Attitude of health-care providers toward childhood leukemia patients with different socio-economic status.
BACKGROUND
Treatment results differ significantly between poor and prosperous children with leukemia in Indonesia. The objective of this study was to determine whether parental socio-economic status influences beliefs, attitude, and behavior of health-care providers (hcp) treating childhood leukemia in Indonesia.


METHODS
A self-administered semi-structured questionnaire was filled in by 102 hcp (69 doctors, 28 nurses, 2 psychologists, 2 hematology technicians, 1 administrator).


RESULTS
Most hcp (98%) asked parents about their financial situation. The decision to start treatment was influenced by parental socio-economic status (86%), motivation of parents (80%), and motivation of doctors (76%). Health-care providers stated that prosperous patients comply better with treatment (64%), doctors comply better with treatment for the prosperous (53%), most patients cannot afford to complete treatment (58%), less extensive explanations are given toward poor families (60%), and communication is impeded by differences in status (67%). When dealing with prosperous families a minority of hcp stated that they pay more attention (27%), work with greater accuracy (24%), take more interest (23%), and devote more time per visit (22%). Most hcp denied differences in the quality of medical care (93%) and the chances of cure (58%) between poor and prosperous patients.


CONCLUSIONS
Beliefs, attitude, and behavior of hcp toward poor versus prosperous patients appeared to differ. These differences may contribute to the immense drop-out rate and slight chances of survival among poor patients with leukemia in developing countries.
Pediatric Hematology Oncology Division, Department of Pediatrics, Vrije University Medical Center, Vrije University, Amsterdam, The Netherlands. s.mostert@vumc.nl
Saskia
S
Mostert
Mei N
MN
Sitaresmi
Chad M
CM
Gundy
Anjo J P
AJ
Veerman
D001291:Attitude of Health Personnel; D002648:Child; D003430:Cross-Sectional Studies; D003469:Culture; D004522:Educational Status; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D009726:Nurses / Q000523:psychology; D011203:Poverty; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires