Associations between clinical and sociodemographic data and patterns of communication in pediatric oncology

Abstract

Pediatric communication directly contributes to treatment adherence, fewer symptoms, better clinical responses, healthier treatment adaptation and management of psychosocial issues. This study aimed to evaluate associations between the clinical and sociodemographic data of caregivers and children and the communicative patterns of pediatricians. Three oncohematology physicians and 44 child-caregiver dyads took part, with audio recording of 146 medical consultations. The physicians interacted more often with older children, offering more guidance, clarifying doubts, and asking for information. The number of questions from children and caregivers was positively correlated with the physician's communicative behaviors. However, there was no association between the age of the children and the number of doubts of the patients. The diagnosis, treatment time, family income, marital status and caregiver's level of education were associated with the amount of interaction provided by physicians to the children and caregivers. This study offers subsides relevant to psychosocial interventions that may improve communication in pediatric oncohematology settings.

Advancing the field of communication research in pediatric oncology: A systematic review of the literature analyzing medical dialogue

“…All 26 studies aimed to describe the content of communication. The majority of studies ( n = 23, 88%) also aimed to describe the quality of communication . Two studies aimed to describe the impact of an intervention on communication styles and strategies .…”

“…The majority of studies ( n = 18, 69%) involved recordings of informed consent conversations . One study recorded conversations at the time of diagnosis, and a minority of studies ( n = 4, 15%) recorded conversations at random visits across the illness trajectory without aiming to capture a specific time point . One study recorded conversations at visits following completion of cancer therapy .…”

“…Three studies (12%) exclusively aimed to describe the content of communication, without qualifying the perceived value or influence of the communication . The remainder of the studies ( n = 23, 88%) presented data with the goal of drawing conclusions about communication quality . Table describes the tools used to assess communication quality in these studies.…”

“…In the remaining non‐informed consent studies, the majority of studies quantified specific physician communication behaviors, including frequencies and types of question‐asking and patient versus physician interactivity as determined by ratios of words spoken and frequencies of speech turns or exchanges . Two studies specifically quantified the occurrence and/or frequencies of “emotional talk,” including discussion of patient or parent fears and hopes and physician responses to emotional cues .…”

“…Discussions were often characterized by short‐term and procedural discussions with a primary focus on things that were going well and acute clinical management . Socioeconomic status and caregiver level of education were associated with amount of interaction provided by physicians to patients and caregivers . Clinicians frequently discussed treatment, but rarely discussed treatment‐related decisions or elicited the patient's preferred level of involvement in decision‐making …”