Information needs of Malaysian parents of children with cancer: A qualitative study

Chai-Eng Tan, Sie Chong Doris Lau, Zarina Abdul Latiff, Chee Chan Lee, Kok Hoi Teh, Sherina Mohd Sidik, Chai-Eng Tan, Sie Chong Doris Lau, Zarina Abdul Latiff, Chee Chan Lee, Kok Hoi Teh, Sherina Mohd Sidik

Abstract

Objective: Informational support is an important pillar of psychosocial care for parents of children with cancer. Understanding the information needs of these parents may improve the provision of family-centered informational support. This paper aims to explore the information needs of Malaysian parents whose children have cancer.

Methods: This qualitative study was conducted among 14 parents of children with cancer and 8 healthcare providers. The parents were recruited from two urban pediatric oncology centers in Malaysia. Healthcare providers were recruited from these centers, as well as from community-based palliative care providers. In-depth interviews were conducted based on semi-structured topic guides, audio-recorded, and transcribed for thematic analysis using elements of the grounded theory approach.

Results: Analysis revealed three themes of information needs, which were: "interaction with the healthcare system," "care for the child at home" and "psychosocial support for parents". Information needs on parents' interaction with the healthcare system consisted of disease and treatment-related information, as well as health system navigation. Information needs on care for the child at home were represented by their caregiving for basic activities of daily living, medical caregiving, and psychosocial caregiving. Psychosocial support for parents included information on practical support and self-care. There were differences in priorities for information needs between parents and healthcare providers.

Conclusions: Meeting the information needs of parents is an important part of psychosocial care in pediatric cancer care. Informational support may empower parents in caregiving for their child. The development of suitable information resources will be invaluable for healthcare providers in supporting parents' needs.

Keywords: Cancer; Information needs; Nursing; Parents; Pediatrics; Psychosocial support.

© 2022 Published by Elsevier Inc. on behalf of Asian Oncology Nursing Society.

Figures

Figure 1
Figure 1
Theme structure.
Figure 2
Figure 2
Distribution of codes across participants.

References

    1. Force L.M., Abdollahpour I., Advani S.M., Agius D., Ahmadian E., Alahdab F., et al. The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. Lancet Oncol. 2019 Sep;20(9):1211–1225.
    1. Bhakta N., Force L.M., Allemani C., Atun R., Bray F., Coleman M.P., et al. Childhood cancer burden: a review of global estimates. Lancet Oncol. 2019;20(1):e42–53.
    1. Azizah A., Hashimah B., Nirmal K., Siti Zubaidah A., Puteri N., Nabihah A., et al. Ministry of Health Malaysia; Putrajaya: 2019. Malaysia National Cancer Registry Report (MNCR) 2012-2016; pp. 1–116.
    1. Jones B.L. The challenge of quality care for family caregivers in pediatric cancer care. Semin Oncol Nurs. 2012;28(4):213–220.
    1. Kowalczyk J.R., Samardakiewicz M., Fitzgerald E., Essiaf S., Ladenstein R., Vassal G., et al. Towards reducing inequalities: European standards of care for children with cancer. Eur J Cancer. 2014;50(3):481–485.
    1. Weaver M.S., Heinze K.E., Bell C.J., Wiener L., Garee A.M., Kelly K.P., et al. Establishing psychosocial palliative care standards for children and adolescents with cancer and their families: an integrative review. Palliat Med. 2016 Mar 28;30(3):212–223.
    1. Kearney J.A., Salley C.G., Muriel A.C. Standards of psychosocial care for parents of children with cancer. Pediatr Blood Cancer. 2015 Dec;62(S5):S632–S683.
    1. Fitch M.I. Supportive care framework. Can Oncol Nurs J. 2008;18(1):6–14.
    1. Kerr L.M.J., Harrison M.B., Medves J., Tranmer J. Supportive care needs of parents of children with cancer: transition from diagnosis to treatment. Oncol Nurs Forum. 2004 Nov 1;31(6):E116–E126.
    1. Maree J.E., Parker S., Kaplan L., Oosthuizen J. The information needs of South African parents of children with cancer. J Pediatr Oncol Nurs. 2016 Jan 2;33(1):9–17.
    1. Koohkan E., Yousofian S., Rajabi G., Zare-Farashbandi F. Health information needs of families at childhood cancer: a qualitative study. J Educ Health Promot. 2019;8(5):246.
    1. Wiener L., Kazak A.E., Noll R.B., Patenaude A.F., Kupst M.J. Standards for the psychosocial care of children with cancer and their families: an introduction to the special issue. Pediatr Blood Cancer. 2015 Dec;62(S5):S419–S424.
    1. Granek L., Rosenberg-Yunger Z.R.S., Dix D., Klaassen R.J., Sung L., Cairney J., et al. Caregiving, single parents and cumulative stresses when caring for a child with cancer. Child Care Health Dev. 2014 Mar;40(2):184–194.
    1. Mouw M.S., Wertman E.A., Barrington C., Earp J.A.L. Care transitions in childhood cancer survivorship: providers' perspectives. J Adolesc Young Adult Oncol. 2017 Mar;6(1):111–119.
    1. Kästel A., Enskär K., Björk O. Parents' views on information in childhood cancer care. Eur J Oncol Nurs. 2011;15(4):290–295.
    1. Sulkers E., Tissing W.J.E., Brinksma A., Roodbol P.F., Kamps W.A., Stewart R.E., et al. Providing care to a child with cancer: a longitudinal study on the course, predictors, and impact of caregiving stress during the first year after diagnosis. Psycho Oncol. 2015 Mar;24(3):318–324.
    1. Institute of Medicine (US), National Research Council (US), National cancer policy board . In: Childhood Cancer Survivorship: Improving Care and Quality of Life. Hewitt M., Weiner S.L., Simone J.V., editors. National Academies Press (US); Washington DC: 2003. 2003. The trajectory of childhood cancer care.
    1. Coyne I., Amory A., Gibson F., Kiernan G. Information-sharing between healthcare professionals, parents and children with cancer: more than a matter of information exchange. Eur J Cancer Care (Engl). 2016;25(1):141–156.
    1. Koch K., Jones B. Supporting parent caregivers of children with life-limiting illness. Children. 2018 Jun 26;5(7):85.
    1. Braun K.L., Kagawa-Singer M., Holden A.E.C., Burhansstipanov L., Tran J.H., Seals B.F., et al. Cancer patient navigator tasks across the cancer care continuum. J Health Care Poor Underserved. 2012 Feb;23(1):398–413.
    1. Charmaz K. In: The SAGE Handbook of Social Research Methods. 1 Oliver's Yard, 55 City Road. Alasuutari P., Bickman L., Brannen J., editors. SAGE Publications Ltd; London EC1Y 1SP United Kingdom: 2008. Reconstructing grounded theory; pp. 461–478.
    1. Kelly M. The role of theory in qualitative health research. Fam Pract. 2009;27(3):285–290.
    1. Collins C.S., Stockton C.M. The central role of theory in qualitative research. Int J Qual Methods. 2018;17(1):1–10.
    1. Saldana J. 3rd ed. SAGE Publications Ltd; London: 2016. The Coding Manual for Qualitative Researchers; pp. 115–119.
    1. Creswell J.W. 3rd ed. Sage Publications; Los Angeles: 2013. Qualitative Inquiry & Research Design: Choosing Among Five Approaches; pp. 86–89.
    1. Rodgers C., Bertini V., Conway M.A., Crosty A., Filice A., Herring R.A., et al. A standardized education checklist for parents of children newly diagnosed with cancer: a report from the children's oncology group. J Pediatr Oncol Nurs. 2018;35(4):235–246.
    1. Markward M.J., Benner K., Freese R. Perspectives of parents on making decisions about the care and treatment of a child with cancer: a review of literature. Fam Syst Health. 2013 Dec;31(4):406–413.
    1. Kilicarslan-Toruner E., Akgun-Citak E. Information-seeking behaviours and decision-making process of parents of children with cancer. Eur J Oncol Nurs. 2013 Apr;17(2):176–183.
    1. Yiu J.M.-C., Twinn S. Determining the needs of Chinese parents during the hospitalization of their child diagnosed with cancer: an exploratory study. Cancer Nurs. 2001 Dec;24(6):483–489.
    1. Hamidah A., Rustam Z.A., Tamil A.M., Zarina L.A., Zulkifli Z.S., Jamal R. Prevalence and parental perceptions of complementary and alternative medicine use by children with cancer in a multi-ethnic Southeast Asian population. Pediatr Blood Cancer. 2009 Jan;52(1):70–74.
    1. Gray W.N., Szulczewski L.J., Regan S.M.P., Williams J.A., Pai A.L.H. Cultural influences in pediatric cancer. J Pediatr Oncol Nurs. 2014 Sep 10;31(5):252–271.
    1. Ryvicker M. A conceptual framework for examining healthcare access and navigation: a behavioral-ecological perspective. Soc Theor Health. 2018;16(3):224–240.
    1. Whop L.J., Valery P.C., Beesley V.L., Moore S.P., Lokuge K., Jacka C., et al. Navigating the cancer journey: a review of patient navigator programs for Indigenous cancer patients. Asia Pac J Clin Oncol. 2012;8(4):89–96.
    1. Kaziunas E., Hanauer D.A., Ackerman M.S., Choi S.W. Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation. J Am Med Inf Assoc. 2016 Jan;23(1):94–104.
    1. Chong D.L.S., Azim E., Latiff Z., Zakaria S.Z.S., Wong S.W., Wu L.L., et al. Transition care readiness among patients in a tertiary paediatric department. Med J Malaysia. 2018;73(6):382–387.
    1. Wong M.Y.F., Chan S.W.C. The qualitative experience of Chinese parents with children diagnosed of cancer. J Clin Nurs. 2006;15(6):710–717.
    1. Palmer S.J. Care of sick children by parents: a meaningful role. J Adv Nurs. 1993;18(2):185–191.
    1. Woodgate R.L., Edwards M., Ripat J.D., Borton B., Rempel G. Intense parenting: a qualitative study detailing the experiences of parenting children with complex care needs. BMC Pediatr. 2015 Dec 26;15(1):197.
    1. Kim M.A., Yi J., Wilford A., Kim S.H. Parenting changes of mothers of a child with cancer. J Fam Issues. 2020;41(4):460–482.
    1. Hamidah A., Wong C.-Y., Tamil A.M., Zarina L.A., Zulkifli Z.S., Jamal R. Health-related quality of life (HRQOL) among pediatric leukemia patients in Malaysia. Pediatr Blood Cancer. 2011 Jul 15;57(1):105–109.
    1. Klassen A., Raina P., Reineking S., Dix D., Pritchard S., O'Donnell M. Developing a literature base to understand the caregiving experience of parents of children with cancer: a systematic review of factors related to parental health and well-being. Support Care Cancer. 2007 Jun 18;15(7):807–818.
    1. Sutan R., Al-Saidi N.A., Latiff Z.A., Ibrahim H.M. Coping strategies among parents of children with acute lymphoblastic leukemia. Health (Irvine Calif) 2017;9(7):987–999.
    1. Zarina A., Radhiyah R., Hamidah A., Syed Zulkifli S., Rahman J. Parenting stress in childhood leukaemia. Med Health. 2011;7(2):73–83.
    1. Paal P., Helo Y., Frick E. Spiritual care training provided to healthcare professionals: a systematic review. J Pastor Care Couns. 2015 Mar 21;69(1):19–30. Adv theory Prof Pract through Sch reflective Publ.
    1. Hildenbrand A.K., Clawson K.J., Alderfer M.A., Marsac M.L. Coping with pediatric cancer: strategies employed by children and their parents to manage cancer-related stressors during treatment. J Pediatr Oncol Nurs. 2011 Nov 22;28(6):344–354.
    1. Clark N.M., Becker M.H., Janz N.K., Lorig K., Rakowski W., Anderson L. Self-management of chronic disease by older adults. J Aging Health. 1991 Feb;3(1):3–27.
    1. Hollis R. The role of the specialist nurse in paediatric oncology in the United Kingdom. Eur J Cancer. 2005 Aug;41(12):1758–1764.

Source: PubMed

3
Tilaa