Parents Report Challenging Relationships With Pediatric Oncology Clinicians

Nearly a quarter of parents said they have a challenging relationship with their child’s pediatric oncology doctor, according to research findings published in JAMA Network Open.

Researchers surveyed parents of children with cancer and oncology clinicians (attending physicians, fellows, and nurse practitioners) at 2 institutions.

Of the 338 evaluated relationships, 9.8% were considered challenging by both the parent and clinician, 24.0% as challenging by the parent, and 37.6% as challenging by the clinician.

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In a multivariate analysis, adjusted for parental gender, there was no significant difference in challenging relationship reports between black and white parents or Hispanic and non-Hispanic parents.

However, parents were more likely to report a challenging relationship if they were Asian or another non-black and white race (odds ratio [OR], 3.62; 95% CI, 1.59-8.26).

Parents were also more likely to report challenging relationships if they had high school or lower education (OR 3.03; 95% CI 1.56-5.90), had anxiety (OR 2.14; 95% CI 1.27-3 .61), said mixed messages were common (OR, 4.42; 95% CI, 2.21-8.83), and reported less patient-centricity during transitions (OR, 5.84; 95% CI, 2.21 -15.38).

The researchers noted that no parent or child characteristics were associated with challenges reported by clinicians. However, clinicians who had been in practice for 10-19 years reported more challenging relationships than those who had been in practice for a shorter period of time (OR 2.65; 95% CI 1.30-5.43).

To manage challenging relationships, clinicians used strategies such as regular family gatherings, giving extra time and attention, and asking another clinician for advice. However, these strategies were most often used for relationships that were considered challenging by the physician and not for relationships that were considered challenging by the parent.

“These findings suggest that new strategies are needed to improve experiences for parents and to help clinicians recognize and treat parents whose experiences are suboptimal,” the researchers wrote.

Reference

Mack JW, Juang T, Uno H, Brakett J. Parental and clinician perspectives on challenging parent-clinic relationships in pediatric oncology. JAMA Netw Open. Published online Nov 17, 2021. doi:10.1001/jamanetworkopen.2021.32138

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