title: Parents' experiences of their children's presence in discussions with physicians about Leukemia.
abstract: OBJECTIVE
  We aimed to examine parents' views regarding their preadolescent child's presence during discussions about serious illnesses.
  
  
  METHODS
  In-depth qualitative interviews with parents of children receiving treatment for acute lymphoblastic leukemia were conducted. Parents were sampled from 6 UK treatment centers. Analysis was informed by the constant comparative method and content analysis.
  
  
  RESULTS
  We report on interviews with 53 parents (33 mothers, 20 fathers). Parents acknowledged the benefits of communicating openly with children, but few thought that their child's presence in discussions was straightforwardly desirable. They described how their child's presence restricted their own communication with physicians, made concentrating difficult, and interfered with their efforts to care for their child emotionally. Children's presence was particularly difficult when significant issues were being discussed, including prognoses, adverse results, and certain medical procedures. Parents felt that such discussions posed a potential threat to their child, particularly when they had not first had an opportunity to discuss information with the physician separately from the child. In contrast, separate meetings enabled parents to absorb information and to convey it to their child at an appropriate time and in a reassuring way. Some parents experienced difficulties in accessing separate meetings with physicians.
  
  
  CONCLUSIONS
  The difficulties parents described could potentially be addressed by extending, beyond the diagnosis period, the practice of sequencing significant information so that it is communicated to parents in separate meetings before being communicated to the child and by periodically exploring with parents what information would be in each child's interests.
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool L69 3GB, United Kingdom. byoung@liv.ac.uk
authors.forename: Bridget
authors.initials: B
authors.lastname: Young
authors.forename: Joanne
authors.initials: J
authors.lastname: Ward
authors.forename: Peter
authors.initials: P
authors.lastname: Salmon
authors.forename: Katja
authors.initials: K
authors.lastname: Gravenhorst
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hill
authors.forename: Tim
authors.initials: T
authors.lastname: Eden
mesh_terms: D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003142:Communication; D004644:Emotions; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology; D010817:Physician-Patient Relations; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D011786:Quality Control; D018570:Risk Assessment; D014342:Truth Disclosure; D006113:United Kingdom