Adolescent childhood cancer survivors talking about cancer: A socioecological perspective.

Objective: This study aimed (1) to investigate the communication patterns of adolescent childhood cancer survivors (ACCSs), including their motivations, methods, context, and outcomes and (2) to identify factors influencing their cancer-related communication (cancer communication) at each level of the socioecological model. Methods: A qualitative descriptive research design was adopted to explore ACCSs' experiences of communicating about cancer and the factors influencing such experiences. Semi-structured interviews were conducted, and the collected data were analyzed using thematic analysis. This study was conducted according to the Standards for Reporting Qualitative Research. Results: The ACCSs were motivated to engage in cancer-related communication by acquiring social support and an altruistic perspective. Although ACCSs rarely initiated cancer-related communication proactively, they communicated with close friends and family members about their cancer experiences. The motivation to communicate with friends shifted from sharing factual information, such as their daily lives in the hospital, to seeking emotional connections shaped by psychosocial development. Dissatisfaction with the limitations of school life and concerns about cancer were primarily discussed with parents. Furthermore, parents' perceptions of cancer and their explanations of the illness to their children appeared to influence the children's perceptions of their cancer experiences and their communication about cancer. Cancer-related communication among ACCSs was influenced by factors at multiple levels. Furthermore, institutional- and community-level factors affected individual and interpersonal factors. Conclusions: A multilayered approach involving ACCSs, parents, educators, school peers, and the broader community is essential for enhancing communication about cancer within this population.