Family Resilience in Adolescent and Young Adult Patients With Hematological Malignancies: A Qualitative Study of Patients and Family Caregivers.

Abstract

Objective: Family resilience plays a vital role in coping with cancer. However, little research has explored how adolescents and young adults (AYAs) with hematological malignancies and their families adapt to cancer, particularly during this critical developmental stage.

Aims: This study aims to explore how AYAs with hematological malignancies and their families experience the dynamic process of family resilience.

Methods: Using a descriptive phenomenological approach, semi-structured interviews were conducted with 40 participants from 26 families, including 19 AYAs with hematological malignancies and 21 family caregivers. Data were collected between April 2023 and March 2025 at two general hospitals in central China. Interviews were analyzed using Colaizzi's method.

Results: Four themes and 11 subthemes emerged. Theme 1: challenges faced by families: (a) multiple challenges for patients, (b) intense family caregiver burden, and (c) shared fear of relapse and uncertainty. Theme 2: internal adaptation within families: (a) flexible role and responsibility adjustment, (b) fostering shared decision-making and autonomy through communication, and (c) emotional suppression and coping strategies. Theme 3: external social support and resources: (a) received social support, and (b) limitations in the social support system. Theme 4: self-transcendence and growth: (a) personal growth, (b) gratitude toward family and society, and (c) maintaining hope and adjusting plans.

Conclusions: This study reveals that family resilience among AYAs with hematological malignancies is a dynamic and cyclical process shaped by continuous adaptation to evolving challenges. While family resilience supports personal growth, families remain under ongoing stress. These findings highlight the need for culturally sensitive and developmentally tailored interventions to better support both patients and caregivers throughout the illness trajectory.