An exploration of the perceptions, experience and practice of cancer clinicians in caring for patients with cancer who are also parents of dependent-age children

摘要

Background Being a parent alongside a cancer diagnosis presents unique challenges. It is unclear to what degree parenting considerations feature in routine care and how doctors approach treatment decision discussions. Objective To explore doctor perspectives regarding patients with cancer who have dependent children. Methodology Focus groups and interviews conducted to ascertain doctor views. Responses were audio-recorded, transcribed and thematically analysed. Results Twenty-eight doctors participated: medical oncology (7), haematology (10), palliative care (8), and psycho-oncology (3). Participants observed cancer impacted upon parenting across several domains: psycho-social, practical, and family implications. Having dependent children was perceived to influence the patient experience and decision-making by patients and clinicians. Participants identified this cohort as emotionally demanding to care for with a range of psychological effects identified for doctors, particularly in highly challenging circumstances (single-parent and non-English speaking families, scenarios involving communication difficulties). Conclusion Participants recognised the presence of dependent children to profoundly influence the experience of being both a parent and a patient with cancer. Identifying patients with parental responsibilities was noted as relevant for management at diagnosis through to death. Greater understanding of doctors' experiences providing care for this cohort may inform the development of resources to assist doctors and their patients.