Adolescents et jeunes adultes atteints de cancer : entre adaptation et conduites à risque

Abstract : The population of adolescents and young adults (AJAs - 15-25 years) with cancer represent approximately 1,700 new cases per year in France. Over The appearance of a potentially lethal cancerous disease during adolescence is affecting young patients at different levels. According to medical examinations, treatments and / or hospitalizations life is punctuated. School or professional activity are often suspended, postponed or even reworked. While in this period of development, adolescents try to separate themselves from their parents, emotionally, financially and socially, there is often a movement back to the parent figures. Moreover, the disease directly impacts the body which is, among other things, at the center of adolescents' concerns. Thus, adolescent problems are at the crossroads of the disease and the so-called "normal" development of the adolescent.Nevertheless, we know that adolescence is the first experience period in terms of romantic relationships, sexual relations and consumption of substances (alcohol, tobacco, cannabis). It is also a period conducive to addictions behaviors, such as video games and internet and eating disorders. The objective of this research is to describe alcohol, tobacco and cannabis consumption in a population of adolescents and young adults with cancer, as well as eating and online behaviors. This study also aims to describe and understand the experiences of these young people and the adaptive strategies they use to deal with both the announcement of the disease and treatments. A mixed methodology was used. The quantitative component uses a set of questionnaires evaluating coping strategies, depressive-anxiety symptoms, tobacco, alcohol and cannabis use, as well as eating behaviors and online behavior. This study proposes a cohort follow-up during the curative treatment phase (N 66); 6 months after the beginning of treatments (N20) where the initial adaptive strategies as well as the consumption and behavior of food and online are related. The qualitative component provides an exploration of the personal experiences of six young patients with disease and treatment using the Interpretative Phenomenological Analysis. Quantitative analyzes showed that the vast majority of participants did not exhibit symptomatology anxio-depressive during anti-cancer treatments and that they generally turn to oriented strategies problems (acceptance and positive reinterpretation). A minority of participants reported using alcohol (3%), tobacco (1.5%) and cannabis (4.5%). Participants claiming to have food disorder count for 9% of the sample, and finally, about 19% of participants report problematic use of the Internet with possible consequences. Six months after the onset of treatment, the intensity of anxiety-depressive symptoms tends to decrease. There are no significant differences between scores of lines at risk at T1 and T2 and the adjustment strategies remain unchanged between the first and the second passes. In the first few months of treatment, adolescents and young adults have no structured anxio-depressive symptoms. Their mode of consumption does not present any risks regarding adherence to anti-cancer treatments. Finally, the information gathered through this work, and in particular the qualitative analyzes, make it possible to understand better and apprehend the experience of young patients treated for a cancerous disease.
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Solène Grégoire. Adolescents et jeunes adultes atteints de cancer : entre adaptation et conduites à risque. Psychologie et comportements. Université Sorbonne Paris Cité, 2017. Français. ⟨NNT : 2017USPCB249⟩. ⟨tel-02179562⟩

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