Communicating with children and adolescents about their cancer.
BACKGROUND
Communication with children and adolescents with cancer about their disease and treatment and the implications of these is an important aspect of good quality care. It is often poorly performed in practice. Various interventions have been developed that aim to enhance communication involving children or adolescents with cancer.


OBJECTIVE
To examine the effects of interventions to enhance communication with children and/or adolescents about their cancer, its treatment and their implications.


METHODS
The following electronic databases were searched: Cochrane Library; Medline; PsycLit; Cinahl; Cancerlit; EMBASE; Sociofile; Health Management Information Consortium; ASSIA; LISA; ERIC; PAIS; Information Science Abstracts; Dissertation Abstracts; JICST; Pascal; Linguistics and Language Behavior Abstracts; Mental Health Abstracts; AMED; MANTIS. Bibliographies of identified studies were also checked and contact made with experts in the field.


METHODS
Randomised and non-randomised controlled trials and before and after studies that evaluated the effects of interventions to enhance communication with children and/or adolescents about their cancer, treatment and related issues.


METHODS
Data relating to the interventions, populations and outcomes studied and the design and methodological quality of included studies were extracted by one reviewer and checked by another reviewer. A narrative summary of the results is presented.


RESULTS
Six studies met the criteria for inclusion. They were diverse in terms of the interventions evaluated, study designs used, types of people who participated and the outcomes measured. One study of a computer-assisted education programme reported improvements in knowledge and understanding about blood counts and cancer symptoms. Two out of two studies of school reintegration programs reported improvements in some aspects of psychosocial wellbeing (one in anxiety and one in depression), social wellbeing (two in social competence and one in social support) and behavioural problems; and one reported improvements in physical competence.


CONCLUSIONS
Interventions to enhance communication involving children and adolescents with cancer have not been widely or rigorously assessed. The weak evidence that exists suggests that some children and adolescents with cancer may derive some benefit from specific information-giving programs and from interventions that aim to facilitate their reintegration into school and social activities. More research is needed to investigate the effects of these and other related interventions.
Health Studies, University of York, University Road, Heslington, York, North Yorkshire, UK, YO10 5DQ. jts2@york.ac.uk
J T
JT
Scott
V A
VA
Entwistle
A J
AJ
Sowden
I
I
Watt
D000293:Adolescent; D002648:Child; D003142:Communication; D005190:Family; D006801:Humans; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D010353:Patient Education as Topic; D011369:Professional-Patient Relations; D016032:Randomized Controlled Trials as Topic