Communicating with child patients in pediatric oncology consultations: a vignette study on child patients', parents', and survivors' communication preferences

被引:62
作者
Zwaanswijk, Marieke [1 ]
Tates, Kiek [1 ,2 ]
van Dulmen, Sandra [1 ]
Hoogerbrugge, Peter M. [3 ]
Kamps, Willem A. [4 ]
Beishuizen, A. [5 ]
Bensing, Jozien M. [1 ,6 ]
机构
[1] NIVEL, Netherlands Inst Hlth Serv Res, NL-3500 BN Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Patient Safety Ctr, Utrecht, Netherlands
[3] Radboud Univ Nijmegen Med Ctr, Dept Pediat Hematooncol, Nijmegen, Netherlands
[4] Univ Groningen, Dept Pediat Oncol, Beatrix Childrens Hosp, Univ Med Ctr Groningen, NL-9700 AB Groningen, Netherlands
[5] Erasmus Univ, Med Ctr, Sophia Childrens Hosp, Dept Pediat Oncol Hematol, Rotterdam, Netherlands
[6] Univ Utrecht, Fac Social Sci, Dept Clin & Hlth Psychol, NL-3508 TC Utrecht, Netherlands
关键词
childhood cancer; pediatric oncology; communication; preferences; vignettes; SIOP WORKING COMMITTEE; OF-THE-LITERATURE; DECISION-MAKING; HEALTH-CARE; PSYCHOSOCIAL ISSUES; CHRONIC ILLNESS; INFORMATION; CANCER; INVOLVEMENT; DIAGNOSIS;
D O I
10.1002/pon.1721
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: To investigate the preferences of children with cancer, their parents, and survivors of childhood cancer regarding medical communication with child patients and variables associated with these preferences. Methods: Preferences regarding health-care provider empathy in consultations, and children's involvement in information exchange and medical decision making were investigated by means of vignettes. Vignettes are brief descriptions of hypothetical situations, in which important factors are systematically varied following an experimental design. In total, 1440 vignettes were evaluated by 34 children with cancer (aged 8-16), 59 parents, and 51 survivors (aged 8-16 at diagnosis, currently aged 10-30). Recruitment of participants took place in three Dutch university-based pediatric oncology centers. Data were analyzed by multilevel analyses. Results: Patients, parents, and survivors indicated the importance of health-care providers' empathy in 81% of the described situations. In most situations (70%), the three respondent groups preferred information about illness and treatment to be given to patients and parents simultaneously. Preferences regarding the amount of information provided to patients varied. The preference whether or not to shield patients from information was mainly associated with patients' age and emotionality. In most situations (71%), the three respondent groups preferred children to participate in medical decision making. This preference was mainly associated with patients' age. Conclusions: To be able to adapt communication to parents' and patients' preferences, health-care providers should repeatedly assess the preferences of both groups. Future studies should investigate how health-care providers balance their communication between the sometimes conflicting preferences of patients and parents. Copyright (C) 2010 John Wiley & Sons, Ltd.
引用
收藏
页码:269 / 277
页数:9
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