{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:10:10Z","timestamp":1792080610564,"version":"4.4.0"},"reference-count":70,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["101136549"],"award-info":[{"award-number":["101136549"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Patient activation\u2014encompassing knowledge, confidence, and skills in managing individual's health\u2014is a cornerstone of person\u2010centered care. However, its significance among childhood, adolescent, and young adult cancer survivors (CAYACS) remains unexplored. This article examines the application of the 13\u2010item Patient Activation Measure (PAM\u201013) in CAYACS, highlights factors influencing activation levels, and draws insights from adult oncology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted to identify studies assessing patient activation using PAM\u201013 in CAYACS populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Only two relevant studies were identified. Reduced activation levels were associated with psychological distress, fatigue, neurocognitive impairment, and complex late effects. Activation levels fluctuated over time, with lower levels during active treatment and higher levels during disease\u2010free survivorship. Evidence from adult oncology suggests that structured education, psychosocial support, and hybrid care models (e.g., Oncokompas and SMARTCare) may enhance health ownership. However, limitations, such as PAM\u201013 ceiling effects and potential psychometric variability in oncology populations, have been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Activation\u2010based approaches hold promise for improving self\u2010management in CAYACS. Future interventions should be developmentally tailored, acknowledge caregiver roles, and address transition\u2010related challenges and disparities in healthcare access. Recognizing patient engagement as a core outcome in survivorship research may strengthen personalized care and support the development of scalable, evidence\u2010based interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Cancer Survivors<\/jats:title>\n                    <jats:p>Despite some measurement biases, activation assessment in CAYACS facilitates identification of vulnerable survivors, enables tailored interventions, and fosters empowerment and self\u2010management to improve personalized survivorship care and long\u2010term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70174","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T06:19:52Z","timestamp":1774592392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patient Activation in Childhood, Adolescent, and Young Adult Cancer Survivors: Current Insights and Implications for Survivorship Care\u2014A Systematic Review From the e\u2010QuoL Project"],"prefix":"10.1002","volume":"73","author":[{"given":"Charlotte","family":"Demoor\u2010Goldschmidt","sequence":"first","affiliation":[{"name":"Pediatric Oncology\u2010Hematology\u2010Immunology Department University Hospital of Angers  Angers France"},{"name":"Pediatric Oncology\u2010Hematology\u2010Immunology Department University Hospital of Caen  Caen France"},{"name":"Epidemiology of Radiation U1018 Inserm, Gustave Roussy  Villejuif France"},{"name":"GCS HUGO, University Hospitals of the Grand Ouest  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7835-1802","authenticated-orcid":false,"given":"Anne","family":"Maas","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine University of Lucerne  Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-0928","authenticated-orcid":false,"given":"Gisela","family":"Michel","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine University of Lucerne  Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandine","family":"Bertrand","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology Institute, Centre L\u00e9on B\u00e9rard  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen E. T.","family":"Thornton","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine Faculty of Medicine Institute of Basic Medical Sciences University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Bellanger","sequence":"additional","affiliation":[{"name":"Institut De Cancerologie de L'ouest  Saint Herblain France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3841-5063","authenticated-orcid":false,"given":"Anna\u2010Liesa","family":"Filbert","sequence":"additional","affiliation":[{"name":"Division of Childhood Cancer Epidemiology, German Childhood Cancer Registry Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desiree","family":"Grabow","sequence":"additional","affiliation":[{"name":"Division of Childhood Cancer Epidemiology, German Childhood Cancer Registry Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Muraca","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology DOPO Clinic IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Roser","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine University of Lucerne  Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Oberti","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology DOPO Clinic IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Roganovic","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology Children's Hospital Zagreb  Zagreb Croatia"},{"name":"Faculty of Biotechnology and Drug Development University of Rijeka  Rijeka Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne Cathrine","family":"Lie","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine Faculty of Medicine Institute of Basic Medical Sciences University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475\u20106773.2004.00269.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.20.6.64"},{"key":"e_1_2_12_4_1","first-page":"1","volume-title":"The Self\u2010Regulation of Health and Illness Behaviour","author":"Leventhal H.","year":"2016"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010009\u20109549\u20100"},{"key":"e_1_2_12_6_1","first-page":"353","article-title":"Improving the Outcomes of Disease Management by Tailoring Care to the Patient's Level of Activation","volume":"15","author":"Hibbard J. 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