Few guidelines offer recommendations on how to assess and manage anxiety and distress in children with cancer: a content
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REVIEW ARTICLE
Few guidelines offer recommendations on how to assess and manage anxiety and distress in children with cancer: a content analysis Tanya Lazor 1
&
Claire De Souza 2,3 & Robin Urquhart 4 & Eva Serhal 5 & Anna R. Gagliardi 6
Received: 5 May 2020 / Accepted: 21 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract 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. Keywords Adolescents . Anxiety . Cancer . Children . Hematopoietic stem cell transplantation . Content analysis . Distress
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s00520-02005845-8. * Tanya Lazor [email protected] 1
Department of Social Work, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
2
Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
3
Department of Psychiatry, University of Toronto, Toronto, Ontario M5S 1A8, Canada
4
Department of Surgery, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada
5
Centre for Addiction and Mental Health, Toronto, Ontario M5J 2C9, Canada
6
Toronto General Hospital Research Institute, Toronto, Ontario M5G 2C4, Canada
Background Despite improvements in the prognosis for children
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