An international feasibility study of parental decision making in pediatric oncology

To describe parental decision making about treatment options for children with cancer and determine the feasibility of a similar but larger international study.

Exploratory.

A pediatric catastrophic illness research hospital in the United States and children's hospitals in Australia and Hong Kong.

A convenience sample of 43 parents (5 fathers and 38 mothers ages 23-59 years).

Six open-ended interview questions posed to parents during private individual interviews. Content analysis techniques were used.

Parental perceptions of (a) factors considered in the decision-making process, (b) behaviors of healthcare professionals that affected the process, and (c) satisfaction with the process. Feasibility of a larger study was estimated by considering ease of access to parents, number of refusals to participate, understanding of the interview questions, and level of interest at each setting.

Access to parents was possible at all sites. Refusal to participate was reported only at the U.S. site. Certain factors (e.g., getting information from the healthcare team, trusting staff) were important to all parents considering end-of-life decisions. Site-specific factors included considering alternative therapies (at the Australian site) and strengthening faith (at the U.S. site).

A larger international study of parental decision making is feasible. Sufficient similarities in parental decision making exist across these sites to justify future efforts to identify universal decision-making factors that, in conjunction with site-specific differences, could be helpful in developing guidelines for healthcare professionals who assist parents in making treatment-related decisions for a sick child.