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J Adolesc Young Adult Oncol. 2019 Apr;8(2):131-141. doi: 10.1089/jayao.2018.0103. Epub 2018 Oct 24.

Using a Heuristic App to Improve Symptom Self-Management in Adolescents and Young Adults with Cancer.

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1 College of Nursing, University of Wisconsin-Milwaukee , Milwaukee, Wisconsin.
2 School of Nursing, Virginia Commonwealth University , Richmond, Virginia.
3 Cancer Blood and Transplant Service, College of Nursing, Primary Children's Hospital, University of Utah , Salt Lake City, Utah.
4 Seattle Children's Hospital , Seattle, Washington.
5 Division of Hematology/Oncology, Children's Mercy Hospital , Kansas City, Missouri.



Adolescents and young adults (AYAs) with cancer need self-management strategies to cope with multiple symptoms. Self-efficacy, self-regulation, and negotiated collaboration are key theoretical components of the self-management process and have not been fully explored with AYAs with cancer. This study examined the effects of a heuristic symptom assessment tool on AYAs' self-efficacy for symptom management, AYAs' self-regulation abilities related to their symptoms, and communication with their providers about symptoms.


AYAs (15-29 years of age) receiving chemotherapy used the Computerized Symptom Capture Assessment Tool (C-SCAT) to illustrate their symptom experience and discuss their symptoms with providers during two clinic visits. Participants completed the PROMIS Self-efficacy for Managing Symptoms Scale, a measure of satisfaction with provider communication, and a short interview about self-regulation and communication behaviors at baseline and after each provider visit.


Eighty-five AYAs who used the C-SCAT showed improved self-efficacy for managing symptoms. Qualitative data suggest that the C-SCAT was useful for enhancing a number of AYAs' self-regulation abilities related to symptom management, such as awareness and recall of symptoms, how symptoms were related, and how they planned to talk about their symptoms to providers. AYAs reported C-SCAT facilitated communication with providers about symptoms and symptom management because it was a visual prompt showing priority and related symptoms.


Because AYAs continue to experience multiple distressing symptoms, symptom self-management remains an important area for practice and research. Use of heuristic tools, such as the C-SCAT, may help AYAs more effectively self-manage their symptoms for better health outcomes.


communication; self-efficacy; self-management; self-regulation; symptoms


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