Analysis of diagnosis announcements in Abidjan pediatric oncology unit 2 years after introduction of the African Pediatric Cancer Announcement Guideline

Couitchere, Line; Coze, Carole; Cissé, Lassana; André, Nicolas; Nigué, L.; Aholi, J.-M.

doi:10.1016/j.arcped.2019.06.006

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…Individual‐level factors were identified in 100 studies, related to individual characteristics of the clinician, parents, or patients, or characteristics of the clinician–patient–family interaction. Clinician characteristics and behaviors that were examined as potential influences on communication included: complexity of language and terminology, 33–38 pacing of information, 39–43 demonstrations of competence, 42,44–48 level of comfort or training related to sensitive topics, 4,42,49–62 perceived importance of certain topics, 51,61–68 concerns about harms of discussing certain topics, 69–72 exploration of family's values and taking them seriously, 38,40,41,73–77 and demonstrations of empathy and caring 7,38,39,78,79 . Some studies identified a tension between a desire to show empathy and a need to create appropriate emotional distance to allow for effective communication and decision‐making 57,64,70,80,81 …”

Section: Resultsmentioning

confidence: 99%

“…Several studies also identified characteristics of the clinician–family interaction that might facilitate or impede communication: impact of culture and cultural differences between clinicians and families, 33,50–52,67,108,111 presence of additional people during sensitive conversations, 41,52 hierarchy or power differential between clinicians and parents, 35,43,75,112,113 and contentious relationships and confrontational advocacy 96,103 . One study described clinicians feeling split loyalties to parents and children 40 …”

Section: Resultsmentioning

confidence: 99%

“…In non‐US studies, social hierarchy potentially contributed to families of lower social status receiving less attention from doctors and having lower understanding of medical information 108,112,121–123 . Additionally, families with lower financial/economic status seemed to receive less information and guidance from clinicians 33,63,123 and demonstrated poorer understanding of medical information 115–117 …”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Multilevel barriers and facilitators of communication in pediatric oncology: A systematic review

Sisk

Harvey

Friedrich

et al. 2021

Pediatric Blood & Cancer

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Multiple factors can facilitate or impede the fulfillment of communication functions in pediatric cancer. In this systematic review, we evaluated 109 studies from the preceding 20 years that presented qualitative or quantitative evidence of barriers or facilitators to communication in pediatric cancer. Using a multilevel framework developed in our prior study, we then analyzed and categorized the levels of barriers and facilitators identified in included studies. The vast majority of studies focused on individual‐level barriers, rather than team, organization/system, collaborating hospital, community, or policy‐level barriers. Future studies should explore the full range of factors that affect communication.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Multilevel barriers and facilitators of communication in pediatric oncology: A systematic review

Sisk

Harvey

Friedrich

et al. 2021

Pediatric Blood & Cancer

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“…These studies are difficult to generalize to EM because they reflect longitudinal relationships between providers and families, less encumbered by the time and acuity constraints characteristic of EM. [12][13][14][15][16][17][18][19][20][21][22] This study attempts to address this gap by exploring parents' experiences receiving life-altering news about their children while seeking care in emergency departments (EDs).…”

mentioning

confidence: 99%

“…The literature investigating parental perspectives from other pediatric settings has been primarily focused on inpatient and outpatient oncology. These studies are difficult to generalize to EM because they reflect longitudinal relationships between providers and families, less encumbered by the time and acuity constraints characteristic of EM 12–22 …”

mentioning

confidence: 99%

Parental Perspectives on Life-Altering News in Emergency Settings

et al. 2023

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IntroductionDelivering life-altering news is a difficult task that is frequently the responsibility of emergency physicians. However, the existing frameworks for guiding such interactions fail to address the physician-parent-patient dynamic of pediatric emergency encounters. To date, no study has investigated the parental perspective, limiting the ability to provide evidence-based recommendations. This study describes how parents experience receiving life-altering news about their child in emergency settings.MethodsThis qualitative study used virtual asynchronous focus groups. Through purposeful sampling of virtual support and advocacy groups, we recruited parents of children diagnosed with either malignancy or type 1 diabetes in an emergency department. Participants were then assigned to private Facebook groups established solely for this study. Questions were posted to these groups over the course of 5 days. At their convenience, participants could post responses, replies, or new questions. Three members of the research team performed thematic analysis and used team consensus to ensure validity.ResultsFour focus groups were conducted with a total of 28 participants. Parents described their experiences receiving life-altering news as a process with 4 primary emergent themes: lens through which they view the experience, the ED encounter, the immediate response, and the long-term impact. Each parent entered into the ED encounter with a unique collection of personal experiences, circumstances, and knowledge. These factors shaped the lens through which they perceived the events of the ED encounter. Ultimately, this determined participants' response to the life-altering news, leading to many long-term impacts on the various dynamics within each parent's life.ConclusionsThe words used to disclose life-altering news are only a small piece of the experience for parents. Personal lenses changed how encounters were perceived, resulting in variable and long-lasting implications. We recommend the following framework for providers: understand the lens, control encounters, manage responses, and respect long-term impacts.

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Parent–provider communication dynamics during the pediatric oncology diagnostic process in Guatemala: A qualitative study

Williams,

Welcome,

Rivas

et al. 2024

Pediatric Blood & Cancer

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BackgroundEffective communication is founded on bidirectional participation from families and healthcare providers. In adult medicine, bidirectional communication promotes treatment adherence and builds the family–provider relationship. However, the relationship between communication styles in pediatrics remains poorly understood, particularly in culturally diverse settings. This study aims to investigate parent–provider communication dynamics and parental involvement during diagnostic cancer communication in Guatemala.ProcedureThis qualitative study included 20 families of children with cancer and 10 providers at Unidad Nacional de Oncología Pediátrica in Guatemala. Psychoeducation and diagnostic conversations between parents, psychologists, and oncologists were recorded and thematically analyzed using a priori and novel codes exploring communication behaviors, parental engagement, and interpersonal dynamics.ResultsParticipating parents had children with various diagnoses. Only 15% of fathers and 5% of mothers reported education beyond primary school. Providers spoke 68% of words during psychoeducation and 85% of words during diagnosis conversations. Providers used supportive communication behaviors providing explanations, demonstrating verbal attentiveness, and soliciting questions and non‐supportive behaviors including paternalistic talk. Parental participation was considered active when they asked questions, expressed hopes or concerns, or asserted their opinions, and non‐active when participation was limited to brief responses to closed‐ended questions. Supportive provider communication often encouraged active participation; non‐supportive communication did not. Furthermore, active parental participation prompted supportive communication from providers, while non‐active participation did not.ConclusionsOur findings highlight the bidirectional nature of effective communication, establishing that provider communication styles both influence and are influenced by parental participation, and emphasizing the importance of supportive provider communication for patient‐centered care.

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Analysis of diagnosis announcements in Abidjan pediatric oncology unit 2 years after introduction of the African Pediatric Cancer Announcement Guideline

Cited by 4 publications

References 22 publications

Multilevel barriers and facilitators of communication in pediatric oncology: A systematic review

Multilevel barriers and facilitators of communication in pediatric oncology: A systematic review

Parental Perspectives on Life-Altering News in Emergency Settings

Parent–provider communication dynamics during the pediatric oncology diagnostic process in Guatemala: A qualitative study

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