Identification of Evidence for Key Positive Psychological Constructs in Pediatric and Adolescent/Young Adult Patients with Cancer: A Scoping Review

Abstract

Introduction: Children and adolescents/young adults (AYAs) with cancer are a vulnerable population susceptible to numerous late effects, such as fatigue and depression, which may diminish their long-term psychological, physical, spiritual, and emotional health. A well-rounded understanding of how positive psychological constructs affect the quality of care and treatment outcomes is therefore warranted. Methods: We conducted a scoping review of 15 positive psychological constructs in children and AYAs with cancer. The primary research questions were (1) what is known about positive psychological constructs in children and AYAs with cancer; (2) what value is ascribed to these constructs by patients?. Results: Two hundred seventy-six articles were included after database search and screening. These studies were mostly observational or qualitative and conducted in North America. Constructs were often poorly defined, and measurement tools used to gather data were wide ranging. Numerous factors were correlated with increased or decreased expression of certain constructs, but overall themes were difficult to identify. Similarly, patients often spoke of what increased or decreased expression of a construct, with less emphasis on what they implicitly value. Discussion: This scoping review found ample evidence for what increases or decreases expression of positive psychological constructs, but this evidence was observational and often conflicting. In the future, we recommend the development of a core set of psychological outcomes, with definitions and corresponding measurement tools. We further recommend an emphasis on randomized trials to more rigorously study how expression of constructs can be improved and what effect this has on the quality of life.

Updating our understanding of health-related quality of life issues in children with cancer: a systematic review of patient-reported outcome measures and qualitative studies

“…Nevertheless, children with cancer have rarely been involved in the development of PROMs [ 22 , 23 ]. Consequently, there is only scarce evidence for the content validity of most available PROMs [ 23 , 65 ]. Thus, it is questionable whether they cover children’s priorities.…”

Conceptualisation and psychometric evaluation of positive psychological outcome measures used in adolescents and young adults living with HIV: a mixed scoping and systematic review protocol

“…11 However, there is limited understanding of the salient positive psychological constructs linked to AYALHIV's improved well-being and healthrelated quality of life. Wayant et al (2021), in their scoping review, mapped 15 positive psychological constructs associated with increased quality of life and survival in AYAL with cancer. 12 Well-being, personal growth, hope, meaning in life, self-esteem, vitality and optimism were the most cited positive constructs; 12 these constructs are potentially transferable to AYALHIV.…”

“…Conversely, etiological differences between cancer and HIV could also lead to differences in lived experiences, resulting in differential perceptions in positive psychological constructs. 12 For instance, HIV-related stigma (often associated with issues related to HIV’s potential infectiousness) may have a greater impact on mental health functioning in AYALHIV 13 14 when compared with the effects of cancer-related stigma. 15 It is thus critical to contextualise the impacts of positive psychological outcomes in AYALHIV.…”

A Reliability Generalization Meta-Analysis of 17 Patient-Reported Outcome Measures for Positive Psychosocial Constructs in Children, Adolescents, and Young Adults with Cancer

“…Including studies where a minority of patients are older than 39 years has increased the included study yield in a prior article because of the recent recognition of AYAs as patients ages 15-39. 16 Despite placing no language restriction on the database search, we only included studies written in English and Spanish, but document studies in other languages to alert readers of their existence. K.B.…”

“…Our scoping review found little standardization in the PROMs used to measure positive psychological constructs and conflicting data about what increases expression of those constructs. 16 Our main recommendations in that scoping review were to work toward the creation of a core set of PROMs that can be used to measure positive psychological constructs. Core outcome sets are an ideal method to standardize the medical literature and promote evidence-based comparison of psychological interventions.…”