Coming of Age With Cancer: Physical, Social, and Financial Barriers to Independence Among Emerging Adult Survivors

Purpose: To explore the transition to self-care among a sample of emerging adult cancer survivors after hematopoietic cell transplantation (HCT). 

Participants & Setting: 18 HCT survivors who were aged 18–29 years at the time of HCT for a primary hematologic malignancy and were 8–60 months post-HCT participated in the study. The study took place in the hematology outpatient setting at City of Hope National Medical Center.

Methodologic Approach: The authors conducted in-depth semistructured interviews and analyzed interview transcripts using grounded theory methodology.

Findings: Health-related setbacks following HCT disrupted not only participants’ journey toward self-care, but also their overarching developmental trajectory toward adulthood. Physically, participants struggled with lack of personal space around caregivers, but felt unready to live on their own. Socially, they relied on multiple caregivers to avoid relying too much on any one person. Financially, participants worried about prolonged dependence and increased needs in the future.

Implications for Nursing: Nurses can support the transition to self-care among emerging adults after HCT by recognizing the broader developmental impact of their cancer experience.