Healthcare professionals' perspectives on disclosure of diagnosis and related issues in childhood cancer: A mixed methods systematic review.
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OBJECTIVES: This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals, with the goal of informing the optimization of disclosure processes and meeting the communication needs of affected families. METHODS: In accordance with the Joanna Briggs Institute (JBI) methodology for mixed methods systematic reviews, the convergent segregated approach was used in this review. Articles were retrieved from 11 databases, including PubMed, Web of Science, CINAHL, CENTRAL, Embase, Ovid/Medline, PsycINFO, PsycArticles, Scopus, ERIC, and China National Knowledge Infrastructure (CNKI). The quality of the selected articles was assessed using the Mixed Method Appraisal Tool (MMAT). The review protocol was registered on PROSPERO (CRD42024542746). RESULTS: A total of 21 studies from 10 countries were included. Their methodological quality was generally medium to high, with MMAT scores ranging from 60 % to 100 %. The synthesis yielded three core themes: 1) the spectrum of professional and societal attitudes toward disclosure; 2) the dynamic practices of navigating disclosure amid uncertainty, including timing and environment, stakeholders, and content of disclosure; and 3) factors influencing disclosure, including children's, parental, healthcare professionals', and socio-cultural factors. CONCLUSIONS: This review synthesized the perspectives and experiences of healthcare professionals regarding disclosure in childhood cancer, highlighting the complexity and multidimensional nature of this process in clinical practice. Future research should further investigate the experiences and needs of children and their parents, explore cultural variations in disclosure practices, develop context-appropriate assessment tools, and construct multidimensional intervention strategies to enhance the humanistic care and professional effectiveness of the disclosure process.