title: Role of communication for pediatric cancer patients and their family.
abstract: BACKGROUND
  Communication is a key component in medical practice. The area of pediatric palliative care is emotionally distressing for families and healthcare providers. Inadequate communication can increase the stress and lead to mistrust or miscommunication.
  
  
  METHODS
  Reviewing the literature on communication between physicians, patients, and their family; we identified several barriers to communication such as paternalism in medicine, inadequate training in communication skills, knowledge of the grieving process, special issues related to care of children, and cultural barriers. In order to fill the gap in area of cultural communication, a study questionnaire was administered to consecutive families of children receiving chemotherapy at a large, north Indian referral hospital to elicit parental views on communication.
  
  
  RESULTS
  Most parents had a protective attitude and favored collusion; however, appreciated truthfulness in prognostication and counseling by physicians; though parents expressed dissatisfaction on timing and lack of prior information by counseling team.
  
  
  CONCLUSIONS
  Training programs in communication skills should teach doctors how to elicit patients' preferences for information. Systematic training programs with feedback can decrease physicians stress and burnout. More research for understanding a culturally appropriate communication framework is needed.
authors.affiliation: Regional Cancer Centre, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, India.
authors.forename: Rajesh Kumar
authors.initials: RK
authors.lastname: Singh
authors.affiliation: Regional Cancer Centre, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, India.
authors.forename: Aditya
authors.initials: A
authors.lastname: Raj
authors.affiliation: Regional Cancer Centre, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, India.
authors.forename: Sujata
authors.initials: S
authors.lastname: Paschal
authors.affiliation: Regional Cancer Centre, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, India.
authors.forename: Shahab
authors.initials: S
authors.lastname: Hussain
keywords: Communication; Counseling; Cultural; Palliative care; Pediatric oncology; Stress