Inclusion of children in the initial conversation about their cancer diagnosis: impact on parent experiences of the communication process
Inclusion of children in the initial conversation about their cancer diagnosis: impact on parent experiences of the communication process
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DOI：
10.1007/s00520-019-4653-3
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发表时间：
2019-04-01
影响因子：
3.1
通讯作者：
Mack, Jennifer W.
中科院分区：
文献类型：
--
作者：
McCarthy, Sarah R. Brand;Kang, Tammy I.;Mack, Jennifer W.
将儿童纳入医疗对话被认为是癌症儿童的护理标准。然而，以前的定性研究提出了关注如何儿童的存在影响父母的沟通经验。目前的研究探讨的频率和影响，在一个严重的医疗对话的父母的沟通经验，在pediatric oncology. MethodsThirty-sixty父母新诊断为癌症的儿童完成了问卷调查，评估儿童的存在，在最初的谈话与肿瘤学家的诊断和治疗，父母的沟通经验。小学肿瘤学家完成了一项调查问题的孩子的pregnancy.Results61%的儿童出现在最初的谈话，3-6岁（44%）和7-12岁（44%）的儿童中的最低利率。儿童的存在与父母的报告，他们收到的预后信息（p=0.20），高质量的信息（p=0.19），或高质量的沟通有关的儿童的癌症（p=1.0）。DiscussionThe父母的沟通经验是不减少的选择，包括儿童。考虑到尽可能让儿童参与有关严重疾病的对话是生物伦理学的必要性，这种关切不应被用来排除儿童，而是在需要时给父母更多的时间来充分处理决定。
IntroductionIncluding children in medical conversations is considered the standard of care for children with cancer. However, previous qualitative research has raised concerns about how the child's presence impacts the parent's communication experience. The current study examines the frequency and impact of child presence during a serious medical conversation on the parent's communication experience in pediatric oncology.MethodsThree hundred sixty parents of children newly diagnosed with cancer completed questionnaires assessing the child's presence during the initial conversation with the oncologist about diagnosis and treatment and parental communication experiences. Primary oncologists completed a survey question about the child's prognosis.ResultsSixty-one percent of children were present during the initial conversation, with lowest rates among children aged 3-6 (44%) and 7-12 (44%). Child presence was not associated with parents' reports that they received prognostic information (p=0.20), high-quality information (p=0.19), or high-quality communication about the child's cancer (p=1.0).DiscussionThe parent's communication experience is not diminished by the choice to include the child. Given the bioethical imperative to include children in conversations about serious illness whenever possible, this concern should not be used to exclude children, but rather to give parents additional time of their own when needed to fully process decisions.