Pediatric cancer communication in Guatemala.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18508-e18508
Author(s):  
Dylan E. Graetz ◽  
Silvia Elena Rivas ◽  
Huiqi Wang ◽  
Yuvanesh Vedaraju ◽  
Meenakshi Devidas ◽  
...  
Keyword(s):  
Decision Making ◽  
Information Exchange ◽  
Cultural Awareness ◽  
The United States ◽  
Cross Sectional Survey ◽  
Children With Cancer ◽  
Cross Sectional ◽  
Middle Income ◽  
Communication Processes ◽  
Healing Relationships

e18508 Background: Effective diagnostic communication is a cornerstone of cancer care. While > 90% of children with cancer live in low- and middle-income countries, little is known about patients’ and families’ communication priorities and experiences. We examined parent priorities for communication and the quality of information-exchange and decision-making during diagnostic communication in Guatemala. Methods: This study was conducted at Unidad Nacional de Oncologia Pediatrica. A cross-sectional survey was verbally administered in Spanish to 100 parents of children with cancer within 8 weeks of diagnosis. The survey included items utilized in pediatric communication studies from high-income countries and novel questions developed specifically for the study population. Results: Guatemalan parents prioritized communication functions including information exchange (99%), fostering healing relationships (98%), decision-making (97%), enabling self-management (96%) and managing uncertainty (94%) over functions such as responding to emotions (66%) and cultural awareness (48%). Almost all Guatemalan parents (96%) wanted as many details as possible about their child’s cancer. However, only 67% reported that they were always given the information they needed without asking for it, and most said they sometimes (56%) or always (18%) had questions they wanted to discuss with the doctor but did not. Half of parents (54%) correctly identified their child’s diagnosis, primary site, extent of disease (localized versus metastatic), length of proposed treatment, and treatment intent (curative versus palliative). Parents of children diagnosed with leukemia were more likely to understand all pieces of information than those whose children had solid tumors (p < 0.001). Most parents (76%) preferred to share in decision-making with oncologists. Two-thirds of parents (65%) held their preferred role in decision-making, with fathers more likely to hold their preferred role than mothers (p = 0.02). Reflecting on decisions they had made, 94% of parents strongly agreed they had made the right decisions. However, 17% of parents endorsed feeling that their choices had caused their children harm. Conclusions: Similar to findings from the United States, parents in Guatemala prioritize many aspects of diagnostic communication, especially information exchange, development of healing relationships, and decision-making. Nonetheless, many parents report challenges in information exchange and decision-making, suggesting a need for interventions to support communication processes.

scholarly journals Communication Priorities and Experiences of Caregivers of Children With Cancer in Guatemala

2021 ◽  
pp. 1529-1536
Author(s):  
Dylan E. Graetz ◽  
Silvia Elena Rivas ◽  
Huiqi Wang ◽  
Yuvanesh Vedaraju ◽  
Ana Lucia Fuentes ◽  
...  
Keyword(s):  
Information Exchange ◽  
Cultural Awareness ◽  
The United States ◽  
Cross Sectional Survey ◽  
Children With Cancer ◽  
Disease Extent ◽  
Cross Sectional ◽  
Middle Income ◽  
Healing Relationships ◽  
Almost All

PURPOSE Although > 90% of children with cancer live in low- and middle-income countries, little is known about communication priorities and experiences of families in these settings. We examined communication priorities and the quality of information exchange for Guatemalan caregivers of children with cancer during diagnostic communication. METHODS A cross-sectional survey including items used in pediatric communication studies from high-income countries and novel questions was verbally administered to 100 caregivers of children with cancer in Guatemala. RESULTS Guatemalan caregivers prioritized communication functions of exchanging information (99%), fostering healing relationships (98%), decision making (97%), enabling self-management (96%), and managing uncertainty (94%) over responding to emotions (66%) and cultural awareness (48%). Almost all caregivers wanted as many details as possible about their child's diagnosis and treatment (96%), likelihood of cure (99%), and late effects (97%). Only 67% were always given the information they needed without asking for it, and most caregivers sometimes (56%) or always (18%) had questions they wanted to discuss but did not. Approximately half of the caregivers (54%) correctly identified their child's diagnosis, primary site, disease extent (localized v metastatic), proposed treatment length, and treatment intent (curative v palliative). Caregivers of children with leukemia were more likely to correctly identify all attributes than those whose children had solid tumors ( P < .001). CONCLUSION Caregivers in Guatemala prioritize many of the same aspects of diagnostic communication as parents in the United States, and experience similar challenges. Shared communication values offer potential for adaptation of communication interventions across settings with varying resources and diverse cultures.

Understanding of Prognosis Among Parents of Children With Cancer: Parental Optimism and the Parent-Physician Interaction

2007 ◽  
Vol 25 (11) ◽  
pp. 1357-1362 ◽  
Author(s):  
Jennifer W. Mack ◽  
E. Francis Cook ◽  
Joanne Wolfe ◽  
Holcombe E. Grier ◽  
Paul D. Cleary ◽  
...  
Keyword(s):  
Decision Making ◽  
Functional Outcome ◽  
Response Rate ◽  
Cross Sectional Survey ◽  
Children With Cancer ◽  
Cross Sectional ◽  
Factors Associated ◽  
Dana Farber Cancer Institute ◽  
Unrealistic Expectations

Purpose Patients often overestimate their chances of surviving cancer. Factors that contribute to accurate understanding of prognosis are not known. We assessed understanding of likelihood of cure and functional outcome among parents of children with cancer and sought to identify factors that place parents at risk for overly optimistic beliefs about prognosis. Patients and Methods We conducted a cross-sectional survey of 194 parents of children with cancer (response rate, 70%) who were treated at the Dana-Farber Cancer Institute and Children's Hospital in Boston, MA, and the children's physicians. Parent and physician expectations for likelihood of cure and functional outcome were compared. In 152 accurate or optimistic parents, we determined factors associated with accurate understanding of likelihood of cure compared with optimism. Results The majority of parents (61%) were more optimistic than physicians about the likelihood of cure. Parents' beliefs about other outcomes of cancer treatment were similar (quality-of-life impairment, P = .70) or more pessimistic (physical impairment, P = .01; intellectual impairment, P = .01) than physicians' beliefs. Parents and physicians were more likely to agree about chances of cure when physicians had confidence in knowledge of prognosis (odds ratio [OR] = 2.55, P = .004) and allowed parents to take their preferred decision-making role (OR = 1.89, P = .019). Conclusion Parents of children with cancer are overly optimistic about chances of cure but not about other outcomes of cancer therapy. Parents tend to be overly optimistic about cure when physicians have little confidence and when the decision-making process does not meet parents' preferences. These findings suggest that physicians are partly responsible for parents' unrealistic expectations about cure.

Parents' Roles in Decision Making for Children With Cancer in the First Year of Cancer Treatment

2011 ◽  
Vol 29 (15) ◽  
pp. 2085-2090 ◽  
Author(s):  
Jennifer W. Mack ◽  
Joanne Wolfe ◽  
E. Francis Cook ◽  
Holcombe E. Grier ◽  
Paul D. Cleary ◽  
...  
Keyword(s):  
Decision Making ◽  
Cancer Treatment ◽  
First Year ◽  
Physician Communication ◽  
Cross Sectional Survey ◽  
High Quality ◽  
Children With Cancer ◽  
Cross Sectional ◽  
Physician Perceptions ◽  
Dana Farber Cancer Institute

Purpose To evaluate the extent to which parents of children with cancer are involved in decision making in the ways they prefer during the first year of treatment. Methods We conducted a cross-sectional survey of 194 parents of children with cancer (response rate, 70%) in their first year of cancer treatment at the Dana-Farber Cancer Institute and Children's Hospital (Boston, MA) and the children's physicians. We measured parents' preferred and actual roles in decision making and physician perceptions of parents' preferred roles. Results Most parents (127 of 192; 66%) wanted to share responsibility for decision making with their children's physician. Although most parents (122 of 192; 64%) reported that they had their preferred role in decision making, those who did not tended to have more passive roles than they wished (47 of 70; 67%; P < .001). Parents were no more likely to hold their ideal roles in decision making when the physician accurately identified the parents' preferred role (odds ratio [OR], 1.04; P = .92). Parents were less likely to hold more passive roles than they wished in decision making when they felt that physician communication (OR, 0.39; P = .04) and information received (OR, 0.45; P = .04) had been of high quality. Parents who held more passive roles than they wished in decision making were less likely to trust their physicians' judgments (OR, 0.46; P = .03). Conclusion Most parents of children in their first year of cancer treatment participate in decision making to the extent that they wish; although, nearly one fourth hold more passive roles than desired. High-quality physician communication is associated with attainment of one's preferred role.

scholarly journals The Devil You Know? Maybe Not: Four Failures to Demonstrate that Scarcity Magnifies Preference for Familiarity

2019 ◽  
Author(s):  
Stephen Antonoplis ◽  
Serena CHEN
Keyword(s):  
United States ◽  
Decision Making ◽  
Recent Work ◽  
Economic Inequality ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Psychological Experience ◽  
The World ◽  
The Devil

As economic inequality increases in the United States and around the world, psychologists have begun to study how the psychological experience of scarcity impacts people's decision making. Recent work in psychology suggests that scarcity—the experience of having insufficient resources to accomplish a goal—makes people more strongly prefer what they already like relative to what they already dislike or like less. That is, scarcity may polarize preferences. One common preference is that for familiarity: the systematic like of more often experienced stimuli, compared to less often experience stimuli. Across four studies—three experiments and one cross-sectional survey (all pre-registered; see https://osf.io/7zyfr/)—we investigated whether scarcity polarizes the preference for familiarity. Despite consistently replicating people's preference for the familiar, we consistently failed to show that scarcity increased the degree to which people preferred the familiar to the unfamiliar. We discuss these results in light of recent failures to replicate famous findings in the scarcity literature.

scholarly journals Adults’ Acceptance of COVID-19 Vaccine for Children in Selected Lower- and Middle-Income Countries

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 11
Author(s):  
Suzanna Awang Bono ◽  
Ching Sin Siau ◽  
Won Sun Chen ◽  
Wah Yun Low ◽  
Edlaine Faria de Moura Villela ◽  
...  
Keyword(s):  
The United States ◽  
Demographic Information ◽  
Cross Sectional Survey ◽  
School Closures ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Negative Effect ◽  
Promotion Strategies ◽  
Vaccines For Children

Since emergency approval of COVID-19 vaccines for children aged between 12 and 15 years old was recently obtained in the United States and Europe, we aimed to assess the willingness to vaccinate children with a COVID-19 vaccine in lower- and middle-income countries (LMICs). Therefore, we launched an online cross-sectional survey in several LMICs. Questions relating to socio-demographic information, knowledge of COVID-19, level of fear/worry of being infected with COVID-19, and willingness to vaccinate children with the COVID-19 vaccine at 50%, 75% and 95% effectiveness levels, were asked. Of the 6571 participants (mean age = 39 ± 14 years), 64.0%, 72.6%, and 92.9% were willing to vaccinate children at 50%, 75%, and 95% effectiveness levels, respectively. Respondents who were undergraduates, who were more worried/fearful about COVID-19, had higher knowledge scores regarding COVID-19, and a higher belief that COVID-19 vaccination is important to protect others, were more willing to accept COVID-19 vaccination of children. COVID-19 vaccination of children will limit the spread of the virus, especially in schools; it may decrease the need for school closures which has a negative effect on child development. Findings from this study are useful for health promotion strategies during COVID-19 vaccination implementation among children in LMICs.

Understanding of prognosis among parents of children with cancer: Parental optimism and the role of the parent-physician interaction

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6033-6033
Author(s):  
J. W. Mack ◽  
E. F. Cook ◽  
J. Wolfe ◽  
H. E. Grier ◽  
P. D. Cleary ◽  
...  
Keyword(s):  
Decision Making ◽  
Emotional Support ◽  
Overall Response Rate ◽  
Cross Sectional Survey ◽  
Children With Cancer ◽  
Cross Sectional ◽  
Physician Perceptions ◽  
Successful Communication ◽  
Dana Farber Cancer Institute

6033 Background: Patients often overestimate their chances of surviving cancer. Factors that contribute to accurate understanding of prognosis among parents of children with cancer are not known. Methods: We conducted a cross-sectional survey of 194 parents of children with cancer (overall response rate 70%), treated at the Dana-Farber Cancer Institute and Children’s Hospital, Boston, Mass, and the children’s physicians. Our main outcome measure was agreement between parent and physician ratings of the child’s likelihood of cure. Results: The majority of parents (61%) were more optimistic about the likelihood of their child’s cure than their child’s physician was. Most parents, however, believed that their opinions about prognosis either matched (70%) or were more pessimistic (26%) than those of their physicians. When physicians were confident in their knowledge of the child’s prognosis, parent and physician perceptions of prognosis were more likely to agree (OR 2.55, P = .004). Parents whose role in decision-making matched their ideal role were more likely to give prognostic estimates that agreed with physician perceptions of prognosis (OR 1.89, P = .019). In contrast, parent confidence in knowledge (OR .07, P < .0001), coping strategies (disengagement, OR .31, P = .007; reliance on emotional support from others, OR .31, P = .029), and use of intuition to understand prognosis (OR .51, P = .012), were associated with overestimation of likelihood of cure. Conclusions: Many parents overestimate their children’s chances of being cured of cancer. Neither physician nor parent attributes alone account for this finding; rather, successful communication about prognosis requires that physicians relate to parents’ individual communication and decision-making needs. No significant financial relationships to disclose.

scholarly journals Global scientific production in the field of knee arthroplasty: A cross-sectional survey of research activities

2017 ◽  
Vol 45 (3) ◽  
pp. 897-903 ◽  
Author(s):  
Lu Wang ◽  
Lingxia Li ◽  
Cai Cheng ◽  
Hua Tian ◽  
Yang Li ◽  
...  
Keyword(s):  
United States ◽  
Knee Arthroplasty ◽  
The United States ◽  
Scientific Production ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Research Activities ◽  
Number Of Publications ◽  
Number Of Citations

Objective To determine the quantity and quality of articles in the field of knee arthroplasty worldwide and elucidate the characteristics of global scientific production. Methods Web of Science was used to identify articles in the field of knee arthroplasty from 2011 to 2015. The total number of papers, number of papers per capita, total number of citations, and mean number of citations were collected. Results In total, 11,590 papers were identified. The number of publications significantly increased from 2011 to 2015. Most originated from North America, East Asia, and West Europe. Most (88.51%) were from high-income countries, 11.48% were from middle-income countries, and only 0.01% were from lower-income countries. The United States had the most articles and total citations. Sweden had the highest mean citations, followed by Denmark and Canada. However, when adjusted by population size, Denmark had the most articles per million population, followed by Switzerland and the Netherlands. Conclusions The number of knee arthroplasty publications has rapidly increased in recent years. The United States is the most prolific, but some European countries are more productive relative to their population.

scholarly journals Exploring the Use of Mobile and Wearable Technology among University Student Athletes in Lebanon: A Cross-Sectional Study

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4472
Author(s):  
Marco Bardus ◽  
Cecile Borgi ◽  
Marwa El-Harakeh ◽  
Tarek Gherbal ◽  
Samer Kharroubi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Student Athletes ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Self Monitoring ◽  
American University ◽  
Fitness Tracker

The markets of commercial wearables and health and fitness apps are constantly growing globally, especially among young adults and athletes, to track physical activity, energy expenditure and health. Despite their wide availability, evidence on use comes predominantly from the United States or Global North, with none targeting college student-athletes in low- and middle-income countries. This study was aimed to explore the use of these technologies among student-athletes at the American University of Beirut (AUB). We conducted a cross-sectional survey of 482 participants (average age 20 years) enrolled in 24 teams during Fall 2018; 230 students successfully completed the web-based survey, and 200 provided valid data. Fifty-three (26.5%) have owned a fitness tracker, mostly for self-monitoring. The most popular were Fitbit, Apple Watch, and Garmin. Similarly, 82 students (40%) used apps, primarily MyFitnessPal, Apple Health, and Samsung Health. Nevertheless, many participants discontinued use due to loss of interest or technical issues (breaking, usability, obsolescence, or lack of engagement). Wearable devices were considered superior to mobile phones alone as physical activity monitors. However, forming regular habits made self-monitoring via technology irrelevant. Further research is needed to better understand what motivates continuous use among student-athletes, who could use trackers to improve athletic performance and overall health.

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