A Space of Their Own: Improving Social Support and Quality of Life for Adolescents and Young Adults with Cancer

Abstract

As cancer remains the leading disease-related cause of death in adolescence, healthcare officials must consider the influence of facility design on peer-to-peer social support and quality of life, while accounting for an adolescent’s unique and changing needs. Both the stress of treatment and the environment in which treatment occurs can influence adolescents during a time of significant social, biological, and cognitive transitions. This dissertation spans developmental psychology and health design to inform specific design guidelines to improve quality of care for adolescents and young adults (AYAs) with cancer. A phenomenology first addresses the gap in AYA research by exploring the experience of cancer during adolescence and young adulthood. Interviews with AYA participants assist in understanding the needs of patients and the structures that support or impede their experience. Following the interviews, a questionnaire is developed to investigate the mediating influence of peer social support on the relationship between features in the built environment and improved quality of life. Multiple regression demonstrates the value of certain environmental characteristics as they influence social support and quality of life. A third study extends the results of the questionnaire through focus groups with AYA participants to further elucidate the preferences of young people in the built environment. The features deemed most influential, along with the evidence for their value, are presented in a set of design guidelines for retroactive and future facility design. Through translational research design, this dissertation will have a wide applied impact on patient quality for a currently under-studied population.