Canteen Australia, NSW, Australia.
Canteen Australia, NSW, Australia; Cancer Nursing Research Unit, University of Sydney, NSW, Australia.
Int J Nurs Stud. 2018 Jan;77:54-80. doi: 10.1016/j.ijnurstu.2017.08.017. Epub 2017 Sep 1.
To i) identify and synthesise evidence published since 2007 regarding the impact of parental cancer on adolescent and young adult offspring, ii) identify methodological and evidence gaps addressed during this period and iii) highlight those requiring further attention.
A systematic review and thematic synthesis of peer reviewed literature regarding the impact of parental cancer upon AYA offspring.
Online searches of CINAHL, Embase, Medline, PsychInfo and Scopus databases were conducted. Reference lists of included articles were screened and additional searches by prominent authors were performed.
Study selection, data extraction and quality analysis was undertaken by three independent researchers. Extracted study data was iteratively reviewed and discussed to achieve consensus regarding thematic synthesis of included studies.
Database and hand-searching yielded 1730 articles, 54 of which were included in the final synthesis. Included studies are discussed with respect to the following themes: i) study design and quality; ii) measurement and sampling; iii) positive and negative aspects of parental cancer; iv) needs; v) communication and information; vi) coping strategies; vii) interventions; and viii) family functioning and other predictors. Twenty-nine studies reported negative impacts related to parental cancer, while eight identified positive outcomes related to post-traumatic growth. Five returned null or mixed findings. Unmet needs were frequently explored and a new validated measure developed. Communication and information were particularly important for offspring, though these needs were often unmet and parents wanted guidance regarding discussions with their children. Offspring may adopt a variety of coping strategies, some of which appear maladaptive, and may cycle between different approaches. Few evaluations of interventions were identified, and further work in this area is needed. Further evidence has emerged that poorer family functioning and other family and illness-related factors predict worse psychosocial outcomes for offspring, however evidence for other predictors such as age and gender remain mixed.
Additional evidence for the negative psychosocial impact of parental cancer on adolescent and young adult offspring, their needs, and factors predicting psychosocial outcomes has emerged in the last decade. However, substantial gaps and methodological issues remain and evidence for the development, efficacy or implementation of interventions for this population is very limited. There is also a clear need for greater focus on bereaved and young adult offspring and those from non-western cultural groups, who remain under-represented in research conducted to date.
i）确定并综合 2007 年以来发表的关于父母癌症对青少年和青年成年子女影响的证据，ii）确定这一时期解决的方法学和证据差距，以及 iii）强调那些需要进一步关注的问题。
对关于父母癌症对 AYA 子女影响的同行评议文献进行系统回顾和主题综合。
对 CINAHL、Embase、Medline、PsychInfo 和 Scopus 数据库进行在线搜索。筛选纳入文章的参考文献列表，并由知名作者进行额外搜索。
三名独立研究人员进行了研究选择、数据提取和质量分析。提取的研究数据经过反复审查和讨论，以就纳入研究的主题综合达成共识。
数据库和手工搜索产生了 1730 篇文章，其中 54 篇被纳入最终综合。对纳入的研究进行了讨论，内容涉及以下主题：i）研究设计和质量；ii）测量和抽样；iii）父母癌症的积极和消极方面；iv）需求；v）沟通和信息；vi）应对策略；vii）干预；以及 viii）家庭功能和其他预测因素。29 项研究报告了与父母癌症相关的负面影响，而 8 项研究确定了与创伤后成长相关的积极结果。五项研究结果为零或混合。未满足的需求经常被探讨，并且开发了一种新的经过验证的测量方法。沟通和信息对子女尤其重要，尽管这些需求经常得不到满足，而且父母希望在与子女的讨论中得到指导。子女可能会采用多种应对策略，其中一些策略似乎不适应，并且可能会在不同的方法之间循环。只发现了很少的干预措施评估，因此在这一领域需要进一步的工作。进一步的证据表明，较差的家庭功能和其他家庭及疾病相关因素预示着子女的心理社会结局较差，然而，其他预测因素（如年龄和性别）的证据仍然存在分歧。
在过去十年中，关于父母癌症对青少年和青年成年子女的负面影响、他们的需求以及预测心理社会结局的因素，出现了更多的证据。然而，仍存在大量差距和方法学问题，并且针对这一人群的干预措施的开发、有效性或实施的证据非常有限。此外，还需要更加关注丧亲的和年轻的成年子女以及来自非西方文化群体的子女，他们在迄今为止进行的研究中代表性不足。
