Care experiences that foster trust between parents and physicians of children with cancer

被引:24
|
作者
Mack, Jennifer W. [1 ,2 ]
Kang, Tammy, I [3 ,4 ]
机构
[1] Dana Farber Canc Inst, Dept Pediat Oncol, Div Populat Sci, 450 Brookline Ave, Boston, MA 02215 USA
[2] Boston Childrens Hosp, Div Pediat Hematol Oncol, Boston, MA USA
[3] Texas Childrens Hosp, Sect Pediat Palliat Care, Houston, TX 77030 USA
[4] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA
关键词
communication; patient-centered care; pediatric cancer; relationship; trust; PATIENT; PROGNOSIS; RACE;
D O I
10.1002/pbc.28399
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Trust is a core aspect of the patient-physician relationship, especially in cancer care. We sought to examine parents' experiences with trust over the first year after a child's cancer diagnosis. Procedure We conducted a prospective, questionnaire-based longitudinal cohort study of parents and physicians of children with cancer at two academic pediatric hospitals. We evaluated trust among 166 parents of children with cancer over the first year after diagnosis. Surveys were administered after diagnosis, at 4 months, and at 12 months after diagnosis. Results Seventy-one percent of parents trusted the child's oncologist "completely" at baseline, as did 79% at 4 months and 77% at 12 months. At baseline, high-quality physician communication (OR 4.11 [1.78-9.51],P = .001) and information (OR 2.82 [1.29-6.16],P = .01) were associated with trust, after adjustment for parent gender, race/ethnicity, and education. Parents were less likely to trust the physician completely at 12 months if the child had experienced cancer relapse or progression (OR 0.28 [0.10-0.81],P = .02). In a mixed linear model adjusted for parent gender, race/ethnicity, education, and clustering by physician, trust was associated with high-quality communication (OR 3.40 [1.61-7.20],P = .001) and receipt of high-quality information (OR 2.48 [1.18-5.21],P = .02), and inversely associated with relapse or progression (OR 0.39 [0.17-0.92],P = 0.03); trust increased over time (P < .0001). Conclusions Most parents form trusting relationships with their children's oncologists. Physicians can foster trust through patient-centered communication and provision of high-quality information about a child's cancer. Poor outcomes such as relapse are a threat to trust.
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页数:6
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