Attitude of health-care providers toward childhood leukemia patients with different socio-economic status.

BACKGROUND

Treatment results differ significantly between poor and prosperous children with leukemia in Indonesia. The objective of this study was to determine whether parental socio-economic status influences beliefs, attitude, and behavior of health-care providers (hcp) treating childhood leukemia in Indonesia.

PROCEDURE

A self-administered semi-structured questionnaire was filled in by 102 hcp (69 doctors, 28 nurses, 2 psychologists, 2 hematology technicians, 1 administrator).

RESULTS

Most hcp (98%) asked parents about their financial situation. The decision to start treatment was influenced by parental socio-economic status (86%), motivation of parents (80%), and motivation of doctors (76%). Health-care providers stated that prosperous patients comply better with treatment (64%), doctors comply better with treatment for the prosperous (53%), most patients cannot afford to complete treatment (58%), less extensive explanations are given toward poor families (60%), and communication is impeded by differences in status (67%). When dealing with prosperous families a minority of hcp stated that they pay more attention (27%), work with greater accuracy (24%), take more interest (23%), and devote more time per visit (22%). Most hcp denied differences in the quality of medical care (93%) and the chances of cure (58%) between poor and prosperous patients.

CONCLUSIONS

Beliefs, attitude, and behavior of hcp toward poor versus prosperous patients appeared to differ. These differences may contribute to the immense drop-out rate and slight chances of survival among poor patients with leukemia in developing countries.