Factors associated with cancer disclosure in adolescent and young adult cancer survivors: An integrative review from the social-ecological model perspective

• Published in: European journal of oncology nursing : the official journal of European Oncology Nursing Society Vol. 69; p. 102542
• Main Authors: Honda, Naoko, Shiroshita, Yui, Miyazaki, Asuka, Sobue, Ikuko
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.04.2024
• Subjects: Adolescents; Cancer survivors; Self-disclosure; Social-ecological framework; Young adult; Cancer survivors; Social-ecological framework; Self-disclosure; Adolescents; Young adult
• ISSN: 1462-3889; 1532-2122
• DOI: 10.1016/j.ejon.2024.102542

Young cancer survivors (“young survivors”) may need to disclose their cancer experiences to reintegrate into society. In such cases, the recognition of social support through the disclosure of cancer experiences may prevent potential social disadvantages． This review aimed to describe the motivations, strategies and outcomes, and benefits and disadvantages of disclosure in young survivors based on the social-ecological model (SEM) to identify the support survivors need when disclosing their cancer experiences. Using the integrated review methodology, we systematically searched six databases in English and Japanese as well as searched the reference lists of the selected studies. The themes identified via thematic analysis were categorized within the SEM levels. This review analyzed 14 studies and identified four themes, including “Motivation for Cancer Disclosure,” “Barriers to Cancer Disclosure,” “Consequences of Cancer Disclosure: Benefits,” and “Consequences of Cancer Disclosure: Disadvantages.” Motivations for young survivors to disclose their cancer involved post-cancer differences, perceptions, relationships, and social context. In navigating barriers, including self-stigma, peer exclusion, and discrimination, they employed strategies such as reassurance and information limitation. Tailored disclosure strategies at each SEM level offered social and psychological benefits, however, disadvantages, including stress, vulnerability, employment issues, and limited insurance coverage, were experienced by young survivors due to cancer disclosure. To optimize the benefits of cancer disclosure for young survivors, addressing psychological burdens, enhancing disclosure skills, offering familial psychological support, and fostering public awareness of cancer are essential. •Young cancer survivors used disclosure strategies appropriate to their socioecological level.•The motivation and strategies for disclosure have both benefits and disadvantages.•A combination of factors at multiple levels of the social-ecological model were at play in the cancer disclosures.