Table 3.

Helpfulness and Meaningfulness of the TMV Intervention for AYA Adjustment to the Transplant Experience.

Core Theme 1. Myriad of intervention mechanisms to reduce AYA suffering
Theme	Subtheme	Data Sample
Positive impact on symptoms	physical symptoms	“…an escape route to get his mind off the pain and the down time he had and for the times he felt bad. It put him in a different world so to speak, an escape and getaway.” (Mom of 14 yr old male)
	depressive mood	“I know that she’s taking medicine for depression but I feel that the study definitely helped her to come out of that.” (Mom of 16 yr old female)
Mechanism to alleviate suffering and improve outcomes. A means to:	engage in something other than treatment	“….it was important because she had something to do. She had an assignment. She had a project and she was a very dedicated person and a very active person so when you take away all that activity she had nothing to do. So having something to work on was very helpful to her…that did a lot for her mind.” (Mom of 16 year old female)
	open a dialogue about the unspoken use of humor connect with others	“… it kind of got her to be able to focus on that (family), and not just lay there and think about that, but to actually think about them and to almost like, she was there with them.” (Dad of 20 year old female)
Resilience outcomes	provide hope confront challenges of transplant growth	“….he’s always been mature and very adult about things and I had seen him sit and face staph infection or fungal infections and brain surgery and lung surgery with just this very matter of fact attitude. Well, okay, what are we going to do? We got to do it, you know.” (Mom of 15 year old male)
Anecdote for uncertainty	acceptance thriving beyond surviving confidence and mastery	“….she needed something to take her mind off of what she was going through and she needed something to lift her up. I know when people tend to just sink into their situation, instead of rise up above it.” (Dad of 20 year old female)
Core Theme 2. Myriad of benefits through TMV process
Theme	Subtheme	Data Sample
Opportunity to give unique reflection of self		“…the way they changed the words to really fit because he’s a, I mean being from Louisiana he’s a, fisherman and a hunter. The whole thing was about things that he enjoyed doing so that was really nice.” (Mom of 21 year old male)
Manageable, non- stressful, joyful activity		“….I know that he enjoyed it a lot, he had a good time doing it, and um, and I can honestly say that because he was putting stuff together and we would talk about it, it was a terrific way for him and I to interact.” (Grandmother of 16 year old male
Process of lyric writing. A means to:	organize and express thoughts	“I think it was meaningful for him b/c it made him take a look at what was going on with himself a little more b/c he had to write the words.” (Mom of 18 year old male)
	communicate/share experience with others	“Maybe it was this and the leukemia and the battle and everything he’s been through, but I think that this exercise has been a good way for him to realize that you need to get it out and you need to express it whether it’s on paper or whether it’s in a video or whether it’s saying it.” (Mom of 16 year old male)
	precipitate meaningful conversation invest in getting the words right
Process of selecting photo images. A means to:	connect and reconnect with others	“one of my sisters came and spent the night with her and she said, “wow she didn’t talk before”. She was talking all night…so the pictures have helped b/c she is showing us times in her life that have some significance to her that we were not aware of.” (Mom of 16 year old female)
	precipitate meaningful conversation
	express gratitude	“Then she was very concerned about having everybody in the video, the people from over there and the people that helped her here for the two months that she was here. So she was always trying to figure out where they fit best in the video.” (Mom of 16 year old female)
Core Theme 3. Power of intervention to enhance connectedness among AYA, healthcare providers, family, and friends
Theme	Subtheme	Data Sample
Enhancement of connectedness with parents and family	strengthened and renewed parent-AYA connectedness
	allowed AYA to talk about undisclosed thoughts/feelings	“Before she didn’t share her emotions but now she’s just letting it out all the time. So we’re not used to that. She is talking more…. She is sharing things that she had never shared before that we didn’t know about her past.” (Mom of 16 year old female)
	making video means to reconnect with family
Enhancement of connectedness with others	connectedness with study personnel	“….if I would have left it up to him I don’t think he would have finished it except he liked the study staff,…. So whether he felt good or not he was going to finish the study because he liked the people that he was working with.” (Mom of 21 year old male)
	provided a way to have meaningful relationship with study personnel who were non-family/nonstaff
	relationship with interventionist source of therapeutic connection	“…with the intervener having the knowledge, I think they made a connection. Before when she started getting sicker, then she started saying, “I don’t want to play anymore”. But now it kept her mind off of what was getting ready to happen to her. The not knowing. I think it kept her mind busy, she knew at a certain time she (intervener) would be there and they would be able to work on stuff” (Mom of 14 year old female)
Enhancement of connectedness with peers	means of staying connected to peers	“She became totally isolated from her friends b/c of the illness. So when she had to put these pictures in she had to go in Facebook and then she would see what her friends were writing to her. So she was able to share with her friends through these pictures and began that contact with them again and just break that isolation process .” (Mom of 16 year old female)
	means of discussing illness with peers