title: In sickness and in health: classmates are highly motivated to provide in-hospital support during childhood cancer therapy.
abstract: Extended hospitalization for school-aged cancer patients increases their risk of social marginalization. School-aged children mature through peer-interaction, but healthcare providers fail to incorporate this in rehabilitation efforts. The RESPECT study offers classmates to cancer patients to become ambassadors during hospital stays. This study explores classmate decision-making patterns about ambassadorship.
  
  
  
  An open-ended question was prospectively and consecutively provided to classmates (N = 221) (and parents) of 10 children diagnosed with cancer in 2014 and enrolled in the RESPECT study. Statements were analysed using thematic content analysis.
  
  
  
  Of 221 classmates, 140 responded (63%). Of these, 81 applied for ambassadorship (median 8/patient), 58 declined, one was undecided. Nine forms were incomplete; leaving 131 in total that revealed 303 statements for analysis. Five major themes emerged: existing friendship (132/303 statements), personal resources (academic, emotional and social) (107/303), attitudes towards the ambassadorship (34/303), hospital environment (18/303) and logistics (12/303). Of the classmates with pre-existing friendships, 77% applied for ambassadorship and 80% with a surplus of personal resources applied. These were predominant predictors for ambassadorship application. Classmate motives were condensed into four archetypes: pre-existing friendship with a surplus of resources (100% applied), non-friend classmates with a surplus of resources (63% applied), pre-existing friendship with limited resources (22% applied) and non-friend classmates with limited resources (0% applied).
  
  
  
  Classmates are highly motivated to support patients during serious illness, irrespective of pre-existing friendships. Ambassadors offer a novel in-hospital approach to promote rehabilitation in children with severe/chronic diseases. Results need validation in other settings. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark.|Institute of Clinical Medicine, The Faculty of Medicine, University of Copenhagen, Denmark.
authors.forename: Lea H
authors.initials: LH
authors.lastname: Lindgren
authors.affiliation: Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark.|Institute of Clinical Medicine, The Faculty of Medicine, University of Copenhagen, Denmark.|Division of Pediatric Hematology/Oncology, Perlmutter Cancer Center and the Langone Medical Center, New York University, New York, NY, USA.
authors.forename: Kjeld
authors.initials: K
authors.lastname: Schmiegelow
authors.affiliation: Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark.
authors.forename: Anne Sofie
authors.initials: AS
authors.lastname: Helms
authors.affiliation: Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark.
authors.forename: Troels
authors.initials: T
authors.lastname: Thorsteinsson
authors.affiliation: Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark.
authors.forename: Hanne B
authors.initials: HB
authors.lastname: Larsen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D005260:Female; D033062:Friends; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009042:Motivation; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010379:Peer Group; D011446:Prospective Studies; D012574:Schools; D012931:Social Environment; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data