title: Attitudes toward infection prophylaxis in pediatric oncology: a qualitative approach.
abstract: BACKGROUND
  The risks and benefits of infection prophylaxis are uncertain in children with cancer and thus, preferences should be considered in decision making. The purpose of this report was to describe the attitudes of parents, children and healthcare professionals to infection prophylaxis in pediatric oncology.
  
  
  METHODS
  THE STUDY WAS COMPLETED IN THREE PHASES: 1) An initial qualitative pilot to identify the main attributes influencing the decision to use infection prophylaxis, which were then incorporated into a discrete choice experiment; 2) A think aloud during the discrete choice experiment in which preferences for infection prophylaxis were elicited quantitatively; and 3) In-depth follow up interviews. Interviews were recorded verbatim and analyzed using an iterative, thematic analysis. Final themes were selected using a consensus approach.
  
  
  RESULTS
  A total of 35 parents, 22 children and 28 healthcare professionals participated. All three groups suggested that the most important factor influencing their decision making was the effect of prophylaxis on reducing the chance of death. Themes of importance to the three groups included antimicrobial resistance, side effects of medications, the financial impact of outpatient prophylaxis and the route and schedule of administration.
  
  
  CONCLUSIONS
  Effect of prophylaxis on risk of death was a key factor in decision making. Other identified factors were antimicrobial resistance, side effects of medication, financial impact and administration details. Better understanding of factors driving decision making for infection prophylaxis will help facilitate future implementation of prophylactic regiments.
authors.affiliation: Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Diorio
authors.forename: Deborah
authors.initials: D
authors.lastname: Tomlinson
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Boydell
authors.forename: Dean A
authors.initials: DA
authors.lastname: Regier
authors.forename: Marie-Chantal
authors.initials: MC
authors.lastname: Ethier
authors.forename: Amanda
authors.initials: A
authors.lastname: Alli
authors.forename: Sarah
authors.initials: S
authors.lastname: Alexander
authors.forename: Adam
authors.initials: A
authors.lastname: Gassas
authors.forename: Jonathan
authors.initials: J
authors.lastname: Taylor
authors.forename: Charis
authors.initials: C
authors.lastname: Kellow
authors.forename: Denise
authors.initials: D
authors.lastname: Mills
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000191:economics / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001424:Bacterial Infections / Q000150:complications / Q000191:economics / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D002755:Choice Behavior; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000191:economics / Q000379:methods; D007239:Infections / Q000150:complications; D009181:Mycoses / Q000150:complications / Q000191:economics / Q000517:prevention & control*; D009369:Neoplasms / Q000150:complications*; D010290:Parents
chemical_list: D000890:Anti-Infective Agents