Publication
The 3 "c's" in the physician-parent alliance in pediatric oncology
Laronne A, Granek L, Golan H, Bubis P · Psycho-Oncology · 2020
Background/Purpose: Pediatric oncologists face challenges when treating children with cancer. These include the emotional challenges of caring for very sick children and the challenges associated with communicating difficult news (ie, prognosis, test results, etc.) to children who are close to end of life and/or at risk of death. These factors can contribute to treatment decisions and to the ability to provide palliative care. Method(s): This study is part of a larger project aimed at gaining an indepth understanding of the barriers and facilitators to early integration of palliative care for children. The sample included 22 pediatric oncologists from six cancer centers across Israel. The data were analyzed using the Grounded Theory method. Line-by-line coding was used to establish categories and themes. Result(s): Three main themes arose from the analysis that we have termed the three "C's". They include: "co-optimism", "collaboration", and "communication". (a) "co-optimism" is defined as the mutual desire of oncologists and parents to maintain hope for a cure. (b) Collaboration refers to "parent-centered care" and focusing on parent's emotional needs while making treatment decisions for their children at end of life. (c) Communication refers to the oncologist's (and parents') difficulties in communicating with children about end of life. Conclusions and Implications: Our findings suggest that the physician-parent alliance, combined with a lack of direct communication with the child about end of life (or avoiding all together communication about end of life), may have implications that interfere with patient-centered care. Training pediatric oncologists to navigate in the complexity of the triad relationship (patient, healthcare clinician, caregiver), increasing their awareness of psychological mechanisms, such as identification/transference towards the parents, and training in communication skills, with children of all ages, specifically about end of life, is critical for enhancing care. Future research is needed to explore these findings on a larger scale and to promote healthcare provider training that will promote children's and parent's quality of life.
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.