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.
Mostert
Saskia
S
Pediatric Hematology Oncology Division, Department of Pediatrics, Vrije University Medical Center, Vrije University, Amsterdam, The Netherlands. s.mostert@vumc.nl
Sitaresmi
Mei N
MN
Gundy
Chad M
CM
Veerman
Anjo J P
AJ
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