Drug Compliance by Adolescent and Young Adult Cancer Patients Challenges for the Physician

Benjamin Gesundheit, Mark L. Greenberg, Reuven Or, and Gideon Koren

22.1 Introduction . . . . . . . . . . . . . . . . . . . . . 353 22.1.1 Compliance: Definition and History,

Cultural Changes During the Last 50 Years 354

22.2 Conclusions 355

22.2.1 Cancer, Compliance, and Adolescence:

Definitions and Interactions . . . . . . 355 22.2.1.1 Cancer and Adolescence . . 355

22.3 Assessment of Compliance 355

22.3.1 Indirect Methods 356

22.3.2 Direct Methods . . . . . . . . . . . . . . 356

22.3.3 Risk Factors and Predictors of Noncompliance 357

22.3.3.1 Features of Treatment and Adverse Effects of Medication . . . . . . . . . . 358

22.3.3.2 Demographic and

22.3.3.3 Parents' and Child's Knowledge and Attitudes . 358

22.4 Discussion . . . . . . . . . . . . . . . . . . . . . . 359 References 361

23 Psychological Support for Adolescents and Young Adults

Christine Eiser and Aura Kuperberg

23.1 introduction . . . . . . . . . . . . . . . . . . . . . 365

23.2 From Diagnosis to Aftercare 365

23.2.1 Diagnosis . . . . . . . . . . . . . . . . . . 366

23.3 Pediatric-, Adolescent- or Adult-Based Care? 367

23.3.1 When Treatment Ends 367

23.3.2 Follow-up Care 367

23.4 Long-Term issues 368

23.4.1 Body Image 368

23.4.2 Fertility. . . . . . . . . . . . . . . . . . . . 368

23.4.3 Employment . . . . . . . . . . . . . . . . 369

23.5 Adolescence to Young Adulthood -

The Developmental Transition 369

23.5.1 Unique Challenges of Adolescence . . 369

23.5.1.2 Sense of Identity and Independence . . . . . 369

23.5.1.3 Sexual Identity 370

23.6 Treatment Approaches to Meet the Developmental Challenges of Adolescents and Young Adults 370

23.6.1 Impact Cancer, a Transition Model . . 371

23.7 Conclusions. . . . . . . . . . . . . . . . . . . . . . 372 References . . . . . . . . . . . . . . . . . . . . . . . . . . . 372

24 Psychosocial Support

Brad J. Zebrack, Mark A. Chesler, and Anthony Penn

24.1 Introduction . . . . . . . . . . . . . . . . . . . . . 375

24.2 Intellectual Issues. . . . . . . . . . . . . . . . . . 376

24.2.1 Information About Cancer Diagnosis, Prognosis, and Treatment 376

24.2.2 Information Seeking . . . . . . . . . . . 376

24.3 Practical Issues . . . . . . . . . . . . . . . . . . . 376

24.3.1 The Hospitalization Experience, Including Pain and Painful Procedures 376

24.3.2 School and Work 377

24.4 Interpersonal Issues . . . . . . . . . . . . . . . . 377

24.4.1 Relationship with Parents 377

24.4.2 Relationships with Peers 378

24.5 Emotional Issues 378

24.5.1 Psychological Distress . . . . . . . . . . 378

24.5.2 Posttraumatic Effects 379

24.5.3 Coping . . . . . . . . . . . . . . . . . . . . 380

24.5.4 The Importance of Social, Peer, and Family Support 380

24.5.5 Support Groups 380

24.6 existential/Spiritual issues 3S1

24.6.1 Uncertainty 3S1

24.7 conclusion 3S2

References . . . . . . . . . . . . . . . . . . . . . . . . . . . 3S2

25 Health-Related Quality of Life

Ernest R. Katz, Tasha Burwinkle, James W. Varni, and Ronald D. Barr

25.1 Introduction 387

25.2 Dimensions Used in Measuring HRQL . . . . 388

25.3 Generic an Cancer-Specific Measures of HRQL 389

25.4 Measuring HRQL in Adolescents vs Adults . 389

25.5 Self Report vs. Proxy Reports

(i.e., Parent, Provider, or Caregiver) 390

25.6 HRQL Measurement and Clinical Cancer Care 390

25.7 Selected HRQL Measures for Adolescents and Young Adults 392

25.8 Barriers to the Use of HRQL Measures and Proposed Solutions 394

25.9 Facilitating Clinical Decision-Making with HRQL Data 394

25.10 Risk Prediction 395

25.11 Conclusions 396

References 396

26 Rehabilitation and Exercise

Marilyn J. Wright

26.1 Introduction 401

26.2 General Principles of Rehabilitation 402

26.3 Rehabilitation and Exercise Needs 402

26.3.1 Body Structure and Function 403

26.3.2 Activity and Participation 404

26.4 Intervention 404

26.4.1 Physical Activity 404

26.4.1.1 Precautions and Contraindication . . . . 406

26.4.2 Other Specific Interventions 406

26.4.3 Facilitating Participation 408

26.4.4 Intervention for the Acutely Ill, Isolated, or Hospitalized Patient . . . . 408

26.4.5 Palliative Care 408

26.5 Conclusion 409

References 409

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