Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany.
Psychooncology. 2018 Oct;27(10):2327-2338. doi: 10.1002/pon.4863. Epub 2018 Sep 11.
Due to the unique importance of parental and sibling relationships and concurrently existing developmental challenges, the loss of a parent or sibling due to cancer is a highly stressful event for children and adolescents. This is the first systematic review that integrates findings on psychosocial outcomes after parental or sibling cancer bereavement.
A systematic search of Web of Science, PubMed, PsycINFO, and PubPsych was conducted, last in December 2017. Quantitative studies on psychosocial outcomes of children and adolescents who lost a parent or sibling due to cancer were included.
Twenty-four studies (N = 10 parental and N = 14 sibling bereavement), based on 13 projects, were included. Ten projects had cross-sectional designs. Only 2 projects used large, population-based samples and nonbereaved comparison groups. Outcomes were partially measured by single-item questions. Bereaved children and adolescents showed similar levels of depression and anxiety compared with nonbereaved or norms. Severe behavioral problems were found rarely. However, in 2 large, population-based studies, about half of the bereaved individuals reported unresolved grief. Bereaved adolescents had a higher risk for self-injury compared with the general population in one large, population-based study. Communication with health-care professionals, family, and other people; social support; distress during illness; age; gender; and time because loss were associated with psychosocial bereavement outcomes.
Results indicate a high level of adjustment in cancer-bereaved children and adolescents. A modifiable risk factor for adverse psychosocial consequences is poor communication. Prospective designs, representative samples, and validated instruments, eg, for prolonged grief, are suggested for future research.
由于父母和兄弟姐妹关系的独特重要性以及同时存在的发展挑战，儿童和青少年因癌症而失去父母或兄弟姐妹是一个高度紧张的事件。这是第一项综合父母或兄弟姐妹癌症丧亲后心理社会结果的系统评价。
对 Web of Science、PubMed、PsycINFO 和 PubPsych 进行了系统搜索，最后一次搜索是在 2017 年 12 月进行的。纳入了关于因癌症失去父母或兄弟姐妹的儿童和青少年心理社会结果的定量研究。
纳入了 24 项研究（N=10 例父母丧亲，N=14 例兄弟姐妹丧亲），基于 13 个项目。10 个项目采用了横断面设计。只有 2 个项目使用了大型、基于人群的样本和未丧亲的对照组。结果部分通过单项问题进行测量。与未丧亲或正常人群相比，丧亲的儿童和青少年表现出相似水平的抑郁和焦虑。很少发现严重的行为问题。然而，在 2 项大型基于人群的研究中，约一半的丧亲者报告存在未解决的悲伤。与一般人群相比，在一项大型基于人群的研究中，丧亲的青少年自残的风险更高。与卫生保健专业人员、家庭和其他人的沟通；社会支持；疾病期间的痛苦；年龄；性别；以及失去亲人的时间都与丧亲后的心理社会结果有关。
结果表明癌症丧亲的儿童和青少年调整水平较高。沟通不畅是不良心理社会后果的一个可改变的风险因素。建议未来的研究采用前瞻性设计、代表性样本和经过验证的工具，例如用于延长悲伤的工具。
