Bibby Helen, White Victoria, Thompson Kate, Anazodo Antoinette
1 Centre for Behavioural Research in Cancer , Cancer Council Victoria, Melbourne, Victoria, Australia .
2 School of Psychological Sciences, University of Melbourne , Victoria, Australia .
J Adolesc Young Adult Oncol. 2017 Mar;6(1):6-30. doi: 10.1089/jayao.2016.0012. Epub 2016 Jul 25.
To assess what is currently known about unmet needs and care experiences of adolescents and young adults (AYAs) with cancer, identify gaps in the research literature, and highlight potential areas for improvement in future research.
Medline, PsycINFO, CINAHL, and EMBASE databases were searched to identify relevant studies from 1990 to July 2015. Eligible articles included self-reported care experiences or unmet needs of cancer patients aged between 15 and 30 years in the period between symptom onset and 2 years post-treatment. Qualitative and quantitative designs were included.
Forty-five articles from 39 studies (23 qualitative, 12 quantitative, and 4 mixed methods) were rated as "adequate" or "good" quality and reviewed. The majority included any cancer diagnoses and none was longitudinal. There was considerable variation in age ranges and time since diagnosis between studies. Only two studies used standardized survey tools, with both tools validated on adult populations. The most common areas assessed for care experiences and needs were information/communication and fertility. In addition, care experience studies commonly examined clinical expertise and age-appropriate settings, while unmet needs studies reported on emotional support and peer interaction.
Findings highlight the need for age-appropriate information and treatment facilities, access to emotional support services, and contact with peers. Fertility information and services are a priority issue for this group. Future research would benefit from a consistent definition of the AYA age range, increased used of standardized scales validated with this population, and longitudinal designs to assess changes over time.
评估目前已知的关于癌症青少年和青年（AYA）未满足的需求及护理体验，识别研究文献中的差距，并突出未来研究中潜在的改进领域。
检索Medline、PsycINFO、CINAHL和EMBASE数据库，以识别1990年至2015年7月期间的相关研究。符合条件的文章包括在症状出现至治疗后2年期间，年龄在15至30岁之间的癌症患者自我报告的护理体验或未满足的需求。纳入了定性和定量设计的研究。
来自39项研究的45篇文章（23篇定性、12篇定量和4篇混合方法）被评为“充分”或“良好”质量并进行了综述。大多数研究包括任何癌症诊断，且均非纵向研究。各研究之间的年龄范围和诊断后的时间差异很大。只有两项研究使用了标准化调查工具，且这两种工具均在成年人群中得到验证。评估护理体验和需求的最常见领域是信息/沟通和生育。此外，护理体验研究通常考察临床专业知识和适合年龄的环境，而未满足需求研究则报告了情感支持和同伴互动情况。
研究结果突出了对适合年龄的信息和治疗设施、获得情感支持服务以及与同伴接触的需求。生育信息和服务是该群体的一个优先问题。未来的研究将受益于对AYA年龄范围的一致定义、更多地使用针对该人群验证的标准化量表，以及采用纵向设计来评估随时间的变化。
