Robb Sheri L, Hanson-Abromeit Deanna
Author Affiliations: School of Nursing, Indiana University, Indianapolis (Dr Robb); School of Music, University of Kansas (Dr Hanson-Abromeit).
Cancer Nurs. 2014 Jul-Aug;37(4):E1-26. doi: 10.1097/NCC.0000000000000095.
There is a positive relationship between parent and young child distress during cancer treatment. Dimensions of parent/child distress are multifaceted and associated with family function and quality of life outcomes. A critical examination of intervention research is needed to identify how dimensions of parent/child distress and related outcomes are being addressed.
The aims of this study were to summarize and describe supportive care intervention research for young children with cancer and parents and to discuss implications for family-based intervention research.
This systematic review examined supportive care intervention studies with randomized and nonrandomized designs for young children with cancer (aged 3-8 years) and/or their parents published between 1991 and 2011. Twenty-two studies that met specific inclusion criteria were reviewed to determine intervention type, intervention components, targeted outcomes and findings, and whether interventions addressed child, parent, or parent/child needs.
Most interventions focused primarily on procedural support, followed by parent education/counseling. Most studies targeted the child or the parent alone; very few targeted parent/child dyads. Outcomes focused primarily on child distress, anxiety, and pain. Quality of life and coping were rarely measured, and no studies examined family function. This body of research is emerging, with most interventions in the developmental pilot phase and few efficacy trials.
Findings confirm underrepresentation of young children in supportive care intervention research and the need for more complex, family-based interventions to advance young child intervention research beyond acute, procedural distress.
The authors discuss the implications of review findings for clinical practice.
在癌症治疗期间，父母与幼儿的痛苦之间存在正相关关系。父母/子女痛苦的维度是多方面的，并且与家庭功能和生活质量结果相关。需要对干预研究进行批判性审查，以确定如何解决父母/子女痛苦的维度及相关结果。
本研究的目的是总结和描述针对患有癌症的幼儿及其父母的支持性护理干预研究，并讨论对基于家庭的干预研究的启示。
本系统评价考察了1991年至2011年间发表的针对患有癌症的幼儿（3至8岁）和/或其父母的随机和非随机设计的支持性护理干预研究。对22项符合特定纳入标准的研究进行了审查，以确定干预类型、干预组成部分、目标结果和发现，以及干预措施是否满足儿童、父母或父母/子女的需求。
大多数干预主要集中在程序支持上，其次是家长教育/咨询。大多数研究仅针对儿童或父母；很少针对父母/子女二元组。结果主要集中在儿童的痛苦、焦虑和疼痛上。很少测量生活质量和应对能力，没有研究考察家庭功能。这一研究领域正在兴起，大多数干预处于发展试点阶段，很少有疗效试验。
研究结果证实了支持性护理干预研究中幼儿的代表性不足，以及需要更复杂的、基于家庭的干预措施，以使幼儿干预研究超越急性、程序性痛苦。
作者讨论了综述结果对临床实践的启示。
