A Review of Supportive Care Interventions to Manage Distress in Young Children With Cancer and Parents

Background: There is a positive relationship between parent and young child distress during cancer treatment. Dimensions of parent/child distress are multifaceted and associated with family function and quality of life outcomes. A critical examination of intervention research is needed to identify how dimensions of parent/child distress and related outcomes are being addressed. Objective: The aims of this study were to summarize and describe supportive care intervention research for young children with cancer and parents and to discuss implications for family-based intervention research. Methods: This systematic review examined supportive care intervention studies with randomized and nonrandomized designs for young children with cancer (aged 3-8 years) and/or their parents published between 1991 and 2011. Twenty-two studies that met specific inclusion criteria were reviewed to determine intervention type, intervention components, targeted outcomes and findings, and whether interventions addressed child, parent, or parent/child needs. Results: Most interventions focused primarily on procedural support, followed by parent education/counseling. Most studies targeted the child or the parent alone; very few targeted parent/child dyads. Outcomes focused primarily on child distress, anxiety, and pain. Quality of life and coping were rarely measured, and no studies examined family function. This body of research is emerging, with most interventions in the developmental pilot phase and few efficacy trials. Conclusions: Findings confirm underrepresentation of young children in supportive care intervention research and the need for more complex, family-based interventions to advance young child intervention research beyond acute, procedural distress. Implications for Practice: The authors discuss the implications of review findings for clinical practice.