Child and Adolescent Cancer Communication Preferences for Treatment Decision Making: A Meta-Synthesis

Background: Children and adolescents (C&A) <18 years of age report varying cancer treatment communication preferences. The aim of this qualitative meta-synthesis was to describe C&A voices regarding their preferences for engagement in their treatment communication. This report shares their preferences specific to their involvement in cancer treatment decision-making (TDM). Methods: Applying meta-aggregation methods, a systematic search was conducted in multiple databases with no limitation to the date range. Studies included participants <18 years of age with childhood cancer using qualitative or mixed research methods, written in English. Findings were limited to C&A self-reported findings. Results: A total of 3213 articles were identified, with 55 articles included. A total of 156 findings related to preferences for TDM were extracted from 39 studies. Three synthesized findings were identified: (1) How I participate in decisions about my cancer treatment, (2) When I do not participate in decisions about my cancer treatment, and (3) Why I participate in decisions about my cancer treatment. Conclusions: This meta-synthesis identified how, when, and why C&A want to be involved in their cancer TDM. Their voices represent a range of preferences for involvement, from a more passive to more active role. Evidence-based practice recommendations were identified with a focus on meeting the C&A communication preferences.