Njuguna F, Mostert S, Seijffert A, Musimbi J, Langat S, van der Burgt R H M, Skiles J, Sitaresmi M N, van de Ven P M, Kaspers G J L
Department of Child Health and Pediatrics, Moi Teaching and Referral Hospital, Eldoret, Kenya,
Support Care Cancer. 2015 May;23(5):1251-9. doi: 10.1007/s00520-014-2475-x. Epub 2014 Oct 17.
Our study explores socioeconomic, treatment-related, and psychological experiences of parents during cancer treatment of their children at an academic hospital in Kenya.
This cross-sectional study used semi-structured questionnaires. Parents whose children came for cancer treatment consecutively between November 2012 and April 2013 were interviewed.
Between 2012 and 2013, 115 oncology patients attended the hospital and 75 families (response rate 65 %) were interviewed. Cancer treatment resulted in financial difficulties (89 %). More information about cancer and treatment was required (88 %). More contact with doctors was needed (83 %). At diagnosis, cancer was perceived as curable (63 %). However, parents were told by health-care providers that most children with cancer die (49 %). Parents had difficulties with understanding doctors' vocabulary (48 %). Common reasons to miss hospital appointments were travel costs (52 %) and hospital costs (28 %). Parents (95 %) used complementary alternative treatment (CAM) for their children. Health-care providers told parents not to use CAM (49 %). Parents had not discussed their CAM use with doctors (71 %). Community members isolated families because their child had cancer (25 %), believed that child was bewitched (57 %), advised to use CAM (61 %), and stopped conventional treatment (45 %). Some families (15 %) never disclosed the child's illness to community members. Parents shared experiences with other parents at the ward (97 %) and would otherwise not understand the disease and its treatment (87 %).
Parents suffer financial hardships and are dissatisfied with doctors' communication regarding their children's condition. CAM is very commonly used. Doctors need to improve their communication skills and discuss CAM more openly. Cancer programs should include more support for parents: financial assistance, a facility where parents and children can stay during the course of therapy, and parent support groups.
我们的研究探讨了肯尼亚一家学术医院中,父母在其子女癌症治疗期间的社会经济、治疗相关及心理体验。
这项横断面研究使用了半结构化问卷。对2012年11月至2013年4月期间其子女连续前来接受癌症治疗的父母进行了访谈。
2012年至2013年期间,115名肿瘤患者到该医院就诊,对75个家庭(应答率65%)进行了访谈。癌症治疗导致了经济困难(89%)。需要更多关于癌症和治疗的信息(88%)。需要更多与医生的接触(83%)。在诊断时,癌症被认为是可治愈的(63%)。然而,医护人员告知父母,大多数患癌症的儿童会死亡(49%)。父母在理解医生的专业术语方面存在困难(48%)。错过医院预约的常见原因是交通费用(52%)和医院费用(28%)。父母(95%)为其子女使用了补充替代疗法(CAM)。医护人员告知父母不要使用CAM(49%)。父母未与医生讨论过他们使用CAM的情况(71%)。社区成员因孩子患癌症而孤立这些家庭(25%),认为孩子被施了魔法(57%),建议使用CAM(61%),并停止常规治疗(45%)。一些家庭(15%)从未向社区成员透露孩子的病情。父母在病房与其他父母分享经历(97%),否则就无法理解疾病及其治疗(87%)。
父母面临经济困难,对医生关于其子女病情的沟通不满意。CAM的使用非常普遍。医生需要提高他们的沟通技巧,并更公开地讨论CAM。癌症项目应该为父母提供更多支持:经济援助、一个在治疗期间父母和孩子可以停留的场所,以及父母支持小组。