Crane Stacey, Haase Joan E, Hickman Susan E
Indiana University in Indianapolis.
Oncol Nurs Forum. 2018 Sep 1;45(5):E67-E97. doi: 10.1188/18.ONF.E67-E97.
Pediatric oncology phase 1 clinical trials (P1Ts) are essential to developing new anticancer therapies; however, they raise complex ethical concerns about balancing the need for this research with the well-being of participating children. The purpose of this integrative review was to synthesize and appraise the evidence of how P1T participation, which begins with consent and ends with the transition off the P1T, can affect the well-being (either positively or negatively) of children with cancer. The Resilience in Individuals and Families Affected by Cancer Framework, which has an outcome of well-being, was used to synthesize findings.
Articles on the experiences of child (n = 21) and adult (n = 31) P1T participants were identified through systematic searches.
Articles were evaluated on rigor and relevance to P1T participant experiences as high, medium, or low.
Minimal empirical evidence was found regarding the effect of P1T participation on the well-being of children with cancer. Adult P1T participant experiences provide insights that could also be important to children's P1T experiences.
To achieve a balanced approach in P1T consent discussions, nurses and healthcare providers who work with children considering participation in a P1T should share the potential effect of participation on participants' well-being.
儿科肿瘤学1期临床试验(P1Ts)对于开发新的抗癌疗法至关重要;然而,在平衡这项研究的需求与参与试验儿童的福祉方面,它们引发了复杂的伦理问题。本整合性综述的目的是综合并评估关于P1T参与(从同意参与开始至结束P1T过渡)如何影响癌症患儿福祉(无论是积极还是消极)的证据。采用了以福祉为结果的“受癌症影响的个人和家庭的复原力框架”来综合研究结果。
通过系统检索确定了关于儿童(n = 21)和成人(n = 31)P1T参与者经历的文章。
根据严谨性以及与P1T参与者经历的相关性,将文章评估为高、中或低。
关于P1T参与对癌症患儿福祉影响的实证证据极少。成人P1T参与者的经历提供了一些见解,这些见解对儿童P1T经历也可能很重要。
为了在P1T同意讨论中采取平衡的方法,与考虑参与P1T的儿童一起工作的护士和医疗保健提供者应分享参与对参与者福祉的潜在影响。