Why do children with cancer withdraw from social interactions? A qualitative study using the COM-B model

Area of Science:

• Pediatric Oncology
• Behavioral Science
• Psychosocial Oncology

Background:

• Social withdrawal is a significant challenge for children with cancer, impacting their quality of life.
• Understanding the underlying factors is crucial for developing effective interventions.

Purpose of the Study:

• To explore the factors and mechanisms of social withdrawal in children with cancer using the COM-B model.
• To identify key influences on social withdrawal, including capability, opportunity, and motivation.

Main Methods:

• A hybrid thematic analysis of 41 online illness narratives from families of children with cancer (≤18 years old).
• Utilized internet-based illness experiences for authentic insights into children's cancer journeys.

Main Results:

• Identified themes in Capability (physical problems, self-acceptance), Motivation (stigma, self-esteem), and Opportunity (interpersonal interaction, parenting style, social support).
• Stigma impacts self-esteem, physical problems affect interactions, and parenting/support influence self-acceptance, all contributing to social withdrawal.
• Revealed indirect pathways through which various factors influence social withdrawal behaviors.

Conclusions:

• The COM-B model provides a framework for understanding multifaceted causes of social withdrawal in pediatric cancer.
• Interventions should focus beyond physical recovery to include psychological acceptance, motivation, and social opportunities.
• Integrated physical-social interventions, positive parenting, and enhanced support networks are recommended to promote social engagement in cancer survivors.