“I Knew I Could Write”: A Novel Narrative Writing Intervention for Adolescents and Young Adults With Cancer

PURPOSE: Adolescents and young adults (AYAs) with cancer often experience social and emotional challenges across the illness course. Recent evidence suggests that engagement with narrative writing may have a positive influence on adolescent wellbeing; however, the potential feasibility, acceptability, and potential impact of narrative writing interventions remains under-explored in the AYA cancer patient population. METHODS: This qualitative study aimed to explore AYAs' perceptions of the feasibility, acceptability, and potential impact of a longitudinal narrative writing intervention for AYAs with cancer aged 15-25 years. Semi-structured interviews with AYAs with cancer who participated in a formal, patient-centered narrative writing intervention related to their illness experience were conducted. Inductive thematic analysis was conducted to identify, classify, and synthesize concepts regarding the feasibility, acceptability, and potential impact of narrative writing on AYAs with cancer. RESULTS: All 20 participants engaged in the writing intervention, with 19 participants completing interviews (one died during the study prior to an interview). Three key themes were identified: (i) accessibility and flexibility enabled intervention feasibility; (ii) guidance and support, from a professional writer and/or encouraging family members, promoted intervention acceptability; and (iii) writing facilitated self-discovery and personal growth by eliciting values of introspection, perspective, and gratitude, affirming the potential for intervention impact. CONCLUSION: A novel longitudinal narrative writing intervention was feasible, acceptable, and impactful for AYAs with cancer in this pilot study. Further research will focus on the impact of narrative writing on patient-centered outcomes for AYAs with cancer.