Systematic Review: Associations Between Family Functioning and Child Adjustment After Pediatric Cancer Diagnosis: A Meta-Analysis

Abstract

Objectives: A systematic review and meta-analysis was conducted to investigate associations between family functioning and child adjustment (patient/siblings) after pediatric cancer diagnosis.

Methods: Database searches were performed using Web of Science, Pubmed, Cochrane, PsycInfo, and Embase. After screening 5,563 articles, 35 were identified regarding this topic; 30 contributed data for meta-analyses. Pearson’s r correlations were the effect of interest. Omnibus and family functioning domain-specific random-effects meta-analyses were conducted. Data are depicted in forest plots.

Results: A statistically significant association was found between family functioning and child adjustment (patient/siblings) after cancer diagnosis (r = 0.19; 95% CI: 0.13–0.24). Greater family cohesion, expressiveness, and support and less family conflict were each associated with better child adjustment outcomes. Conclusions Family functioning is associated with patient and sibling adjustment after pediatric cancer diagnosis. Limitations in the existing literature preclude strong conclusions about the size of these effects and potential moderators.

Keywords: adaptation; childhood cancer; family; meta-analysis; systematic review.