Skip to main content

Prognostic Communication Between Oncologists and Parents of Children With Advanced Cancer.

Publication ,  Journal Article
Kaye, EC; Stall, M; Woods, C; Velrajan, S; Gattas, M; Lemmon, M; Baker, JN; Mack, JW
Published in: Pediatrics
June 2021

BACKGROUND AND OBJECTIVES: Parents of children with cancer perceive deficits in quality of prognostic communication. How oncologists disclose information about disease progression and incurability and how prognostic communication impacts parental understanding of prognosis are poorly understood. In this study, we aimed to (1) characterize communication strategies used by pediatric oncologists to share prognostic information across a child's advancing illness course and (2) explore relationships between different communication approaches and concordance of oncologist-parent prognostic understanding. METHODS: In this prospective, longitudinal, mixed-methods study, serial disease reevaluation conversations were audio recorded across an advancing illness course for children with cancer and their families. Surveys and interviews also were conducted with oncologists and caregivers at specific time points targeting disease progression. RESULTS: Seventeen children experienced advancing illness on study, resulting in 141 recordings (40 hours). Fewer than 4% of recorded dialogue constituted prognostic communication, with most codes (77%) occurring during discussions about frank disease progression. Most recordings at study entry contained little or no prognosis communication dialogue, and oncologists rated curability lower than parents across all dyads. Parent-oncologist discordance typically was preceded by conversations without incurability statements; ultimately, concordance was achieved in most cases after the oncologist made direct statements about incurability. Content analysis revealed 3 distinct patterns (absent, deferred, and seed planting) describing the provision of prognostic communication across an advancing pediatric cancer course. CONCLUSIONS: When oncologists provided direct statements about incurability, prognostic understanding appeared to improve. Further research is needed to determine optimal timing for prognostic disclosure in alignment with patient and family preferences.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

June 2021

Volume

147

Issue

6

Location

United States

Related Subject Headings

  • Young Adult
  • Truth Disclosure
  • Prospective Studies
  • Prognosis
  • Professional-Family Relations
  • Pediatrics
  • Pediatrics
  • Parents
  • Neoplasms
  • Neoplasm Staging
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kaye, E. C., Stall, M., Woods, C., Velrajan, S., Gattas, M., Lemmon, M., … Mack, J. W. (2021). Prognostic Communication Between Oncologists and Parents of Children With Advanced Cancer. Pediatrics, 147(6). https://doi.org/10.1542/peds.2020-044503
Kaye, Erica C., Melanie Stall, Cameka Woods, Srilakshmi Velrajan, Melanie Gattas, Monica Lemmon, Justin N. Baker, and Jennifer W. Mack. “Prognostic Communication Between Oncologists and Parents of Children With Advanced Cancer.Pediatrics 147, no. 6 (June 2021). https://doi.org/10.1542/peds.2020-044503.
Kaye EC, Stall M, Woods C, Velrajan S, Gattas M, Lemmon M, et al. Prognostic Communication Between Oncologists and Parents of Children With Advanced Cancer. Pediatrics. 2021 Jun;147(6).
Kaye, Erica C., et al. “Prognostic Communication Between Oncologists and Parents of Children With Advanced Cancer.Pediatrics, vol. 147, no. 6, June 2021. Pubmed, doi:10.1542/peds.2020-044503.
Kaye EC, Stall M, Woods C, Velrajan S, Gattas M, Lemmon M, Baker JN, Mack JW. Prognostic Communication Between Oncologists and Parents of Children With Advanced Cancer. Pediatrics. 2021 Jun;147(6).

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

June 2021

Volume

147

Issue

6

Location

United States

Related Subject Headings

  • Young Adult
  • Truth Disclosure
  • Prospective Studies
  • Prognosis
  • Professional-Family Relations
  • Pediatrics
  • Pediatrics
  • Parents
  • Neoplasms
  • Neoplasm Staging