ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025
In their words: Experience of decision-making in adolescents with cancer - a qualitative meta-synthesis.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeDecision-making is the process of making informed choices about medical treatments and care. This study aimed to synthesize qualitative evidence on adolescents' lived experiences of decision-making in cancer care, with particular attention to the barriers, facilitators, and emotional dimensions influencing their participation.
methodsThis study was conducted using the qualitative meta-synthesis methodology outlined by Sandelowski and Barroso (2007). We searched in four databases (PubMed, CINAHL, Embase, and Web of Science) for studies on decision-making in adolescents with cancer. The search period was set from 1989 to April 2023. Eligible studies were peer-reviewed qualitative research on decision-making in cancer care among adolescents; studies focusing only on parents, providers, or clinical trials were excluded. A meta-synthesis was conducted at the quotation-level through iterative discussion and consensus-building.
resultsWe reviewed 18 articles published between 2004 and 2022, involving a total of 343 adolescent participants. Over half were conducted in the United States. Medicine was the most prevalent field, with eight articles, followed by nursing (n = 6). Among the 18 studies, seven articles provided detailed research methods, including three qualitative descriptive studies, three ethnographic studies, and one grounded theory study. The comprehensive meta-synthesis revealed three main categories and seven subcategories: (1) the "I" in decision-making, (2) healthcare environments make decision-making challenging, and (3) attitude toward illness.
conclusionThe findings suggest the need to develop adolescent-centered decision-making models and provide ethics-based training for healthcare professionals. Creating supportive care environments that respect adolescents' autonomy and encourage active participation is also essential.
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