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.