School of Clinical Medicine, Discipline of Paediatrics and Child Health, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia.
Kids Cancer Centre, Sydney Children's Hospital Randwick, Sydney, Australia.
Psychooncology. 2024 Nov;33(11):e70011. doi: 10.1002/pon.70011.
This study investigated the prevalence, methods and factors leading carers of childhood cancer patients to seek second opinions.
A prospective, questionnaire-based study was conducted among families attending oncology clinics at Sydney Children's Hospital, Randwick. Participants were asked whether they had sought a second opinion for their child and if so, their motivations. Factors including cancer diagnosis, carer demographics and online health seeking behaviours were evaluated in association with second opinions. A separate online questionnaire invited paediatric oncologists worldwide to indicate the frequency of, and their approach to, second opinion requests via email.
Fourteen out of 126 carers (11.1%) sought a second opinion from another oncologist to confirm diagnoses (64.3%), explore treatment options (64.3%) or receive additional information (57.1%). A brain cancer diagnosis was the most significant predictor for second opinion seeking in univariate (p = 0.009) and multivariate analyses (p = 0.015). Among carers who reported using the internet for health information seeking (n = 98), second opinions were independently associated with social media use (p = 0.014) and frequent health-related searches (p = 0.027). Most paediatric oncologists (71/89, 79.8%) had received second opinion requests via email, with 21.3% (19/89) reporting that these occur at least weekly. Surveyed oncologists provided a second opinion for some (59.2%) or all (33.8%) requests they received, with 68.5% supporting guideline development for second opinions in paediatric oncology.
Second opinions are regularly sought by carers of childhood cancer patients, with many paediatric oncologists approached over email. International guidelines may be warranted to assist paediatric oncologists and families in navigating these requests.
本研究调查了儿童癌症患者照顾者寻求第二意见的流行率、方法和影响因素。
在悉尼儿童医院兰威克肿瘤科诊所，对 126 名家属进行了前瞻性、基于问卷的研究。参与者被问及他们是否为孩子寻求过第二意见，如果有，他们的动机是什么。评估了癌症诊断、照顾者人口统计学和在线健康搜索行为等因素与第二意见的关系。一项单独的在线问卷调查邀请全球儿科肿瘤医生通过电子邮件表示他们对第二意见请求的频率和处理方法。
14 名照顾者（11.1%）向另一名肿瘤医生寻求第二意见，以确认诊断（64.3%）、探讨治疗方案（64.3%）或获得额外信息（57.1%）。在单变量（p=0.009）和多变量分析（p=0.015）中，脑癌诊断是寻求第二意见的最显著预测因素。在报告使用互联网获取健康信息的照顾者中（n=98），第二意见与社交媒体使用（p=0.014）和频繁的健康相关搜索（p=0.027）独立相关。大多数儿科肿瘤医生（71/89，79.8%）通过电子邮件收到了第二意见请求，其中 21.3%（19/89）报告这些请求每周至少发生一次。接受调查的肿瘤医生对他们收到的一些（59.2%）或所有（33.8%）请求提供了第二意见，68.5%的医生支持为儿科肿瘤学制定第二意见指南。
儿童癌症患者的照顾者经常寻求第二意见，许多儿科肿瘤医生通过电子邮件收到请求。可能需要制定国际指南，以帮助儿科肿瘤医生和家属处理这些请求。
