Physician's role in home care for children with cancer

We interviewed 29 physicians who had participated to varying degrees in a home care program for children dying of cancer. All physicians stated that they would use home care again and saw such care as an integral part of their practice. Most physicians felt that home care provides psychological advantages to the family; they viewed assessment of the family's needs by the home care nurses an important factor of home care treatment. Some physicians expressed concern of the nurse's assuming too much responsibility or failing to report significant changes observed in the patient, particularly observations of the side effects of medication. Divergent philosophies of physicians and nurses regarding side effects were seen by some physicians as a potential source of confusion and anxiety for families. The legal ramifications of home care were discussed by only a few physicians; the consensus of opinion among the physicians was that close contact among physician, family, and nurse would assure the absence of legal problems.