Conclusion
With evidence that parent-child communication worsens over time with more problems in communication following the diagnosis of childhood cancer, oncologists should continue to provide families with support in communication throughout the child’s illness journey rather than only in the immediate new diagnosis period. Providers should consider continued involvement of interdisciplinary teams, including psychologists, social workers, child life specialists, and palliative care providers in order to best support communication within the family over time. Furthermore, providers can encourage high-quality communication within the family by modeling open communication in the clinic, including sharing medical information with both the parent and child while eliciting questions and concerns from each, establishing the expectation for ongoing openness at home.
Future studies are needed to determine if there is an optimal time for intervention after a child’s diagnosis or relapse to most effectively prevent worsening parent-child communication. Additional prospective studies evaluating parent-child communication over time from the child’s cancer diagnosis through relapse may better elucidate the impact of each of these milestones on quality of communication. With many more mothers than fathers participating in this and most other studies for parents of children with cancer and other chronic childhood illnesses, further research endeavors specifically targeting fathers would also be valuable. Such research is critical to improving care and decreasing suffering for vulnerable pediatric patients and their caregivers.
Conflict of Interest Statement: The authors have no conflicts of interest to disclose.
Data Sharing Statement: The data that support the findings of this study are available upon request from the Palliative Care Research Cooperative Group.
Acknowledgements: We thank the children and parents who kindly participated in this study.