Abstract

Complementary and alternative medicine (CAM) use in children with cancer has a high prevalence. If (parents of) patients bring up the topic of CAM, pediatric oncologists (POs) face considerable challenges regarding knowledge and professional behavior. In this study, we explore German POs’ understanding of CAM and related attitudes as well as challenges and strategies related to CAM discussions by means of semi-structured interviews analyzed according to principles of qualitative thematic analysis with parents of children with cancer. We could conduct 14 interviews prior to theoretical saturation. The interviews had a duration of 15–82 min (M = 30.8, SD = 18.2). Professional experience in pediatric oncology was between 0.5 and 26 years (M = 13.8, SD = 7.6). Main themes identified were a heterogeneous understanding and evaluation of CAM, partly influenced by personal experiences and individual views on plausibility; the perception that CAM discussions are a possible tool for supporting parents and their children and acknowledgement of limitations regarding implementation of CAM discussions; and uncertainty and different views regarding professional duties and tasks when being confronted with CAM as a PO. Our interdisciplinary interpretation of findings with experts from (pediatric) oncology, psychology, and ethics suggests that there is need for development of a consensus on the minimal professional standards regarding addressing CAM in pediatric oncology.

摘要

补充和替代医学 (CAM) 在患有癌症的儿童中的使用具有很高的流行性。如果患者（的父母）提出 CAM 的话题，儿科肿瘤学家 (PO) 将在知识和专业行为方面面临相当大的挑战。在本研究中，我们通过根据定性主题分析原则对癌症患儿父母进行的半结构化访谈，探索德国 PO 对 CAM 的理解和相关态度，以及与 CAM 讨论相关的挑战和策略。我们可以在理论饱和之前进行 14 次访谈。访谈持续时间为 15-82 分钟（M  = 30.8，SD  = 18.2）。儿科肿瘤学专业经验在 0.5 到 26 年之间（M  = 13.8，标准差 = 7.6)。确定的主题是对 CAM 的不同理解和评估，部分受到个人经验和个人对合理性观点的影响；认为 CAM 讨论可能是支持父母及其子女的工具，并承认实施 CAM 讨论的局限性；当作为 PO 面对 CAM 时，对专业职责和任务的不确定性和不同看法。我们与来自（儿科）肿瘤学、心理学和伦理学的专家对研究结果的跨学科解释表明，需要就解决儿科肿瘤学中的 CAM 的最低专业标准达成共识。