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[Parents' opinions of pediatric oncology day hospitals]
D Oppenheim1, M C Le Deley, F Pein
1Département de pédiatrie et unité de psychiatrie et psycho-oncologie, institut Gustave-Roussy, Villejuif, France.
Insights
Parents overwhelmingly prefer pediatric oncology day hospitals (DH) over conventional hospitalization (CH) for improved quality of life and reduced anxiety. However, DH organization must address social, psychological, and logistical factors for optimal pediatric cancer care.
Area of Science:
- Pediatric Oncology
- Healthcare Management
- Patient-Centered Care
Context:
- Pediatric oncology day hospitals (DH) offer an alternative to conventional hospitalization (CH).
- Parental perspectives are crucial for optimizing DH services.
- Understanding parental preferences informs healthcare delivery models.
Purpose:
- To evaluate parental opinions on the advantages and disadvantages of pediatric oncology day hospitals (DH) compared to conventional hospitalization (CH).
- To identify areas for improving DH structure to meet children's needs and parental expectations.
- To assess the DH as a viable alternative to CH in pediatric cancer care.
Summary:
- A survey of 39 parents revealed a strong preference for DH (69%) over CH (15%).
- Parents perceived DH as reducing illness severity perception, anxiety, and facilitating normal family life.
- CH offered more comprehensive information, disease monitoring, and social support among parents.
Impact:
- DHs are appreciated for maintaining family life quality and reducing treatment constraints.
- Successful DH implementation requires consideration of social, economic, psychological, and logistical factors.
- Optimized DH organization is essential to meet patient and parent expectations and ensure adequate care.
Aim:
The aim of this study was to assess parental opinions on the advantages and disadvantages of a pediatric oncology day hospital (DH) so that the structure can be better adapted to the children's needs and parents' expectations, and provide a potentially valid alternative to conventional hospitalization (CH).
Methods:
Over a 15-days period, 39 parents of children treated at a DH were approached and asked to fill in a questionnaire on their opinion of the advantages and disadvantages of a DH compared to a CH.
Results:
The results of this survey were significant. The majority of parents preferred the DH to the CH (69% versus 15%). The illness was perceived as being less severe; and as the child was not continually in the CH context, he/she was able to forget the illness and the hospital to some extent, and was therefore not as anxious. The DH appeared to be better adapted to the child's needs and facilitated the pursuit of normal family life and everyday activities, but imposed constraints on social and professional activities. On the other hand, the CH provided a reassuring treatment context including more comprehensive information, and in particular a better integration of the child and careful monitoring of the disease within the oncology department, and closer relations between the different parents visiting the hospital. In spite of the high preference rate for the DH, in some instances certain disadvantages could outweigh the advantages, e.g., fatigue due to journeys to and from the hospital, or living too far away from the DH; a lack of punctuality, which meant that the parents were unable to plan their day with any certainty; insufficient comfort (noise, a limited number of rooms available); inadequate information; a lack of privacy; and the anxiety connected with having to assume too much responsibility.
Conclusion:
Overall, it was concluded that the parents appeared to appreciate the aims of the DH (i.e., limiting the treatment constraints imposed on the patient and on the parents themselves, thereby maintaining the quality of family life, assuring adequate treatment, reducing cost of treatment). However, the authors consider that the DH has to be organized in such a way that it takes into account the following: the social aspects, i.e., living conditions, parents' social, economic and professional status; parents' and children's psychological traits, expectations; and access to a local care system. The DH should also have sufficient means and staff at its disposal. Without taking these factors into consideration, the DH and other alternatives to the CH will not be able to adequately care for the patients, or meet the parents' expectations, and may even have a negative effect on the family.