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Saturday, 16 November 2013
Learning Objective 1: Compare and contrast the benefits and challenges to using proxy reporting of symptoms in children with cancer.
Learning Objective 2: Discuss instances where proxy reporting may be utilized when conducting research in young children with cancer.
Collecting information about symptoms in children with cancer younger than seven-years old can be challenging due to developmental aspects of children. Children under the age of seven are often excluded from symptom studies because of their limited language skills, their focus on the present-time, and issues with recall related to developing cognitive abilities. Addressing the benefits and limitations of proxy reporting could be valuable for future symptom studies in young children with cancer. The purpose of this literature review was to: discover what symptoms are experienced in young children with cancer and to explore ways to maximize proxy reporting. The databases CINAHL and PubMed were searched using the search terms “symptoms” and “pediatric cancer” and “proxy” and “childhood cancer”. Criteria for article inclusion were: published in English, addressed symptoms identified by parent proxy reporting in children with cancer, and published in a peer-reviewed journal. References lists for each article were also reviewed. This search yielded a total of fifteen articles. Results of the review show that the symptom experience in young children with cancer remains largely unexplored. In terms of proxy reporting, congruence in agreement has been shown between parent and child in more objective symptoms like nausea, vomiting and quality of life through both quantitative and qualitative measurements. On the other hand, more subjective symptoms were harder to identify and recognize by parents and were shown to be under-reported. Most studies in the review did use proxy reporting while some did involve the child’s input. Although there are limitations to proxy-reporting, parents may be the most reliable source of information for children with cancer under the age of seven. Additionally, if the child is able, their input should also be sought in addition to the parent.