The experience of body image of children and adolescents with cancer: A meta-synthesis.
Objectives: The objective of this study was to describe the body image experience of children and adolescents with cancer.


METHODS
This review considered studies that utilised qualitative methods to examine the experience of children and adolescents with cancer. The phenomena of interest were experiences of children and adolescents with cancer living in acute care, home, and community settings of any cultural context. The research was limited to studies published in Chinese or English only.


METHODS
The search strategy sought to find both published and unpublished studies. CINAHL, MEDLINE, Mednar, Scius, ProQuest Dissertations and Theses, electronic theses and dissertations system and Chinese electronic periodical services were used to search the articles.Methodological quality: Each paper was assessed independently by two reviewers for methodological quality. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise the methodological quality of the articles. Any disagreements that arose between the reviewers were resolved through discussion with a third reviewer.


METHODS
Qualitative research findings were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument.


RESULTS
Eight papers were included in the review. Four meta-syntheses emerged from the analysis: (1) Being kept away from body: Clinicians should be aware that children and adolescents with cancer feel that they are kept away from normal body, (2) Loss of self-identity: Clinicians should be aware that children and adolescents with cancer feel that they have lost their self-identity, (3) Self-protective strategies and support: Clinicians should understand the protective strategies that children and adolescents with cancer develop and utilise with support from family and friends, and (4) Getting rid of shackles of the body: There should be a strategy to facilitate the development of positive attitudes toward the illness and body image change in children and adolescents with cancer.


CONCLUSIONS
Children and adolescents with cancer also experience various problems associated with body image change. Repeated courses of treatment lead to loss of a normal orderly life, and may even result in changes in interpersonal interactions. In response to body image change, self-protective coping strategies are developed. Children and adolescents who experience life-threatening cancer come to face body image change positively and may hold a confident attitude towards future life.The implications for practice include: (1) Clinicians should be aware that children and adolescents with cancer feel that they are kept away from normal body; (2) Clinicians should be aware that children and adolescents with cancer feel that they have lost their self-identity; (3) Clinicians should be understand the protective strategies that children and adolescents with cancer develop and utilise with support from family and friends; (4) There should be a strategy to facilitate the development of positive attitudes toward the illness and body image change in children and adolescents with cancer.The research tools concerning social support and guidance can be further developed in the future to increase the confidence and capacity of children and adolescents with cancer to face body image change and reduce psychological stress.
1. Taiwan Joanna Briggs Institute Collaborating Center, Taiwan 2. School of Nursing, National Yang-Ming University 3. Ching Kuo Institute Management and Health 4. Deputy Director of Bureau of Nursing and Health Services Department, R. O. C. 5. Department of Nursing, Veteran General Hospital, Taipei, Taiwan R. O. C.
Mei-Yin
MY
Lee
Pei-Fan
PF
Mu
Shwu-Feng
SF
Tsay
Shih-Shang
SS
Chou
Yu-Chi
YC
Chen