How Can Health Care Professionals Communicate Effectively with Adolescent and Young Adults Who Have Completed Cancer Treatment? A Systematic Review

Abstract

Communication with teenage and young adult or adolescent and young adult (AYA) patients with cancer is critically important and not consistently taught in health care education. We have developed a local training for medical students to experience and join AYA cancer consultations to improve clinicians' abilities in the future. We have undertaken a systematic review of the literature, to provide a comprehensive overview of studies evaluating communication in this specific patient group, to guide clinical practice and future research. We searched MEDLINE, EMBASE, PsycINFO, Web of Science, and CINAHL databases for literature containing data relating to communication in AYAs previously treated for malignant disease. To ensure as comprehensive a review as possible, the researchers defined the AYA age range using the extremes used globally: 13-39 years. Two thousand eight hundred and thirty-seven articles were identified, which were reduced to 1517 after duplicates were removed. After handsearching references and citation tracking, 1556 abstracts were screened of which 40 full-text articles were assessed for eligibility. Only 12 met all inclusion criteria and were included in the final analysis. Young people want to be heard and have trust in their health care professionals (HCPs). They want to be involved in decisions about their care, and HCPs must establish who else the AYA wants to be involved in the decision-making process. AYAs want information to be given in an amount they can control and at a time preferred by them. Further education of communication skills, especially triadic communication, is essential for professionals involved in AYA care.

Prepared for survivorship? Multidisciplinary healthcare professionals' experiences with adolescents’ transition off cancer treatment: A focus group study

“…HCPs admitted that they often turned to the parents for their opinions, even if the patients were 16 years or older and thus legal adults in the context of healthcare in Norway (Norwegian Ministry of Health and Care Services, 2015). The importance of changing this practice was discussed, and is supported by two systematic reviews emphasizing that adolescents want more involvement and decisional authority in their cancer care (Lin et al, 2020;Smith et al, 2020). The young age of the patients, cancer severity and strict treatment protocols are often seen as contributing to the lack of tradition around involving children and adolescents with cancer in shared-decision-making (SDM) (Coyne et al, 2014).…”

“…However, on a positive note, a recent systematic review has made recommendations on how HCPs can communicate effectively and facilitate SDM with adolescents and young adults post-cancer (Smith et al, 2020). They recommend e.g.…”

Web-Based Research Trends on Child and Adolescent Cancer Survivors Over the Last 5 Years: Text Network Analysis and Topic Modeling Study

“…We identified anxiety, burden, depression, resilience, stress, counseling, measurement, and post-traumatic growth. In 7 meta-analyses [53][54][55][56][57][58][59], child and adolescent cancer survivors were highly likely to experience mood or affective disorders [56], and brain tumor in child and adolescent cancer survivors was significantly associated with anxiety, depression, and health-related QOL, highlighting the importance of psychosocial screening. Furthermore, in 1 systematic review and meta-study [54], dealing with the keyword post-traumatic growth identified in this study, the need for targeted social support, clinical intervention, and education to facilitate posttraumatic growth was suggested through an analysis of 18 studies.…”

The Impact of Hispanic Ethnicity and Language on Communication Among Young Adult Childhood Cancer Survivors, Parents, and Medical Providers and Cancer-Related Follow-Up Care

“…Communication challenges that survivors encounter are exclusion from decision making, vague recommendations about long-term follow-up, and parents' avoidance in discussing late effects with their children. 1,5,6 With Hispanic/Latino populations, YACCSs and parents are more reliant on hospital resources for health information compared with non-Hispanic White populations. 7,8 Language barriers impair effective communication, and language preference in pediatric cancer care may influence communication behaviors, thus contributing to health disparities.…”

“…18 Other studies revealed that communication between the medical team, YACSSs, and parents about the transition process, follow-up plan, and late effects symptoms were important for a successful transition from pediatric to adult-centered survivorship care and engagement in long-term follow-up care. 6,19,20 Yet, these studies are limited in that they do not explore these relationships among Hispanic/Latino populations, and the one study that focused on Hispanic/Latino survivors and parents was a qualitative study.…”