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

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.