title: Managing communication with young people who have a potentially life threatening chronic illness: qualitative study of patients and parents.
abstract: OBJECTIVE
  To examine young people's and parents' accounts of communication about cancer in childhood.
  
  
  METHODS
  Semistructured interviews analysed using the constant comparative method.
  
  
  METHODS
  Paediatric oncology unit.
  
  
  METHODS
  13 families, comprising 19 parents (13 mothers, six fathers) and 13 patients aged 8-17 years, recruited from one paediatric oncology unit. The patients had cancer or brain tumour.
  
  
  RESULTS
  Most parents described acting in an executive-like capacity, managing what and how their children were told about their illness, particularly at the time of diagnosis. Their accounts were shaped by concerns to manage their identity as strong and optimistic parents and to protect their child's wellbeing. The patients identified elements of their parents' role that both facilitated and constrained their communication, and while they welcomed their parents' involvement, some expressed unease with the constraining aspects of their parents' role. Some young people described feeling marginalised in consultations and pointed to difficulties they experienced in encounters with some doctors.
  
  
  CONCLUSIONS
  There are difficulties in managing communication with young people who have a chronic, life threatening illness. Health professionals need to be aware of how the social positioning of young people (relative to adults) and the executive role of parents can contribute to the marginalisation of young people and hamper the development of successful relationships between themselves and young patients.
authors.affiliation: Department of Psychology, University of Hull, Hull HU6 7RX. B.Young@hull.ac.uk
authors.forename: Bridget
authors.initials: B
authors.lastname: Young
authors.forename: Mary
authors.initials: M
authors.lastname: Dixon-Woods
authors.forename: Kate C
authors.initials: KC
authors.lastname: Windridge
authors.forename: David
authors.initials: D
authors.lastname: Heney
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D003142:Communication; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010817:Physician-Patient Relations; D011368:Professional-Family Relations