Parents' Challenges and Physicians' Tasks in Disclosing Cancer to Children. A Qualitative Interview Study and Reflections on Professional Duties in Pediatric Oncology
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID
3401781
Author(s)
Badarau, Domnita O.; Wangmo, Tenzin; Ruhe, Katharina M.; Miron, Ingrid; Colita, Anca; Dragomir, Monica; Schildmann, Jan; Elger, Bernice S.
Author(s) at UniBasel
Elger, Bernice Simone Wangmo, Tenzin Ruhe, Katharina Badarau, Domnita
Year
2015
Title
Parents' Challenges and Physicians' Tasks in Disclosing Cancer to Children. A Qualitative Interview Study and Reflections on Professional Duties in Pediatric Oncology
Journal
Pediatric Blood and Cancer
Volume
62
Number
12
Pages / Article-Number
2177-82
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.
Publisher
Wiley
ISSN/ISBN
1545-5009 ; 1545-5017
edoc-URL
http://edoc.unibas.ch/41717/
Full Text on edoc
No
Digital Object Identifier DOI
10.1002/pbc.25680
PubMed ID
http://www.ncbi.nlm.nih.gov/pubmed/26207515
ISI-Number
WOS:000365412600021
Document type (ISI)
Journal Article, Multicenter Study
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