title: Tumor Talk and Child Well-Being: Perceptions of "Good" and "Bad" News Among Parents of Children With Advanced Cancer.
abstract: Little is known about how parents of children with advanced cancer classify news they receive about their child's medical condition.
  
  
  
  To develop concepts of "good news" and "bad news" in discussions of advanced childhood cancer from parent perspectives.
  
  
  
  Parents of children with advanced cancer cared for at three children's hospitals were asked to share details of conversations in the preceding three months that contained "good news" or "bad news" related to their child's medical condition. We used mixed methods to evaluate parent responses to both open-ended and fixed-response items.
  
  
  
  Of 104 enrolled parents, 86 (83%) completed the survey. Six (7%) parents reported discussing neither good nor bad news, 18 (21%) reported only bad news, 15 (17%) reported only good news, and 46 (54%) reported both good and bad news (one missing response). Seventy-six parents (88%) answered free-response items. Descriptions of both good and bad news discussions consisted predominantly of "tumor talk" or cancer control. Additional treatment options featured prominently, particularly in discussions of bad news (42%). Child well-being, an important good news theme, encompassed treatment tolerance, symptom reduction, and quality of life.
  
  
  
  A majority of parents of children with advanced cancer report discussing both good and bad news in the preceding three months. Although news related primarily to cancer control, parents also describe good news discussions related to their child's well-being. Understanding how parents of children with advanced cancer classify and describe the news they receive may enhance efforts to promote family-centered communication.
authors.affiliation: Dana-Farber Cancer Institute, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA; Ariadne Labs, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. Electronic address: Angela_Feraco@dfci.harvard.edu.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Feraco
authors.affiliation: Dana-Farber Cancer Institute, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA; Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
authors.forename: Veronica
authors.initials: V
authors.lastname: Dussel
authors.affiliation: Biostatistics Unit, Deakin University, Geelong, Victoria, Australia.
authors.forename: Liliana
authors.initials: L
authors.lastname: Orellana
authors.affiliation: Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, USA; Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Tammy I
authors.initials: TI
authors.lastname: Kang
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA.
authors.forename: J Russell
authors.initials: JR
authors.lastname: Geyer
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA.
authors.forename: Abby R
authors.initials: AR
authors.lastname: Rosenberg
authors.affiliation: Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Feudtner
authors.affiliation: Dana-Farber Cancer Institute, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Wolfe
mesh_terms: D022126:Access to Information / Q000523:psychology*; D000328:Adult; D002648:Child; D000067576:Child Health / Q000145:classification / Q000706:statistics & numerical data; D002669:Child Welfare / Q000523:psychology* / Q000706:statistics & numerical data; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D011788:Quality of Life / Q000523:psychology*; D014342:Truth Disclosure; D055815:Young Adult
keywords: Good news; advanced childhood cancer; bad news; hope; parental perceptions; tumor talk