Communication and information sharing with pediatric patients including refugees with advanced cancer, their caregivers, and health care professionals in Jordan: a qualitative study

Frontiers in Oncology

Oncology

Ghadeer Alarjeh¹  Sawsan Alajarmeh¹  Waleed Alrjoub¹  Omar Shamieh²  Richard Harding³  Sabah Boufkhed⁴  Ping Guo⁵  Mousa Abdal-Rahman⁶  Tezer Kutluk⁷  Sema Yurduşen⁸  Fahad Ahmed⁹  Anwar Alnassan^1,10  Shireen Al-Awady^1,10 

[1] Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan;Department of Palliative care, King Hussein Cancer Center (KHCC), Amman, Jordan;Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan;Department of Palliative care, King Hussein Cancer Center (KHCC), Amman, Jordan;College of Medicine, the University of Jordan, Amman, Jordan;Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom;Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom;Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, United Kingdom;Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom;School of Nursing and Midwifery, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom;Department of Palliative care, King Hussein Cancer Center (KHCC), Amman, Jordan;Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye;Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye;Department of Psychology, Ankara Science University, Ankara, Türkiye;Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye;Department of Public Health, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Türkiye;Department of Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan;

关键词: pediatric;    palliative care;    cancer;    refugees;    communication;    information sharing;   

DOI  :  10.3389/fonc.2023.1118992

 received in 2022-12-08, accepted in 2023-04-11,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionEffective communication in pediatric palliative cancer care is an important aspect of practice to enhance patient- and family-centered care, and to optimize decision-making. However, little is known about communication preferences practices from the perspectives of children, caregivers and their health care professionals (HCPs) in the Middle Eastern region. Furthermore, involving children in research is crucial but limited. This study aimed to describe the communication and information-sharing preferences and practices of children with advanced cancer, their caregivers, and health care professionals in Jordan.MethodsA qualitative cross-sectional study was conducted using semi-structured face to face interviews with three groups of stakeholders (children, caregivers and HCPs). Purposive sampling recruited a diverse sample from inpatient and outpatient settings at a tertiary cancer center in Jordan. Procedures were in line with the Consolidated criteria for reporting qualitative research (COREQ) reporting guidelines. Verbatim transcripts were thematically analyzed.FindingsFifty-two stakeholders participated: 43 Jordanian and 9 refugees (25 children, 15 caregivers and 12 HCPs). Four major themes emerged: 1) Hiding information between the three stakeholders which includes parents who hide the information from their sick children and ask the HCPs to do so to protect the child from distressful emotions and children who hide their suffering from their parents to protect them from being sad; 2) Communication and sharing of clinical versus non-clinical information; 3) Preferred communication styles such as use of a companionate approach by acknowledging patients and caregivers’ suffering, building a trustful relationship, proactive information sharing, considering child age and medical status, parents as facilitators in communication, and patients’ and caregivers’ health literacy; 4) Communication and information sharing with refugees where they had dialect issues, which hindered effective communication. Some refugees had unrealistically high expectations regarding their child’s care and prognosis, which posed challenges to communication with staff.DiscussionThe novel findings of this study should inform better child-centered practices and better engage them in their care decisions. This study has demonstrated children’s ability to engage in primary research and to express preferences, and parents’ ability to share views on this sensitive topic.

【 授权许可】

Unknown   
Copyright © 2023 Alarjeh, Boufkhed, Alrjoub, Guo, Yurduşen, Ahmed, Abdal-Rahman, Alajarmeh, Alnassan, Al-Awady, Kutluk, Harding and Shamieh