Supporting the Decision Making of Children With Cancer: A Meta-synthesis

Abstract

<b>Background:</b> Recently, awareness of children's decision making has increased in an effort to enhance palliative care. However, the conceptual framework for decision making among children with cancer remains unclear. <b>Aims:</b> We clarified the decision-making process of children with cancer regarding their care, treatment, and support from family and health care professionals, and identified their needs and preferences. <b>Design:</b> We used metaethnography to conduct a metasynthesis of relevant studies. <b>Data sources:</b> We searched PubMed, EMBASE, PsycINFO, MEDLINE, and CINAHL. This report was prepared in accordance with the PRISMA statement. <b>Results:</b> Of the 7,237 retrieved studies, 27 met our inclusion criteria. Four themes emerged that reflected the decision-making process of children with cancer: (a) facing changes brought about by a health threat, (b) preparing for action, (c) asserting one's choice, and (d) internal and external influences. <b>Conclusion:</b> Children with cancer initially undergo a decision-making process. Respecting children's preferences, values, and emotions may help build trusting relationships and promote their decision-making capability. Future research should focus on children's emotions, cognition, development, and interactions with parents and health care professionals.