Treatment Decision-Making Involvement in Adolescents and Young Adults With Cancer.
Kimberly A Pyke-Grimm, Linda S Franck, Katherine Patterson Kelly and 4 others
PMID 30547960WHAT IT FOUND
Adolescents and young adults with cancer often wanted information and shared decisions, not sole control.
Their preferred role changed with illness, stress and treatment stage, so ask each time rather than assume.
Key findings
01Preferred involvement ranged from no role to making most decisions, and family was usually involved.
02Information and communication were important, but wanting information did not necessarily mean wanting decision control.
03Involvement was situational: some studies linked age or maturity to participation, others did not, and disease stress plus parent and provider control also shaped it.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies did not focus only on the target adolescent and young adult age range, and many did not report results separately by age, so the review cannot show how findings differ by age. Treatment decision making was defined differently across studies, so findings are hard to compare. Many studies were retrospective and relied on recall, which can bias memories of involvement. Study quality varied, with some lower quality, and minority groups were underrepresented. The review included older children, survivors and people with other chronic illness, so it is not a clean picture of cancer treatment decisions in adolescents and young adults alone. The review did not test whether involving patients in decisions improves adherence or outcomes.
The easy way to misread this
Do not conclude that involving adolescents and young adults in decisions improves cancer outcomes. This review synthesizes preferences and barriers from mostly qualitative studies, not tested interventions with outcome data.