How do healthcare providers adapt to AYA-parent dynamics when supporting adolescents and young adults (AYA) with cancer? A qualitative study.
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PURPOSE: This paper aims to better understand the challenges faced by oncology teams in dedicated adolescent and young adult (AYA) units as they strive to involve both patients and their parents, seeking a balance between patient-centered and family-centered care. Specifically, it examines the dynamics between AYAs, their parents, and healthcare providers (HCPs) during prolonged hospitalizations. METHODS: Conducted between 2018 and 2021 in a dedicated AYA hematology unit in Paris, the study included 10 in-depth individual interviews, research observations, and focus groups. Data were analyzed inductively according to Grounded Theory principles. RESULTS: Rather than combining patient-centered and family-centered care, HCPs tend to adopt an "AYA-parent dyad-centric" model of care. These results highlight the importance of understanding and assessing the unique dyadic dynamics between AYAs and their parents to effectively support AYA's psychosocial needs, particularly in fostering their autonomy process. CONCLUSION: Our findings suggest that a dyad-centered model of care, one that allows the involvement of AYAs and their parents as a dyad, enables a better understanding of and adaptation to the family dynamics at play, leading to more tailored and effective healthcare management.