Hauskov Graungaard Anette, Roested Bendixen Christina, Haavet Ole Rikard, Smith-Sivertsen Tone, Mäkelä Marjukka
Section and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.
Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
Child Care Health Dev. 2019 Mar;45(2):147-158. doi: 10.1111/cch.12647.
This systematic review explored the occurrence and types of somatic symptoms in children (0-20 years) who have experienced parental cancer.
We complemented a systematic literature search from PubMed and PsycInfo with a reference search. We identified 1,694 articles, which were independently screened by two authors; they further evaluated potentially relevant papers for quality and extracted the data. We found nine relevant studies (10 publications) on altogether 672 children with a parent who had cancer; four studies included a control group.
The studies typically focused on children's psychosocial reactions on parental cancer rather than somatic complaints, so symptom prevalence cannot be reliably summarized. Several studies were small, and the types of somatic symptoms were only specified in five studies. Somatic symptoms were reported as a measure of emotional reactions in the remaining four studies. Three studies provided longitudinal data. The main types of specific symptoms reported were eating problems, pain, sleeping troubles, and bed-wetting. Children of cancer patients tended to show an increase of unspecified somatic symptoms and pain, but evidence was inconsistent. There was a tendency that somatic complaints were associated with increased emotional distress in the children. The material did not allow for separate analysis by age group or bereavement status.
Children in families with parental cancer may present with somatic complaints, but the prevalence and significance is not possible to estimate due to very sparse research in this area. Health professionals or counselling providers should not overlook this possible sign of distress. Qualitative studies report significant health anxiety in these children; this may represent a specific topic for counselling in this population. Targeted studies are needed to evaluate the prevalence and significance of somatic symptoms, and especially vulnerable groups need to be identified.
本系统评价探讨了经历过父母患癌的儿童（0至20岁）躯体症状的发生情况及类型。
我们在PubMed和PsycInfo进行系统文献检索的基础上补充了参考文献检索。我们共识别出1694篇文章，由两位作者独立筛选；他们进一步评估了潜在相关论文的质量并提取了数据。我们发现了9项关于672名父母患癌儿童的相关研究（10篇出版物）；4项研究纳入了对照组。
这些研究通常关注儿童对父母患癌的心理社会反应而非躯体不适，因此无法可靠地总结症状患病率。几项研究规模较小，只有5项研究明确指出了躯体症状的类型。其余4项研究将躯体症状作为情绪反应的一种度量指标。3项研究提供了纵向数据。报告的特定症状的主要类型为饮食问题、疼痛、睡眠障碍和尿床。癌症患者的子女往往表现出未明确的躯体症状和疼痛有所增加，但证据并不一致。有迹象表明，躯体不适与儿童情绪困扰增加有关。现有资料无法按年龄组或丧亲状况进行单独分析。
父母患癌家庭中的儿童可能会出现躯体不适，但由于该领域的研究非常稀少，患病率及重要性无法估计。卫生专业人员或咨询服务提供者不应忽视这种可能的困扰迹象。定性研究报告称这些儿童存在明显的健康焦虑；这可能是该人群咨询服务的一个特定主题。需要有针对性的研究来评估躯体症状的患病率及重要性，尤其需要识别出特别脆弱的群体。
