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Parents' Challenges and Physicians' Tasks in Disclosing Cancer to Children. A Qualitative Interview Study and Reflections on Professional Duties in Pediatric Oncology

Badarau, Domnita O. and Wangmo, Tenzin and Ruhe, Katharina M. and Miron, Ingrid and Colita, Anca and Dragomir, Monica and Schildmann, Jan and Elger, Bernice S.. (2015) Parents' Challenges and Physicians' Tasks in Disclosing Cancer to Children. A Qualitative Interview Study and Reflections on Professional Duties in Pediatric Oncology. Pediatric Blood and Cancer, 62 (12). pp. 2177-2182.

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Official URL: http://edoc.unibas.ch/41717/

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Abstract

Professional guidelines encourage physicians to provide children with as much information regarding their health as deemed developmentally and emotionally appropriate. However, empirical research indicates that in clinical practice, an open discussion with children about cancer is often lacking. This study explores impeding factors to and possible strategies for open communication of cancer diagnosis to children from the perspectives of parents and physicians.; Semi-structured interviews were conducted with 18 parents of children with cancer and 10 treating oncologists. The patient sample was obtained from three pediatric units in Romania. Interviews were transcribed verbatim and interpreted using thematic analysis. Inductive open-coding procedures identified participants' accounts regarding their experiences with cancer diagnosis and treatment. Final themes were selected by grouping codes that formed a pattern in the data.; An interplay of mainly three different factors-information overload and emotional turmoil, lack of knowledge and skills for disclosing the diagnosis, and assumptions about burdening the child when discussing cancer-restricted parent-patient communication and subsequently affected physician-patient exchanges. Oncologists recommended open communication at diagnosis, but left the final decision to the parents. They adapted their communication style with patients to parents' preference.; Although physicians need to respect the wishes of children's legal representatives, they also have a duty to promote patients' best interests. We recommend that physicians employ a proactive stance in ensuring that children with cancer are appropriately informed about their diagnosis. In case of parents' arduous objections to full disclosure, an ethical consultation should be considered. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc.
Faculties and Departments:08 Cross-disciplinary Subjects > Ethik > Institut für Bio- und Medizinethik > Bio- und Medizinethik (Elger)
03 Faculty of Medicine > Departement Public Health > Ethik in der Medizin > Bio- und Medizinethik (Elger)
UniBasel Contributors:Elger, Bernice Simone and Wangmo, Tenzin and Ruhe, Katharina and Badarau, Domnita
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Wiley
ISSN:1545-5009
e-ISSN:1545-5017
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:03 Oct 2017 13:29
Deposited On:03 Oct 2017 13:29

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