The Current State of Palliative Care Research for Adolescents and Young Adults With Cancer: A Systematic Review and Meta-Thematic Analysis of Empirical Literature.
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BACKGROUND: Palliative care is critical to the wellness of cancer patients and survivors, but adolescents and young adults (AYAs) with cancer are confronted with the divide between pediatric and adult palliative care as well as pediatric and adult/medical oncology. Consequently, attention to palliative care for AYAs with cancer has just started, and our understanding of palliative care for AYA oncology remains limited. AIM: This study aims to update our understanding of this salient topic through rigorous research synthesis. DESIGN: A systematic review of empirical literature was adopted, and data was innovatively analyzed using meta-thematic analysis. The review was pre-registered on OSF (https://osf.io/zy9cs). Studies were searched across ten electronic databases from inception to August 1, 2024 (i.e., the search date). Eligibility criteria include: (1) study the topic of palliative care; (2) focus on AYA cancer; and (3) report empirical data. Meta-thematic analysis and reflexive thematic analysis informed data analysis methods. RESULTS: Fifty-six primary studies from 2004 to 2024, inclusive of 478 data points, were included in the meta-thematic analysis. Five broad themes were identified: (1) the overall state of AYA palliative care; (2) key characteristics of palliative care for AYAs with cancer; (3) AYA palliative care communication, decision-making, and AYA involvement; (4) prevalent symptoms, care preferences, and priorities in palliative care among AYAs with cancer; and (5) effective interventions. CONCLUSIONS: Key insights regarding AYA cancer palliative care have been revealed. Notable areas of improvement regarding the delivery of palliative care to AYAs and future research directions have been identified.