{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T13:06:00Z","timestamp":1780923960768,"version":"3.54.1"},"reference-count":51,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"OSUCOM Department of Internal Medicine Junior Investigator Pilot Grant"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Adolescent and Young Adult Oncology"],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Young adults (YAs) with advanced cancer face distinct medical and psychosocial challenges, making high-quality tailored communication essential. Yet the optimal timing and facilitation of serious illness conversations (SIC) remain variable. This study explores YA and multidisciplinary clinician perspectives on experiences with SIC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using a prospective, cross-sectional mixed methods design, we surveyed 98 participants 39 YAs aged 18\u201339 years with advanced disease across cancer types and 59 clinicians across disciplines and cancer specialties. Qualitative data, using basic qualitative description, were integrated to triangulate quantitative findings related to advance care planning (ACP) and palliative care (PC) understanding and to identify SIC barriers, facilitators, and readiness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>YAs reported substantial emotional and career\/education disruption from cancer. Nearly half (49%) were unsure about ACP, while others linked it with proxy decisions or end-of-life (EOL) planning. Clinicians broadly endorsed similar ACP topics, emphasizing care preferences, code status, and surrogate decision-making. Most YAs (59%) had limited PC knowledge and often equated it with EOL care. Shared SIC barriers included emotional toll and time limits, while a key facilitator was conversation initiation by the other party. Readiness for SIC was tied to emotional acceptance and clinical turning points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>YAs with advanced cancer demonstrate varied awareness of ACP, PC, and experiences with SIC. Conversations typically arise at pivotal disease moments, a tipping point, requiring mutual readiness and recognition of changing realities by both patients and clinicians. Earlier and tailored communication may improve concordance of care delivered with YA values and preferences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21565333261451813","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T02:10:39Z","timestamp":1779934239000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Through Both Lenses: Patient\u2013Clinician Dynamics in Serious Illness Conversations for Young Adults with Advanced Cancer"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4470-4731","authenticated-orcid":false,"given":"Bethany J.","family":"Lockwood","sequence":"first","affiliation":[{"name":"Division of Palliative Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Hawthorn","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA."},{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, The Ohio State University College of Medicine, Columbus, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura J.","family":"Rush","sequence":"additional","affiliation":[{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, The Ohio State University College of Medicine, Columbus, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Di Tosto","sequence":"additional","affiliation":[{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, The Ohio State University College of Medicine, Columbus, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen O.","family":"Moss","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Nursing, Columbus, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seuli","family":"Bose Brill","sequence":"additional","affiliation":[{"name":"Combined Internal Medicine Pediatrics Section, Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2017.0110"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049909113510394"},{"key":"e_1_3_3_4_1","unstructured":"3.National Cancer Institute. Adolescents and Young Adults with Cancer. 2025. Available from: https:\/\/www.cancer.gov\/types\/aya [Last accessed: December29 2025]."},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000341"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.78.2128"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-2800"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/107327481502200413"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/COAYA.S29757"},{"key":"e_1_3_3_10_1","unstructured":"9.National Cancer Institute Surveillance Epidemiology and End Results Program. Cancer Stat Facts: Cancer Among Adolescents and Young Adults (Ages 15\u201339). 2025. 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For AYAs with Advanced Cancer Study Finds Serious Communication Gaps About Their Care. 2025. Available from: https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2025\/aya-cancer-treatment-goals"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.02331"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2016.0515"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000465"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_3_3_29_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2024","unstructured":"28.R Core Team. R: A Language and Environment for Statistical Computing. 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