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      Clinical practices for communicating the diagnosis in pediatric oncology: a systematic review Translated title: Prácticas clínicas de comunicación del diagnóstico en oncología pediátrica: una revisión sistemática

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          Abstract

          Abstract Communication of diagnosis in chronic disease has been little studied in pediatric oncology. Clinical practices for disclosure are mainly carried out at the end of life, not at the onset of the disease, and there does not seem to be clarity on how to communicate to families. Objective: to understand the current communication practices of diagnosis in children and young people with oncologic disease. Method: systematic review according to PRISMA guidelines. Results: A total of 17 studies were obtained that met the inclusion criteria. Two protocols for communicating the diagnosis were identified and several recommendations were found for disclosure according to the patient's age, the right to be informed, and the importance of involving the family. Discussion: validated communication practices are required that respond to the mental health needs in pediatric oncology, considering the culture and environment of patients and their families, and other barriers to effective communication.

          Translated abstract

          Resumen La comunicación del diagnóstico en enfermedades crónicas ha sido poco estudiada en oncología pediátrica. Las prácticas clínicas para la revelación son al final de la vida, pero poco al inicio de la enfermedad, por lo que no parece haber claridad sobre cómo comunicar a las familias. Objetivo: conocer cuáles son las prácticas de comunicación del diagnóstico en niños y jóvenes con enfermedad oncológica. Método: revisión sistemática según lineamientos PRISMA. Resultados: se encontraron 17 estudios que cumplían con los criterios de inclusión. Se identificaron dos protocolos para comunicar el diagnóstico y varias recomendaciones para hacer la revelación según la edad del paciente, el derecho a estar informado y la importancia de involucrar a la familia. Discusión: se requieren prácticas de comunicación validadas que respondan a las necesidades de salud mental en oncología pediátrica, que incluyan la cultura y contexto de paciente y familia, así como las barreras que dificultan la comunicación.

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          Most cited references25

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          Prognostic Disclosures to Children: A Historical Perspective

          Prognostic disclosure to children has perpetually challenged clinicians and parents. In this article, we review the historical literature on prognostic disclosure to children in the United States using cancer as an illness model. Before 1948, there was virtually no literature focused on prognostic disclosure to children. As articles began to be published in the 1950s and 1960s, many clinicians and researchers initially recommended a “protective” approach to disclosure, where children were shielded from the harms of bad news. We identified 4 main arguments in the literature at this time supporting this “protective” approach. By the late 1960s, however, a growing number of clinicians and researchers were recommending a more “open” approach, where children were included in discussions of diagnosis, which at the time was often synonymous with a terminal prognosis. Four different arguments in the literature were used at this time supporting this “open” approach. Then, by the late 1980s, the recommended approach to prognostic disclosure in pediatrics shifted largely from “never tell” to “always tell.” In recent years, however, there has been a growing appreciation for the complexity of prognostic disclosure in pediatrics. Current understanding of pediatric disclosure does not lead to simple “black-and-white” recommendations for disclosure practices. As with most difficult questions, we are left to balance competing factors on a case-by-case basis. We highlight 4 categories of current considerations related to prognostic disclosure in pediatrics, and we offer several approaches to prognostic disclosure for clinicians who care for these young patients and their families.
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            Children with cancer share their views: tell the truth but leave room for hope

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              Does "telling" less protect more? Relationships among age, information disclosure, and what children with cancer see and feel.

              Parents report telling young children less about the diagnosis, treatment, and prognosis of cancer than older children and adolescents. This is often based on the desire to spare children from being overwhelmed. 43 children diagnosed with cancer reported on information disclosed to them at diagnosis, their causal attributions, illness-related stress, and coping strategies. Consistent with parental reports, children under 9 years (n = 18) were told less than children 9-14 years (n = 15) and adolescents (n = 10). Young children's reports of illness impact differed from older children and adolescents only with respect to school and social domains. Younger children reported fewer cognitive strategies than older children and adolescents. Even though young children were told much less than older children they reported similar levels of distress. This suggests that nondisclosure fails to mask the salient and distressing aspects of the illness.
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                Author and article information

                Journal
                pappsicol
                Papeles del Psicólogo
                Pap. Psicol.
                Consejo General de Colegios Oficiales de Psicólogos (Madrid, Madrid, Spain )
                0214-7823
                1886-1415
                August 2022
                : 43
                : 2
                : 117-124
                Affiliations
                [4] Bogotá orgnameUniversidad El Bosque Colombia panperez@ 123456unbosque.edu.co
                [1] Bogotá orgnameUniversidad El Bosque Colombia castrorubby@ 123456unbosque.edu.co
                [5] Bogotá orgnameUniversidad El Bosque Colombia jalmartinezc@ 123456unbosque.edu.co
                [2] Bogotá orgnameUniversidad El Bosque Colombia larcer@ 123456unbosque.edu.co
                [3] Bogotá orgnameUniversidad El Bosque Colombia anavarretep@ 123456unbosque.edu.co
                Article
                S0214-78232022000200006 S0214-7823(22)04300200006
                10.23923/pap.psicol.2977
                3f6f46a5-9189-4edd-8a14-3411df1487ea

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 09 September 2021
                : 02 December 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 8
                Product

                SciELO Spain

                Categories
                Articles

                Psycho-Oncology,Oncology,Communication Barriers,Systematic review,Revelación de la verdad,Oncología,Barreras de comunicación,Psicooncología,Revisión sistemática,Truth Disclosure

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