Technology-Based Psychosocial Intervention for Adolescent and Young Adult Survivors of ALL

By Dustin Samples - January 17, 2023

Adolescent and young adult (AYA) survivors of acute lymphoblastic leukemia (ALL) face certain challenges their typically developing peers do not. Treatment and significant time spent in medical care separates an AYA with cancer from their peer group. This can lead to delayed social development, poor self-efficacy, anxiety, distress, depression, social withdrawal, and peer conflict among other challenges. Though AYAs with ALL do not typically experience increased physical morbidity, these domains can negatively impact their lives as a direct result of treatment for ALL.

Technology-based psychosocial interventions are a promising avenue for AYA coping and development after treatment and during long-term follow-up for ALL. The current generation of AYAs are very technology savvy and motivated. As such, these interventions may be more attractive and have better adherence compared with traditional forms of psychosocial intervention.

A research team in Ankara, Turkey, led by Tuba Arpaci, RN, PhD, sought to determine whether technology-based interventions could improve 3 domains of AYA cancer survivorship: quality-of-life, self-efficacy, and coping skills. To do so, the team recruited and randomized AYA survivors to an intervention and control group.

The intervention group (n=24) underwent 10 weeks of web-based counseling and education and 3 months of follow-up. According to the research team, web-based education “consisted of 5 modules: 1) ‘Self-knowledge and Goal Development,’ 2) ‘Communication Skills,’ 3) ‘Coping Skills,’ 4) ‘Problem-Solving Skills,’ and 5) ‘Awareness Raising and Health Promotion.’” The researchers assessed the participants’ quality-of-life, self-efficacy, and coping skills at 4 timepoints throughout the follow-up period: baseline, 10 weeks postintervention, 1 month after completion of modules, and 3 months after completion of modules. Assessment consisted of administering 5 participant-completed instruments completed at each of the 4 timepoints.

The research team published the study design and results in Cancer Nursing. Per their report, “The 3-month postintervention QOL total and psychosocial subscale scores in the intervention group were significantly higher than those in the control group (P < .05). In addition, the emotional self-efficacy subscale scores and the active coping scores of the intervention group adolescents were significantly higher than those in the control group (P < .05). Negative coping scores were lower in the intervention group than in the control group (P < .05).”

The team concluded that the technology-based interventions did indeed improve the 3 domains of interest in AYA survivors of ALL. They feel the study has strong implications for nurses specifically, stating that “in most high-income countries such as America and European countries, pediatric oncology nurses play an active role in the follow-up of survivors.” In conclusion, “nurses could use such programs as one of the support methods in providing and maintaining LTFU care.”


Evaluation of the effectiveness of a technology-based psychosocial education and counseling program for adolescent survivors of childhood leukemia: a randomized controlled trial.