Few guidelines offer recommendations on how to assess and manage anxiety and distress in children with cancer: a content analysis

• Published in: Supportive care in cancer Vol. 29; no. 5; pp. 2279 - 2288
• Main Authors: Lazor, Tanya, De Souza, Claire, Urquhart, Robin, Serhal, Eva, Gagliardi, Anna R.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2021; Springer; Springer Nature B.V
• Subjects: Adolescent; Anxiety; Anxiety - therapy; Anxiety Disorders; Cancer; Cancer therapies; Care and treatment; Chemotherapy; Child; Child psychology; Child, Preschool; Children; Content analysis; Fear & phobias; Guidelines as Topic; Hematopoietic stem cells; Hospitals; Humans; Infant; Infant, Newborn; Medical diagnosis; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Neoplasms - etiology; Neoplasms - psychology; Nursing; Nursing Research; Oncology; Pain Medicine; Patients; Pediatrics; Psychological Distress; Qualitative research; Quality of life; Rehabilitation Medicine; Review Article; Stem cell transplantation; Stem cells; Systematic review; Teenagers; Transplantation; Anxiety; Distress; Children; Adolescents; Hematopoietic stem cell transplantation; Cancer; Content analysis
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-020-05845-8

Purpose To (1) describe and compare, across all eligible guidelines, recommendations that address any aspect of clinical assessment or management of anxiety and distress experienced by children and adolescents undergoing cancer treatment or hematopoietic stem cell transplantation (HSCT), and (2) assess guideline characteristics that influence identified recommendations. Methods We searched five databases for relevant guidelines and conducted a grey literature search. Guidelines had to refer to children 0–18 years old who were undergoing cancer treatment or HSCT, describe any aspect of clinical assessment or management of symptoms of anxiety and distress, and be publicly accessible and published in English on or after 2000. Results We identified 118 guidelines on pediatric cancer of which 13 mentioned clinical assessment or management of anxiety and distress. Six contained ≥ 1 recommendation addressing assessments of symptoms of which only two recommended specific screening instruments. Ten contained ≥ 1 recommendation addressing interventions for symptoms, of which six described specific interventions such as distraction and medication. Psychologists and nurses were the most common panel members and three guideline panels included a patient advocate. Only two guidelines received overall quality ratings > 80.0%. Conclusion We identified no guidelines that were specific to clinical assessment or management of anxiety and distress among children and adolescents undergoing cancer treatment or HSCT, and thus, clinicians lack evidence-informed guidance on how to manage these specific symptoms. Future research should establish high-quality guidelines that offer recommendations specific to clinical assessment and management of anxiety and distress in pediatric oncology and HSCT.