Inclusion of children with cancer in conversations with oncologists at the time of their diagnosis is not detrimental to parents’ ability to effectively communicate in this setting, according to a study published in Supportive Care in Cancer.
Previous research has shown that early involvement of children and adolescents with cancer in medical conversations, now considered the standard-of-care, is associated with decreased stress, improved coping skills, and an increased likelihood of developing a trusting relationship with their physician. Nevertheless, there is conflicting evidence regarding the impact of the child’s presence at these meetings on his or her parents. Specifically, this study addressed whether parents are hindered in communicating with the physician and obtaining high-quality information, including information related to prognosis, when the child is present.
The survey-based study was conducted at Dana-Farber Cancer Institute/Boston Children Hospital in Boston and the Children’s Hospital of Philadelphia in Philadelphia from November 2008 to April 2014. Of the 565 parents of children with newly diagnosed cancer deemed eligible for study participation, which included a cancer diagnosis within the previous 1 to 6 weeks, 360 completed the survey; only one parent per family was eligible. In addition, 95 physicians completed matched surveys in order to provide an assessment of the child’s prognosis. The majority of parents surveyed were female, white, and English-speaking, although the survey was also available in Spanish.
The child was reported by the parent to be present in 61% of initial discussions with the oncologist. The likelihood of the child’s presence at the initial consultation with the oncologist was found to be dependent on patient age, with infants and adolescents more likely to be present than children ages 3 to 12 years. However, the parents did not associate the child’s presence with prognostic disclosure, receipt of high-quality information, or receipt of high-quality communication.
“While this study focused on the child’s presence during the initial conversation about a cancer diagnosis, the findings are likely generalizable to other significant medical conversations such as at the time of relapse or transition to palliative care,” the authors concluded.
Brand McCarthy SR, Kang TI, Mack JW. Inclusion of children in the initial conversation about their cancer diagnosis: impact on parent experiences of the communication process [published online January 23, 2019]. Support Care Cancer. doi: 10.1007/s00520-019-4653-3