Returning to school after adolescent cancer : a qualitative examination of Australian survivors' and their families' perspectives

Purpose: To examine key factors related to adolescent cancer survivors’ return to school after cancer treatment completion, which can be a time of complex transition. Patients and Methods: Seventy semi-structured interviews were conducted with 19 adolescent cancer survivors (mean age 16.1 years), 21 mothers, 15 fathers, and 15 siblings from 22 Australian families. The conceptual framework of Miles and Huberman (1994) was employed to analyze interview data and emergent themes were organized using the software package QSR NVivo 8.0. Results: Barriers to successful school re-entry included symptoms of fatigue, anxiety (particularly regarding examinations), and poor communication between families and the broader school community. Changing grade or school typically extinguished pre-existing support networks and was perceived by parents as a period of unmet need. Support from friends, teachers, tutors, and the hospital outreach nurse were seen as instrumental in creating a positive school re-entry experience. However, the majority of participants reported that support from the school counselor was minimal. Siblings reported this period as relatively non-impactful regarding their own education. Conclusions: Additional support is needed to help parents navigate the education system and to advocate effectively for their child’s academic needs beyond the immediate re-entry period. There is strong potential for school counselors to increase the level of support they provide adolescents and their parents during the school reentry period. The impact of this period on siblings’ education is under-studied and warrants further research.