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SAMMANFATTNING Bakgrund: Ungdomar och unga vuxna under cancerbehandling är i behov av specialanpassad och ålderslämplig vård då deras åldersgrupp genomgår unika livsutvecklande milstolpar i övergången från barndom till att bli vuxen som påverkas av cancersjukdomen. En störd livsutveckling kan resultera med långsiktiga negativa konsekvenser som kan påverka ungdomar och unga vuxna även efter avslutad behandling.   Syfte: Att undersöka ungdomar och unga vuxnas upplevelser av sin psykosociala situation under cancerbehandling.   Metod: Litteraturstudie med systematisk ansats med beskrivande design. Litteratursökningen använde MEDLINE, CINAHL, och PsycINFO. Resultatet baserades på elva kvalitativa studier samt en kvantitativ studie med kvalitativ bearbetning av ett fritextsvar publicerade mellan år 2014–2020.   Resultat: Ungdomar och unga vuxna värderade bibehållandet av ett normalt liv och strävade efter att uppnå detta med olika strategier. Självständighet och känslan för den egna identiteten kunde störas. Stöttning från anhöriga, närstående, cancerdrabbade jämnåriga, och vårdpersonal var av betydelse men inte alltid tillräckligt. Upprymdhet upplevdes över att avsluta cancerbehandlingen men också en oro inför framtiden efteråt.   Slutsats: Rapporterade upplevelser av psykosociala påfrestningar under cancerbehandlingen leder till slutsatsen att kunskap om hur dessa utmaningar kan bemötas på ett specialanpassat och ålderslämpligt vis är bristfällig. En vidare fördjupad förståelse för ungdomar och unga vuxnas psykosociala upplevelser under cancerbehandling från ytterligare forskning kan potentiellt förbättra sjukvårdens möjlighet till att erbjuda adekvat vård.   Nyckelord: Ungdomar och unga vuxna (AYA), Cancerbehandling, Psykosocial, Erfarenheter. / ABSTRACT Background: Adolescents and young adults undergoing cancer treatment are in need of specially adapted and age appropriate care since their age group undergoes unique life-developing milestones in the transition period between childhood and adulthood that may be affected by cancer. A disrupted life development may result in long-term negative consequences that may affect adolescents and young adults even after the end of cancer treatment.   Aim: This study aimed to examine adolescents and young adults’ experiences of their psychosocial situation during cancer treatment.   Method: Literature review with descriptive design. The literature search used MEDLINE, CINAHL, and PsycINFO. The result was based on eleven qualitative studies and a quantitative study with qualitative processing of a free text answer published between 2014-2020.   Result: Adolescents and young adults valued the maintenance of a normal life and strived to achieve this with different strategies. Independence and the feeling for one's own identity could be disturbed. Support from family, friends, cancer-stricken peers, and healthcare staff was of importance, but not always enough. Exaltation was experienced over ending the cancer treatment but also a concern for the future afterwards.   Conclusion: Reported experiences of psychosocial stress during cancer treatment lead to the conclusion that knowledge of how these challenges can be met in a specially adapted and age-appropriate way is deficient. A further in-depth understanding of adolescents and young adults' psychosocial experiences during cancer treatment from further research may potentially improve healthcare's ability to offer adequate care.   Keywords: Adolescents and Young Adults (AYA), Cancer Treatment, Psychosocial, Experiences.

Background: Sexuality is an important aspect of quality of life for adolescent and young adults that remains understudied in cancer patients. Most current knowledge about how cancer and cancer treatments can affect patients’ sexuality pertains to reproductive cancer patients (breast, gynecological, male reproductive organs), whereas only little is known about how the disease affects the sex lives of patients with other types of cancer. This study examined sexual satisfaction and sexual supportive care needs among adolescent and young adult cancer patients, with a particular focus on how the type of cancer a person has is associated with these issues differently. Methods: Five hundred seventy-seven (n = 424 females, 73.5%) patients between 18 and 39 years of age at diagnosis and representing all major tumor entities completed the standardized questionnaire. The analysis addressed the following topics: sexual satisfaction (Life Satisfaction Questionnaire), sexual supportive care needs (Supportive Care Needs Survey), and changes in sexuality (Questions on Life Satisfaction Modules). These topics were tested by mean differences between reproductive and non-reproductive cancer, equivalence testing and regression analyses. Results: About one third of the patients reported being dissatisfied with their sexuality and having supportive care needs in this area. Changes in sexuality were significantly more common in women with reproductive cancers than in those who had other types of cancer (t = − 2.693, p = .007), while both groups had equivalence in scores for sexual satisfaction and sexual supportive care needs. Reproductive cancers are not more associated with deterioration of sexual satisfaction (R2 = .002, p = .243), changes in sexuality (R2 = .006, p = .070) or increased sexual supportive care needs than non-reproductive cancers (R2 = .004, p = .131). Conclusions: The results indicate that about a third of adolescents and young adults with both reproductive but also with non-reproductive cancer experience sexual dissatisfaction in similar measure. An equal percentage of these patients also express a desire to receive supportive care in this area. Consequently, health care professionals should address issues of sexuality and cancer as a matter of routine when caring for young adults even when patients have a non-reproductive cancer.:Inhaltsverzeichnis 1. Inhaltsverzeichnis 2 2. Abkürzungsverzeichnis 3 3. Einleitung 4 3.1 Sexualität im jungen Erwachsenenalter 4 3.2 Tumorerkrankungen im jungen Erwachsenenalter 5 3.3 Auswirkungen von Tumorerkrankungen auf die Sexualität 7 3.4 Erfassung von Aspekten der Sexualität 9 3.5 Forschungsstand zur Thematik Sexualität nach einer Tumorerkrankung im jungen Erwachsenenalter 12 3.6 Forschungsfragen 13 4. Publikation 15 5. Zusammenfassung 28 5.1 Einführung 28 5.2 Methodik 29 5.3 Ergebnisse 30 5.4 Diskussion 31 6. Literaturverzeichnis 33 7. Anlagen 7.1 Spezifizierung des eigenen Beitrags 39 7.2 Erklärung über die eigenständige Abfassung der Arbeit 40 7.3 Danksagung 41 7.4 Lebenslauf 42 7.5 Verzeichnis der wissenschaftlichen Veröffentlichungen und Vorträge 43