Lived experiences of cancer and the impacts on well-being among adolescents in Aotearoa New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Health Science (by thesis) in Psychology at Massey University, Albany, Aotearoa New Zealand

Abstract

Although advancements in cancer treatment have improved adolescent survival rates worldwide, it is important to recognise that an active cancer journey presents diverse well-being impacts, both positive and negative. Well-being impacts from cancer for adolescents often differ to those for other age groups because adolescents face a unique dual crisis: managing a serious illness while simultaneously navigating a volatile developmental stage characterised by identity versus role confusion. Existing knowledge emphasises the physical outcomes and the survivorship stage of cancer and is largely generalised from international adolescent and young adult studies. Consequently, knowledge of adolescents lived cancer experiences, particularly regarding the holistic well-being outcomes is largely unknown. Interestingly, despite multiple reports in Aotearoa New Zealand (hereafter Aotearoa) documenting poor cancer experiences, unsatisfactory care, and substantial unmet well-being needs among young adults, adolescents, in contrast, have received limited research attention. In recent years, calls have grown for Aotearoa research to better understand adolescents’ cancer realities and their developmentally situated well-being needs. Those calls have motivated this study, which explored the lived experiences of adolescents with cancer in Aotearoa and examined how their well-being was affected. Seven adolescents aged 16–21 years with an active cancer diagnosis participated in a one-off, individual semistructured qualitative interview lasting approximately 45 minutes. Reflexive thematic analysis was used to analyse interviews, enabling the identification and interpretation of shared patterns of meaning surrounding cancer experiences and well-being impacts. Participants described persistent emotional instability alongside diminished self-confidence, appearance changes, and disconnection to pre-cancer identities. Social dynamics often shifted as peers withdrew or struggled to engage, whereas family relationships frequently emerged as a strong source of support. Many participants reported unavoidable existential questioning, reflecting on purpose and meaning in ways hitherto unfamiliar to them. Critically, adolescents’ in-between positioning within the Aotearoa healthcare system left some feeling out of place and overlooked. As the first culturally grounded exploration of Aotearoa adolescents’ cancer experiences and related well-being outcomes, the findings of this study offer nuanced insights that can inform the creation of developmentally attuned cancer care and supportive healthcare environments.