A child and parent illustrating non-compliance with treatment: understanding non-compliance with treatment

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Daniel Oppenheim1, Olivier Hartmann, Arthur Ablin

  • 1Dept. of Pediatrics, and Unit of Psycho-Oncology, Institut Gustave-Roussy, 94805 Villejuif, France.

Bulletin Du Cancer
|July 24, 2002
PubMed

Insights

Treatment non-compliance in pediatric cancer patients is often due to parental ambivalence, not just the child. Psychotherapeutic interventions addressing family dynamics can improve treatment adherence and outcomes.

Area of Science:

  • Pediatric Oncology
  • Child Psychology
  • Family Therapy

Background:

  • Treatment non-compliance is a significant challenge in pediatric and adolescent healthcare.
  • Understanding the complex factors contributing to non-compliance is crucial for effective treatment.

Observation:

  • A 10-year-old boy with medulloblastoma refused high-dose chemotherapy and Autologous Bone Marrow Transplantation.
  • Psychotherapeutic interviews involving the child, parents, and medical staff were conducted to address the non-compliance.

Findings:

  • The child's non-compliance reflected his parents' underlying ambivalence and anxieties, despite initial informed consent.
  • Parental fears, including the mother's conviction of the child's impending death, influenced their engagement with the treatment plan.
  • Therapeutic discussions facilitated parental acceptance and role assumption, enabling the child to perceive their support for the treatment.

Implications:

  • Pediatric treatment non-compliance arises from multifaceted interactions between the child, parents, and healthcare team, influenced by past and present experiences.
  • Parental ambivalence, particularly when a child's life is at risk, can impair understanding and acceptance of therapy.
  • Building trust and establishing clear therapeutic goals among the child, parents, and staff are essential to prevent and manage non-compliance, mitigating clinical, legal, and ethical concerns.
Abstract

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