Navigating the Pediatric Cancer Survivorship Experience Through the Perspectives of Adolescents: An AI-Assisted...

Pediatric cancer survivorship is a complex and evolving process marked by persistent emotional, physical, and social challenges. Adolescents, in particular, experience heightened uncertainty regarding future health, fear of recurrence, and difficulties reintegrating into social and academic life. Despite increasing survival rates, empirical evidence capturing adolescents' lived survivorship experiences remains limited. This study aimed to explore the lived survivorship experiences and support needs of adolescents who had completed pediatric cancer treatment.

An exploratory qualitative design employing an AI-assisted photovoice methodology was used. The study was conducted with 14 adolescent cancer survivors aged 12 to 18 years at a university hospital between February and May 2025. Data were collected using a Characteristic Information Form, semi-structured interviews, and participant-generated AI-assisted visual narratives reflecting survivorship experiences. Data were analyzed using reflexive thematic analysis to identify core patterns of meaning.

Participants, predominantly survivors of acute lymphoblastic leukemia, had a mean age of 14.86 ± 2.03 years. Three interrelated themes emerged: Silent Scars: Redefining Self After Pediatric Cancer, reflecting enduring physical and emotional sequelae; Reframing Hope and Meaning-Making after Survival, illustrating adolescents' reconstruction of future-oriented purpose; and Roots and Wings: The Power of Support, highlighting the central role of family, peers, and community in fostering empowerment, resilience, social reintegration, and psychosocial well-being.

This study reveals survivorship as a complex journey characterized by invisible scars, emotional ambivalence, meaning-making, and the transformative power of connection, amplifying the voices of adolescent cancer survivors. The findings emphasize the pressing need for customized, developmentally appropriate, and relationship-focused survivorship care that not only promotes medical recovery but also psychological healing and identity reconstruction IMPLICATIONS FOR NURSING PRACTICE: Findings highlight the need for adolescent-centered, developmentally sensitive nursing interventions; age-appropriate psychosocial assessment, fear of recurrence management, identity-focused counseling, and peer reintegration support, to address ongoing psychosocial challenges in pediatric cancer survivorship. Empowerment-based and participatory approaches may support emotional expression, meaning-making, and resilient transitions into survivorship. AI-assisted photovoice may offer an innovative approach for facilitating adolescent self-expression and identifying psychosocial support needs.