# Autonomy in adolescents in palliative care and its biopsychosocial impact: A systematic review

## TL;DR

This review explores ways to support teens in palliative care by promoting their independence through communication, involvement, and emotional support.

## Contribution

The study systematically identifies and evaluates strategies to promote autonomy in adolescents receiving palliative care.

## Key findings

- Effective communication tools like Voicing My Choices and BOOST-pACP help teens participate in care decisions.
- Family-centered approaches such as the FACE model improve communication and support for both teens and families.
- Open communication, psychosocial support, and teen involvement are essential for promoting autonomy in palliative care.

## Abstract

Adolescence is a period of significant physical, psychological, and social changes, which can be intensified by the diagnosis of serious or chronic illnesses. This makes promoting autonomy in palliative care particularly challenging.

The present review aimed to identify factors and strategies that promote the autonomy of adolescents in palliative care.

We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, Web of Science, and Scopus. This systematic review synthesized existing literature and evidence regarding communication, involvement, and psychosocial support strategies in adolescent palliative care.

The study examined various tools and models, including Voicing My Choices, Building Our Solutions Together for Pediatric Advance Care Planning (BOOST-pACP), and the Family-Centered Advance Care Planning (FACE) model, to evaluate their effectiveness in facilitating communication, family support, and decision-making.

Effective communication tools and family-centered approaches are crucial for promoting adolescent autonomy. Strategies focused on open communication, psychosocial support, and active adolescent involvement in decisions can enhance autonomy, although further research is needed to assess their effectiveness.

Implementing communication facilitation, psychosocial support, and adolescent involvement strategies is essential. Despite the need for more evidence, the review offers a set of recommendations to support the autonomy of adolescents in palliative care.

Supporting teen autonomy in palliative care: Key strategies and approaches

Adolescence is a time of big physical and emotional changes, which can be made even more challenging when teens have serious or long-term illnesses. It’s important to help these young people take part in decisions about their care, but this can be difficult. This review looked at ways to support teens’ independence and involvement in their own care. It found that good communication, involving teens in decisions, and providing emotional support are very helpful. Tools like Voicing My Choices and BOOST-pACP make it easier for teens, their families, and healthcare teams to work together. The family-centered FACE model also helps families connect and meet everyone’s needs. Using these strategies can help teens feel more in control and respected. More research is needed to see how well these approaches work, but for now, these strategies are recommended to support adolescents in palliative care.