaborative working relationship between the young person and their clinical care team.


  1. 1.
    Zebrack B, Santacroce SJ, Patterson P, Gubin A. Adolescents and young adults with cancer: a biopsychosocial approach. In: Pediatric psychosocial oncology: textbook for multidisciplinary care. New York, NY: Springer; 2016. p. 199–217.CrossRefGoogle Scholar
  2. 2.
    Patterson P, McDonald FEJ, Zebrack B, Medlow S. Emerging issues among adolescent and young adult cancer survivors. Semin Oncol Nurs. 2015;31(1):53–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Lewis P, Mooney-Somers J, Patterson P, Jordens CFC, Bennett D, McDonald FEJ, et al. Caring for young people with cancer: practical implications of qualitative engagement with cancer survivors and members of the multidisciplinary team The Australian. J Cancer Nurs. 2014;15(2):39–42.Google Scholar
  4. 4.
    Palmer S, Patterson P, Thompson K. A national approach to improving adolescent and young adult (AYA) oncology psychosocial care: the development of AYA-specific psychosocial assessment and care tools. Palliat Support Care. 2014;12(3):183–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Wakefield CE, Patterson P, McDonald FEJ, Wilson HL, Davis E, Sansom-Daly UM. Assessment of psychosocial outcomes in adolescents and young adults with cancer: a systematic review of available instruments. Clin Oncol Adolesc Young Adults. 2013;3:13–27.Google Scholar
  6. 6.
    CanTeen. Adolescent and young adult oncology psychosocial care manual, Rev. Ed. Newtown, NSW: CanTeen; 2015.Google Scholar
  7. 7.
    On Target (GB). On target intervention report: IAM website. Bristol: On Target (GB); 2015.Google Scholar
  8. 8.
    Community Affairs References Committee. The cancer journey: informing choice. Report on the inquiry into services and treatment options for persons with cancer. Canberra, ACT: The Senate Community Affairs References Committee; 2005.Google Scholar
  9. 9.
    Australian Government, Cancer Australia, CanTeen. National service delivery framework for adolescents and young adults with cancer. Canberra, ACT: Commonwealth of Australia; 2008.Google Scholar
  10. 10.
    Goldenring JM, Cohen E. Getting into adolescents’ heads. Contemp Pediatr. 1988;5:75–90.Google Scholar
  11. 11.
    Youth Cancer Service SA/NT. Adolescent and young adult oncology psychosocial survivorship care process. Adelaide, SA: Youth Cancer Service SA/NT; 2012.Google Scholar
  12. 12.
    National Health Service (NHS) England. 2013/13 NHS standard contract for cancer: teenagers and young adults. London: NHS; 2013.Google Scholar
  13. 13.
    National Institute for Health and Clinical Excellence. Improving outcomes in children and young people with cancer. London: National Institute for Health and Clinical Excellence; 2005.Google Scholar
  14. 14.
    MacMillan Cancer Support (GB). The recovery package. London: MacMillan Cancer Support (GB); 2013.Google Scholar
  15. 15.
    National Health Service (NHS) England. NHS five year forward view. London: NHS England; 2014.Google Scholar
  16. 16.
    National Health Service (NHS) England. Achieving world-class cancer outcomes: taking the strategy forward. London: NHS England; 2016.Google Scholar
  17. 17.
    Teenage and Young Adult Cancer Service South West. Help! I’ve got cancer: supporting the wellbeing of teenagers and young adults. Bristol: University Hospitals Bristol NHS Foundation Trust; 2014. Available from: Scholar
  18. 18.
    Patterson P, McDonald FEJ, Anazodo A, Costa DSJ, Wakefield CE, White K, et al. Preliminary data from the validation of the distress thermometer for use among adolescents and young adults with cancer in Australia. Unpublished raw data; 2017.Google Scholar
  19. 19.
    IAM Portal Project (GB). IAM portal project: evaluation report. Bristol: University Hospitals Bristol; 2017.Google Scholar
  20. 20.
    Clinical Oncology Society of Australia Psychosocial Management of AYA Cancer Patients Working Group. Psychosocial management of AYAs diagnosed with cancer: guidance for health professionals. Sydney, NSW: Cancer Council Australia; 2015.Google Scholar
  21. 21.
    Quinn GP, Vadaparampil ST. Fertility preservation and adolescent/young adult cancer patients: physician communication challenges. J Adolesc Health. 2009;44(4):394–400.CrossRefPubMedGoogle Scholar
  22. 22.
    Robertson EG, Sansom-Daly UM, Wakefield CE, Ellis SJ, McGill BC, Doolan EL, et al. Sexual and romantic relationships: experiences of adolescent and young adult cancer survivors. J Adolesc Young Adult Oncol. 2016;5:286–91.CrossRefPubMedGoogle Scholar
  23. 23.
    Wiener L, Weaver MS, Bell CJ, Sansom-Daly UM. Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer. Clin Oncol Adolesc Young Adults. 2015;5:1.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Zadeh S, Pao M, Wiener L. Opening end-of-life discussions: how to introduce Voicing My CHOiCESTM, an advance care planning guide for adolescents and young adults. Palliat Support Care. 2015;13:591–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Casillas J, Kahn KL, Doose M, Landier W, Bhatia S, Hernandez J, et al. Transitioning childhood cancer survivors to adult-centered healthcare: insights from parents, adolscent, and young adult survivors. Psychooncology. 2010;19:982–90.CrossRefPubMedGoogle Scholar
  26. 26.
    Robertson EG, Wakefield CE, Marshall KM, Sansom-Daly UM. Strategies to improve adherence to treatment in adolescents and young adults with cancer: a systematic review. Clin Oncol Adolesc Young Adults. 2015;4:35–49.CrossRefGoogle Scholar
  27. 27.
    Haase EJ. The adolescent resilience model as a guide to interventions. J Pediatr Oncol Nurs. 2004;21(5):289–99.CrossRefPubMedGoogle Scholar
  28. 28.
    Sansom-Daly UM, Wakefield CE. Distress and adjustment among adolescents and young adults with cancer: an empirical and conceptual review. Transl Pediatr. 2013;2(4):167–97.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Pandora Patterson
    • 1
    • 2
    Email author
  • Frances Hardman
    • 3
  • Jennifer Cheshire
    • 4
  • Ursula Sansom-Daly
    • 5
    • 6
  1. 1.CanTeen AustraliaSydneyAustralia
  2. 2.Cancer Nursing Research UnitThe University of SydneySydneyAustralia
  3. 3.Teenage and Young Adult Cancer Service South West, Bristol Cancer InstituteUniversity Hospitals Bristol, NHS Foundation TrustBristolUK
  4. 4.Teenage Cancer TrustLondonUK
  5. 5.Behavioural Sciences Unit, Faculty of Medicine, Kids Cancer CentreSydney Children’s HospitalSydneyAustralia
  6. 6.School of Women’s and Children’s HealthThe University of New South WalesSydneyAustralia

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