title: Hospital-based home care for children with cancer: feasibility and psychosocial impact on children and their families.
abstract: BACKGROUND
  To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer.
  
  
  METHODS
  A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety, and cost. A controlled trial was conducted to assess children's health-related quality of life (HRQOL) using the parent-reported and self-reported PedsQL generic core scale and PedsQL cancer module, and the psychosocial impact on the family by PedsQL family impact module comprising a subsample of 28 children and 43 parents in the home care group, and 47 children and 66 parents receiving standard hospital care.
  
  
  RESULTS
  All parents in the HBHC program were satisfied and preferred home care. There were no serious adverse events associated with HBHC, and costs did not increase. When adjusting for age, gender, diagnosis and time since diagnosis, we found significant higher HRQOL scores in parent-reported physical health (P = 0.04; 95% confidence interval (CI): -0.2-19.5) and worry (P = 0.04; 95% CI: -0.4-20.6) in the home-care group indicating better physical health and less worry for children in the home-care group. No significant difference was found in the Family Impact Module.
  
  
  CONCLUSIONS
  This study indicates that HBHC is a feasible alternative to hospital care for children with cancer, and is greatly preferred by parents. Specific aspects of children's HRQOL may be improved with HBHC and the psychosocial burden on the family does not increase.
authors: Research Unit Women's and Children's Health, The Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. helena.hansson@rh.regionh.dk
authors: Helena
authors: H
authors: Hansson
authors: Hanne
authors: H
authors: Kjaergaard
authors: Christoffer
authors: C
authors: Johansen
authors: Inger
authors: I
authors: Hallström
authors: Jane
authors: J
authors: Christensen
authors: Marianne
authors: M
authors: Madsen
authors: Kjeld
authors: K
authors: Schmiegelow
mesh_terms: D000293:Adolescent; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005190:Family / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000191:economics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000451:nursing*; D010290:Parents / Q000523:psychology; D011594:Psychometrics; D011788:Quality of Life