Navigating the Psychosocial Journey: A Meta-Ethnographic Review of the Psychosocial Needs and Experiences of Children and Adolescents (0-19 Years) Diagnosed With Cancer Across the Care Continuum.

BACKGROUND

Survival rates for childhood cancer have improved; however, psychosocial challenges remain across diagnosis, treatment, and survivorship. Existing qualitative studies typically examine a single phase of care, limiting understanding of how psychosocial needs persist and change over time.

AIM: This meta-ethnographic review synthesised qualitative evidence on the psychosocial needs and experiences of children and adolescents (0-19 years) diagnosed with cancer across the care continuum and examined how these needs evolve across phases.

METHOD: A meta-ethnographic synthesis was conducted following Noblit and Hare's approach and reported in accordance with eMERGe guidance. Searches of six databases (Scopus, MEDLINE, Web of Science, PsycINFO, CINAHL, and Google Scholar) identified 31 qualitative studies published between January 2009 and February 2025. First- and second-order constructs were extracted, coded by age group and continuum phase, and integrated into a line-of-argument synthesis.

RESULTS

Six psychosocial domains consistently shaped children's needs and experiences: family, relationships, psychosocial care, emotions, control, and information needs. These domains remained consistent across diagnosis, treatment, and survivorship but differed in expression over time. Diagnosis was characterised by emotional shock, uncertainty, and reliance on parental containment. During treatment, children experienced procedural distress, disrupted peer relationships, and fluctuating autonomy. Survivorship involved fear of relapse, challenges with reintegration, and inconsistent psychosocial follow-up. Evidence gaps were identified for toddlers' and school-aged children's needs in survivorship.

CONCLUSION

This synthesis highlights the prehabilitation phase as a potential window for early psychosocial intervention and supports the development of phase-responsive, developmentally responsive psychosocial care pathways extending into survivorship.