Survivors of child and adolescent cancer experiences of bullying at school or work: self-report and parent proxy report

Abstract

Background: Childhood cancer survivors can face social difficulties on return to school after treatment. One such difficulty with significant consequences is bullying. This study aimed to describe the experiences of bullying among survivors of childhood cancer. Methods: We recruited survivors aged 8–25 years, 1–10 years posttreatment and their parents. Participants completed a survey, and we conducted semistructured interviews about their experiences with bullying and other social experiences on return to school or work. Results: A total of 73 survivors (52 children/adolescents and 21 young adults) and 61 parents (including 47 survivor-parent dyads) participated in a questionnaire. Nine survivors and 16 parents completed interviews. A large proportion of survivors experienced some form of bullying (44%) on survey, and one survivor and 7 parents reported experiencing some form of bullying during interview. There was low agreement between survivor self-reports and parent reports of bullying, with survivors more commonly reporting experiencing bullying. Bullying commonly included verbal teasing or social exclusion. Survivors and parents that reported bullying resulted from peer misunderstanding regarding survivors' physical or psychological differences or from survivors' poor social competence. Having proactive parents and close friendships were protective. Programs that increased peer understanding, facilitated friendships and directly targeted bullying reduced or prevented bullying of survivors. Conclusions: A significant proportion of young survivors experienced bullying on return to school which was associated with poor social and emotional functioning. A coordinated approach between young survivors, their families, treating team and school, combined with opportunities for socialization and peer education, is needed to reduce bullying.