title: Health literacy variables related to parents' understanding of their child's cancer prognosis.
abstract: BACKGROUND
  Obtaining an accurate understanding of a child's cancer prognosis can help parents make informed decisions about treatment. Research has shown that parents tend to overestimate their child's cancer prognosis relative to physicians. Thus, we examined whether the content of physician communication, parent sources of medical information, and parent demographic factors affected the association between oncologist and parent estimates of a child's cancer prognosis.
  
  
  METHODS
  Families were recruited 3-8 weeks after a child's new diagnosis or relapse of cancer. Parents (77 mothers; 42 fathers) completed questionnaires regarding their sources of medical information, age, and education. The child's oncologist reported on the content of their communication with parents regarding prognosis. Parents and oncologists estimated the child's chance of 5-year survival using a visual-analogue scale.
  
  
  RESULTS
  Mothers and fathers reported a more favorable prognosis for their child, which was on average about 30% higher than oncologists. Time since diagnosis was correlated with less discrepancy between physician and mother prognosis ratings, with a similar trend noted for fathers. Agreement between oncologists and parents was better for younger fathers, but it was unrelated to physician communication, sources of medical information, or other demographic factors.
  
  
  CONCLUSIONS
  Fathers' age may be important to their understanding of their child's cancer prognosis, but we did not find support for other factors related to prognosis literacy. Given the homogeneity of our sample, future research should assess differences in parents' prognosis knowledge across cancer diagnosis, race, ethnicity, and socioeconomic status (SES), which may aid in developing interventions to improve parent understanding.
authors.affiliation: Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio 43205-2696, USA.
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Miller
authors.forename: Kathryn
authors.initials: K
authors.lastname: Vannatta
authors.forename: Michael
authors.initials: M
authors.lastname: Vasey
authors.forename: Nicholas
authors.initials: N
authors.lastname: Yeager
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Compas
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Gerhardt
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000523:psychology / Q000628:therapy; D010290:Parents / Q000523:psychology*; D010353:Patient Education as Topic; D011379:Prognosis; D012959:Socioeconomic Factors; D013997:Time Factors