• Lei Cheng, Fang Liu, Sheng Feng, Yingwen Wang, Ying Gu, and Qiongfang Kang.
• School of Nursing, Fudan University, Shanghai, China. Electronic address: chengleis@126.com.
• J Pain Symptom Manage. 2019 Jul 1; 58 (1): 157-166.

ContextChildren with cancer endure multiple symptoms during treatment. However, there remains a lack of systematic approaches to capture the whole picture of the symptom experience of children with cancer younger than eight years of age.ObjectiveThe purpose of this study was to conduct an integrative review to explore symptom experience of children with cancer younger than eight years of age.MethodsA literature search of PubMed, CINAHL, Web of Science, PsycINFO, Cochrane databases, and four Chinese databases was performed to identify empirical studies, followed by an evaluation of empirical quality and data extraction and synthesis.ResultsTwelve articles covering 11 symptoms met the inclusion criteria. Children with cancer under the age of eight years experienced multiple intense symptoms, especially pain, worry, and anxiety. PedsQL™ Cancer Module (for age five to seven years) was the most commonly used instruments. There were limited data on these children's symptom quality, timing, and distress. Discordance between a child's age and symptom intensity was noted. Inconsistent concordance existed between children and their proxy symptom reports.ConclusionChildren with cancer younger than eight years of age experience multiple symptoms. There is a need to investigate the full symptom profiles of these young children in consideration of their developmental nuances; to examine the concordance among different symptom reporters; and to conduct more qualitative studies to explore their symptom experience.Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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