What parents expect from pediatric oncologic communication

Pediatric cancer is a tough experience for both child and parent. There are many questions and concerns that either may have and how clinicians communicate or facilitate that communication can mean a world of difference in how that care is perceived. A report in Pediatrics examines how oncology communications from a clinician functions from the perspective of the parent.¹

Researchers ran semistructured interviews. They performed these interviews with 78 parents of children who had cancer and were being treated at 3 academic medical centers. The parents were interviewed at 1 of 3 possible time points during the child’s cancer course: treatment, survivorship, or bereavement. The researchers then analyzed the transcripts from the interviews.

They found 8 distinct functions for communication in the sphere of pediatric oncology. Six of the functions were found to be similar to findings seen with adult oncology patients:

• Response to emotions
• Management of uncertainty
• Decision making
• Supporting family self-management
• Trading information
• Forming and maintaining relationships

They also found 2 functions that hadn’t been seen with adult oncology patients: offering validation and supporting hope. Clinicians who supported the hope had shown that they intended to cure the child’s cancer, did not give the parent false hope, making sure that parent and child looked at what was positive, and working with parent and child to have hope that extended beyond only survival. Validation included substantiating concerns, making parents partners and advocates in their child’s care, and continually confirming “good parenting” beliefs. All 8 of the functions did interact, but building relationships with parents and the child seemed to be the foundational function.

The investigators concluded that their interviews gave evidence for 8 discrete functions for communication in the field of pediatric oncology. They believe that the information found in their study could help providers better fulfill the communications needs of parents of children who have been diagnosed with a serious and potentially life-limiting illness. They said that further work in the field should examine whether teams are performing these function as well as creating and utilizing intervention that target these functions.

Reference

1. Sisk B, Friedrich A, Blazin L, Baker J, Mack J, DuBois J. Communication in pediatric oncology: a qualitative study. Pediatrics. August 20, 2020. Epub ahead of print. doi:10.1542/peds.2020-1193