Article Text

Parental terminal cancer and dependent children: a systematic review
  1. Alexandra Wray1,
  2. Julie Seymour2,
  3. Sarah Greenley3 and
  4. Jason W Boland4,5
  1. 1Wolfson Palliative Care Research Centre, Hull York Medical School, Univeristy of Hull, Hull, UK
  2. 2Institiute of Clinical Applied Health Research, Hull York Medical School, Univeristy of Hull, Hull, UK
  3. 3Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
  4. 4Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
  5. 5Palliative Medicine, Care Plus Group and St Andrew’s Hospice, NE Lincolnshire, UK
  1. Correspondence to Alexandra Wray, Wolfson Palliative Care Research Group, Hull York Medical School, Hull, UK; Alexandra.wray{at}


Background When a parent has terminal cancer, their children are part of that experience. Parents often want to protect their children from their disease and prognosis. Knowledge of dependent children’s experience will help ensure they receive appropriate support. To date, there is lack of synthesis of this evidence examining children’s perspectives.

Objectives To systematically search and synthesise the qualitative literature exploring the experiences of dependent children when their parent has terminal cancer.

Methods Databases of MEDLINE, Embase, PsycINFO, CINAHL, Assia and the Cochrane library were searched systematically from inception to July 2020 to determine eligible studies. Included studies were appraised for quality and thematically synthesised using Thomas and Harden’s thematic synthesis framework.

Results Fourteen studies were included, which interviewed children about their experiences (n=654 children aged 4–18 years at the time of parental death), from six countries. Five descriptive themes were identified, further categorised into two broad themes: (1) finding out about parental cancer and its impact on the family and (2) coping with life with parental cancer, death and beyond.

Conclusion Children want to be involved in their parent’s cancer experience and to help support the family. Healthcare professionals are ideally placed to support and encourage parents to include their children. They should reassure parents that children can cope well and that maintaining normality will help, and explain the benefits of honest and open communication and how they can include dependent children from diagnosis and beyond.

  • cancer
  • communication
  • terminal care
  • family management

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. No datasets were generated for this study.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. No datasets were generated for this study.

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  • Contributors AW and SG developed the search strategy for the review and reviewed search output. AW and JS contributed to the quality assessment of papers and data extraction. All authors (AW, JS, SG and JWB) contributed to the thematic synthesis. AW wrote the first draft of the manuscript, which was reviewed, revised and given final approval by all authors. AW is the guarantor of the content.

  • Funding The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: this work was funded by Yorkshire Cancer Research (Award reference number HEND405PhD) awarded to the lead author to undertake this research as part of an academic clinical fellowship, within the TRANSFORMing Cancer Outcomes in Yorkshire programme.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.