The objective of this systematic review is to look at the key determinants of psychological distress in teenagers and young adults (TYAs) affected by cancer. Sources to be searched are MEDLINE, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, EMBASE and PsycARTICLES. Any quantitative studies that assess the association among different factors (including individual and contextual types of factors commonly explored in the available literature in the subject area) with psychological distress will be included e.g. cross-sectional and longitudinal studies. Participants will be teenagers and young adults (TYA) a) aged 13-24 years at cancer diagnosis (in line with Teenage Cancer Trust’s definition b) at any stage of cancer, c) diagnosed with anxiety, depression, or/and PTSD or reported depressive/anxiety/PTSD symptomatology (on a validated self-report or clinician measure)

Bak-Klimek, Anna

Campbell, Karen

Lee, Siew Hwa

MacLean, Rory

McInally, Wendy

Spencer, Emily

English

Open Access Institutional Repository at Robert Gordon University

BAK-KLIMEK, A., SPENCER, E., LEE, S., CAMPBELL, K., MCINALLY, W. and MACLEAN, R. 2022. Determinants of psychological distress in teenagers and young adults (TYAs) affected by cancer: a systematic review and meta-analysis. [Protocol]. PROSPERO [online], Item number CRD42022322069. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022322069      This document was downloaded from https://openair.rgu.ac.uk Determinants of psychological distress in teenagers and young adults (TYAs) affected by cancer: a systematic review and meta-analysis. [Protocol] BAK-KLIMEK, A., SPENCER, E., LEE, S., CAMPBELL, K., MCINALLY, W. and MACLEAN, R. 2022 PROSPEROInternational prospective register of systematic reviews Determinants of psychological distress in teenagers and young adults (TYAs) affected by cancer: asystematic review and meta-analysis CitationAnna Bak-Klimek, Emily Spencer, Siew Lee, Karen Campbell, Wendy McInally, Rory MacLean. Determinants ofpsychological distress in teenagers and young adults (TYAs) affected by cancer: a systematic review and meta-analysis.PROSPERO 2022 CRD42022322069 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022322069 Review question  [1 change]What are the key determinants of psychological distress in teenagers and young adults (TYAs) affected by cancer? Searches  [1 change]Sources to be searched: MEDLINE, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, EMBASE andPsycARTICLES.Data range: any date.Language: English.Grey literature to be included: no.Additional search strategy information can be found in the attached PDF document (link provided below). Types of study to be included  [1 change]Inclusion:  Primary research will be included. Any quantitative studies that assess the association among different factors (including individual and contextual types offactors commonly explored in the available literature in the subject area) with psychological distress will be included e.g.cross-sectional and longitudinal studies.Exclusion:We will exclude qualitative studies, mixed methods, commentary papers, discussion papers and systematic reviews. Anystudies that will not assess the association among different factors with psychological distress will be excluded.Studies that focus solely on examining the prevalence of psychological distress will be excluded. Condition or domain being studied                               Page: 1 / 6PROSPEROInternational prospective register of systematic reviewsPsychological distress in teenagers and young adults (TYAs) affected by cancer. Participants/population  [1 change]Inclusion: teenagers and young adults (TYA) a) aged 13-24 years at cancer diagnosis (in line with Teenage Cancer Trust’sdefinition b) at any stage of cancer, c) diagnosed with anxiety, depression, or/and PTSD or reporteddepressive/anxiety/PTSD symptomatology (on a validated self-report or clinician measure).Exclusion: children below 13 years and adults over 24 years. Intervention(s), exposure(s)  [1 change]Teenagers and young adults (TYA) at any stage of cancer will be included e.g. (diagnosis/pre-treatment, duringtreatment, post-treatment/discharge, end of life, survivorship (patients in remission from cancer beyond five years afterdiagnosis) Comparator(s)/controlGiven the focus of this review included studies do not require a comparator. Context  [1 change]Studies have to investigate at least one possible determinant of psychological distress to be included in the systematicreview. Main outcome(s)  [1 change]Anxiety, depression, post-traumatic stress disorder (PTSD).Measures of effectWe will use Pearson's correlation coefficient r as the effect-size index for this study. For studies that presented data asmeans and standard deviations, or inferential statistics, such as t, F, or p-values, results will be converted to Pearson'scorrelation coefficient r using the ES calculator provided by Wilson (2001). For the effect size of a longitudinal study atseveral different time points, we will choose the effect size of the time point with the largest sample size. If a studyreports a separate coefficient r for independent samples (different patient groups) a combined weighted correlation willbe calculated. We will use Cohen's guidelines to interpret the effect size, where r of at least 0.10 = small, 0.30 = medium,and 0.50 = large (Cohen, 1992).  Additional outcome(s)None.Measures of effectNot applicable. Data extraction (selection and coding)  [1 change]Two review authors (ABK and ES) will independently review the titles and abstracts of all studies and disagreements will                               Page: 2 / 6PROSPEROInternational prospective register of systematic reviewsbe solved by discussion.Using a standardized data extraction form, two review authors (ABK and ES) will independently extract data fromeligible studies including: Study characteristics e.g. authors names, date of publication, location, study design, samplesize; Participant characteristics: age at participation, gender, ethnic group, employment/school status, relationship/maritalstatus; Outcome Measures (e.g. anxiety, depression, PTSD), The determinant studied; Theoretical Framework used tostudy distress; Main results (including a) whether the association was significant and if so, the direction of theassociation. b) effect size Risk of bias (quality) assessmentTwo authors will independently assess the risk of bias. The quality of included studies will be assessed with the Newcastle-Ottawa Scale (NOS) checklist. Disagreements between review authors about risk of bias in particular studies will be resolved by discussion, withinvolvement of a third review author where necessary. Strategy for data synthesis  [1 change]SynthesisWe will provide a narrative synthesis of the findings from the included studies, structured around the populationcharacteristics, predictors of psychological distress, type of outcome (e.g. anxiety, depression, PTSD) and theoreticalframeworks used to inform the study on psychological distressThe Biopsychosocial Model and the literature on cancer will inform the data synthesis on predictors. The determinants ofpsychological distress will be categorized into: individual factors (including demographics, psychological factors e.g.personality traits, coping skills; clinical/treatment-related factors: e.g. cancer stage and type, physical condition (e.g. pain,fatigue, nausea) AND social/environmental factors (including family environment, social networks, parent-childcommunication etc).Only those individual and social/environmental determinants that were investigated by three or more studies will beincluded in the review as fewer than three is considered as insufficient evidence for narrative synthesis, as recommendedby previous systematic reviews.We will consider conducting a meta-analysis. A meta-analysis will be conducted for each predictor (e.g. social support)where at least two independent studies reported a measure of effect size. When appropriate, we will use the shifting unitof analysis approach (Cooper, 2010) e.g. the effect sizes of support from different sources (e.g., parent, peer, andteacher) will be combined into an effect size of social support.  Random-effect models will be used in the study, assuming significant heterogeneity in all of the studies. A χ² test will be performed to determine the probability that the obtained effect sizes are not heterogeneous.Publication bias will be examined by visual inspection of funnel plots. Analysis of subgroups or subsets  [1 change]                               Page: 3 / 6PROSPEROInternational prospective register of systematic reviewsWe are expecting significant heterogeneity in all of the studies in terms of the following sample and study characteristicse.g. study design, outcome measures, country of study, sample size, stage of cancer treatment.We are considering subgroup and meta-regression analyses to investigate whether effect sizes for factors are moderatedby different characteristics e.g. study design (cross sectional vs. longitudinal); outcome measure (e.g. validated self-report or clinician measure); Stage of Treatment (e.g. diagnosis/pre-treatment, during treatment, post-treatment/discharge, end of life, survivorship); sample size. Contact details for further informationDr Anna Bak-KlimekA.Bak-Klimek@napier.ac.uk Organisational affiliation of the reviewEdinburgh Napier University Review team members and their organisational affiliations  [1 change]Dr Anna Bak-Klimek. Edinburgh Napier UniversityMiss Emily Spencer. Edinburgh Napier UniversityDr Siew Lee. Robert Gordon UniversityAssistant/Associate Professor Karen Campbell. Edinburgh Napier UniversityDr Wendy McInally. Open UniversityDr Rory MacLean. Type and method of reviewEpidemiologic, Meta-analysis, Narrative synthesis, Systematic review Anticipated or actual start date  [1 change]05 May 2022 Anticipated completion date  [1 change]30 June 2023 Funding sources/sponsorsEdinburgh Napier UniversityGrant number(s)State the funder, grant or award number and the date of awardEdinburgh Napier University, 10/12/21                                Page: 4 / 6PROSPEROInternational prospective register of systematic reviewsConflicts of interest LanguageEnglish CountryScotland Stage of reviewReview Ongoing Subject index terms statusSubject indexing assigned by CRD Subject index termsAdolescent; Adolescent Health; Anxiety; Anxiety Disorders; Depression; Humans; Mental Disorders; Mental Health;Neoplasms; Psychological Distress; Public Health; Risk Factors; Stress Disorders, Post-Traumatic; Young Adult Date of registration in PROSPERO09 May 2022 Date of first submission06 April 2022 Stage of review at time of this submission  [2 changes] Stage Started CompletedPreliminary searches No YesPiloting of the study selection process No YesFormal screening of search results against eligibility criteria No YesData extraction No YesRisk of bias (quality) assessment No YesData analysis Yes No Revision noteQuality Assessment has been completedSystematic Review Analysis has been completed and Meta-Analysis hasstartedAn additional member Dr Rory MacLean has been added. Rory has expertise in statistics and offers guidance on                               Page: 5 / 6PROSPEROInternational prospective register of systematic reviewsconducting a meta-analysisThe record owner confirms that the information they have supplied for this submission is accurate and complete and theyunderstand that deliberate provision of inaccurate information or omission of data may be construed as scientificmisconduct.The record owner confirms that they will update the status of the review when it is completed and will add publicationdetails in due course. Versions09 May 202222 August 202229 January 2023Powered by TCPDF (www.tcpdf.org)                               Page: 6 / 6

Determinants of psychological distress in teenagers and young adults affected by cancer: a systematic review and meta-analysis. [Protocol]

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Determinants of psychological distress in teenagers and young adults affected by cancer: a systematic review and meta-analysis. [Protocol]

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