Journal Article

Cancer treatment decision-making among parents of paediatric oncology patients in Guatemala: a mixed-methods study

Mack, Jennifer W, Cáceres-Serrano, Ana, Devidas, Meenakshi, Metzger, Monika, Rodriguez-Galindo, Carlos, Graetz, Dylan E, Rivas, Silvia, Wang, Huiqi, Fuentes, Lucia, Antillon-Klussmann, Federico, Vedaraju, Yuvanesh, Ferrara, Gia

2022

Overview

ObjectivesTo examine treatment decision-making priorities and experiences among parents of children with cancer in Guatemala.SettingThis study was conducted at Guatemala’s National Pediatric Cancer Center in Guatemala City.ParticipantsSpanish-speaking parents of paediatric patients (≤18 years of age) diagnosed with any form of cancer within the 8 weeks prior to study enrolment. The quantitative portion of this study included 100 parent participants; the qualitative component included 20 parents. Most participants were Catholic or Evangelical Spanish-speaking mothers.OutcomesPriorities and experiences of cancer treatment decision-making including decision-making role and experienced regret.ResultsA range of paediatric ages and cancer diagnoses were included. Most Guatemalan parents surveyed (70%) made decisions about their child’s cancer together and almost all (94%) without input from their community. Surveyed parents predominately preferred shared decision-making with their child’s oncologist (76%), however 69% agreed it was best not to be provided with many options. Two-thirds of surveyed parents (65%) held their preferred role in decision-making, with fathers more likely to hold their preferred role than mothers (p=0.02). A small number of parents (11%) experienced heightened decisional regret, which did not correlate with socio-demographic characteristics or preferred decision-making role. Qualitative results supported quantitative findings, demonstrating a decision-making process that emphasised trust and honesty.ConclusionsGuatemalan parents preferred to make decisions with their medical team and appreciated providers who were honest and inclusive, but directive about decisions. This study reinforces the importance of the provider–parent relationship and encourages clinicians in all settings to ask about and honour each parent’s desired role in decision-making.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Cancer therapies / Children & youth / Culture / Decision making / Families & family life / Global Health / High income / Low income groups / Mixed methods research / Oncology / paediatric oncology / paediatrics / Parents & parenting / Patients / Pediatrics / Psychologists / Qualitative research / Shared decision making / Sociodemographics / Verbal communication