King's College London, London, UK.
J Adv Nurs. 2018 Apr;74(4):800-808. doi: 10.1111/jan.13476. Epub 2017 Nov 9.
To establish and quantify the main reasons for treatment abandonment in children with cancer in Sub-Saharan Africa through a systematic review of the literature.
Great advances have been made in the treatment of childhood cancer, however this requires that families are able to complete treatment. Failure to do this is referred to as treatment abandonment, which is recognized as a reason for treatment failure.
Systematic review and meta-analysis of data on the reasons for treatment abandonment in Sub-Saharan Africa.
Ovid MEDLINE 1946 to May Week 1 2017 and Embase 1974 to 2017 Week 19. Additional hand-searching was undertaken.
Two reviewers independently screened papers and extracted the data. The R package meta was used to calculate the relative risk of treatment abandonment or the proportion of parents stating a reason.
The relative risk of treatment abandonment was highest for not being in a research cohort; followed by mothers only having primary education, being HIV negative, parents not being employed, travel and no insurance. When parents who had abandoned treatment were asked, the most common reason was finance, followed by insurance, transport, lack of social support, their child appearing well, fear and waiting.
More data are needed on the extent of treatment abandonment in different countries. Clinicians should encourage parents without insurance to enrol onto the relevant insurance programme straight after diagnosis, provide housing for patients and families close to the treatment centres and to develop treatment at more localized centres.
通过系统评价文献，确定并量化撒哈拉以南非洲儿童癌症治疗中断的主要原因。
儿童癌症的治疗已经取得了巨大进展，但这需要家庭能够完成治疗。未能完成治疗被称为治疗中断，这被认为是治疗失败的原因之一。
对撒哈拉以南非洲地区治疗中断原因的文献进行系统评价和荟萃分析。
Ovid MEDLINE 1946 年至 2017 年 5 月第 1 周和 Embase 1974 年至 2017 年第 19 周。此外还进行了额外的手工检索。
两名评审员独立筛选文献并提取数据。使用 R 包 meta 计算治疗中断的相对风险或表示治疗中断原因的父母比例。
未纳入研究队列的治疗中断风险最高；其次是母亲只有小学教育、HIV 阴性、父母未就业、旅行和无保险。当询问已经放弃治疗的父母时，最常见的原因是经济原因，其次是保险、交通、缺乏社会支持、孩子看起来状况良好、恐惧和等待。
需要更多关于不同国家治疗中断程度的数据。临床医生应鼓励没有保险的父母在诊断后立即参加相关的保险计划，为患者和家庭提供靠近治疗中心的住房，并在更本地化的中心开展治疗。
