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Through Their Eyes: Parental Perceptions on Hospital Admissions for Febrile Neutropenia in Children With Cancer
Katrina J Anderson1, Natalie K Bradford1, Julia E Clark1
11 Oncology Services Group, Lady Cilento Children's Hospital, South Brisbane, QLD, Australia.
Insights
Parents of children undergoing cancer treatment face significant challenges when managing fever with neutropenia (a low white blood cell count). Their experiences highlight the need for better communication and support within healthcare settings to improve care for pediatric oncology patients.
Area of Science:
- Pediatric Oncology
- Hematology
- Qualitative Health Research
Background:
- Febrile neutropenia is a common oncologic emergency in children, necessitating rapid assessment and antibiotic treatment.
- Parental vigilance and timely hospital presentation are crucial for optimal outcomes, yet delays in care are frequent.
- Understanding the parental experience is vital for improving clinical management of febrile neutropenia in pediatric cancer patients.
Purpose of the Study:
- To explore and describe the lived experiences of parents whose children were treated for febrile neutropenia during cancer therapy.
- To identify key factors influencing parental perceptions and engagement in their child's care for fever with neutropenia.
Main Methods:
- A descriptive phenomenological approach was employed.
- Semi-structured interviews were conducted with nine parents of children with cancer who experienced febrile neutropenia.
- Interviews focused on recent hospitalization experiences related to fever and neutropenia management in Queensland, Australia.
Main Results:
- Three emergent themes characterized parental experiences: feeling heard, confidence in healthcare professionals, and managing distress and uncertainty.
- Parental advocacy was central across all themes, influencing their experience.
- Familiarity with healthcare providers enhanced parental confidence and improved their overall experience; unexpected admissions significantly impacted parents negatively.
Conclusions:
- Parental experiences with febrile neutropenia are complex, influenced by communication, trust in providers, and the emotional burden of uncertainty.
- Enhancing healthcare professional-parent relationships and communication can improve the management of febrile neutropenia.
- Addressing parental needs for support and clear communication is essential for optimizing care and outcomes in pediatric oncology.
Abstract:
Febrile neutropenia requires prompt assessment and antibiotic administration and is the most common reason for unexpected hospital admission in pediatric oncology. Parents are expected to be vigilant and "drop everything" to take their child to their nearest hospital for assessment if fever occurs. Delays in antibiotic administration are associated with poorer outcomes; however, delays are common. Our aim was to understand and describe the lived experience of parents of children with cancer who received treatment for fever with confirmed/suspected neutropenia. We used descriptive phenomenological concepts to undertake and analyze interviews with parents, who were asked to describe their recent experience of hospitalization in Queensland, Australia. Nine participants were interviewed. Five children were treated in the tertiary treating center and four were treated in smaller regional towns. Three main categories were identified that shaped and characterized parents' experiences: being heard, confidence in capabilities of health care professionals, and living with anticipated distress and uncertainty. Parents' experiences were related to the level they needed to advocate for their child's care across all themes. Familiarity with health care professionals increased confidence and improved parents' experiences. Maintaining vigilance and managing the child and family's response to an unexpected admission had a substantial negative effect on parents. Understanding parents' experiences and perceptions of the management of febrile neutropenia adds to the current body of knowledge and offers potential new insights to improve clinical practice.
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