An international feasibility study of parental decision making in pediatric oncology.
OBJECTIVE
To describe parental decision making about treatment options for children with cancer and determine the feasibility of a similar but larger international study.


METHODS
Exploratory.


METHODS
A pediatric catastrophic illness research hospital in the United States and children's hospitals in Australia and Hong Kong.


METHODS
A convenience sample of 43 parents (5 fathers and 38 mothers ages 23-59 years).


METHODS
Six open-ended interview questions posed to parents during private individual interviews. Content analysis techniques were used.


METHODS
Parental perceptions of (a) factors considered in the decision-making process, (b) behaviors of healthcare professionals that affected the process, and (c) satisfaction with the process. Feasibility of a larger study was estimated by considering ease of access to parents, number of refusals to participate, understanding of the interview questions, and level of interest at each setting.


RESULTS
Access to parents was possible at all sites. Refusal to participate was reported only at the U.S. site. Certain factors (e.g., getting information from the healthcare team, trusting staff) were important to all parents considering end-of-life decisions. Site-specific factors included considering alternative therapies (at the Australian site) and strengthening faith (at the U.S. site).


CONCLUSIONS
A larger international study of parental decision making is feasible. Sufficient similarities in parental decision making exist across these sites to justify future efforts to identify universal decision-making factors that, in conjunction with site-specific differences, could be helpful in developing guidelines for healthcare professionals who assist parents in making treatment-related decisions for a sick child.
Hinds
P S
PS
Divison of Patient Care Services, St. Jude Children's Research Hospital, Memphis, TN, USA. pam.hinds@stjude.org
Oakes
L
L
Quargnenti
A
A
Furman
W
W
Bowman
L
L
Gilger
E
E
Gattuso
J
J
Martinson
I
I
Yi
K H
KH
Drew
D
D
D000293:Adolescent; D000328:Adult; D001315:Australia; D002648:Child; D003431:Cross-Cultural Comparison; D003657:Decision Making; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006723:Hong Kong; D006801:Humans; D008020:Life Support Care; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D009859:Oncology Nursing; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D016414:Resuscitation Orders; D015144:Southeastern United States; D013727:Terminal Care / Q000523:psychology*