Abstract

Announcing drug resistance is complex for pediatric oncologists because they have to provide a substantial amount of medical information while taking a major emotional impact on the parents into account. This study aimed to understand how these announcements are currently conducted and how pediatric oncologists adapt the information given to each family in situations where there is resistance to treatment. Semi-structured interviews were conducted with 15 pediatric oncologists (66.7% women, aged 44.7 years on average). Interviews were audio-recorded and a thematic content analysis was conducted. Announcements of drug resistance are stressful, as they are not well codified, difficult to anticipate, and pediatric oncologists have many issues about how best to behave and which words to choose. The majority of them believe that the severity, or even the incurability of the disease, and the offer of a therapeutic alternative are essential components of the information to pass on. Pediatric oncologists describe how they adapt their communication to each family, particularly in relation to parents’ questions, and also to their reactions during the announcement. They also need to adapt to the prior acquaintance they may have with the families, and to previous exchanges. Finally, pediatric oncologists acknowledge their subjectivity when estimating the parents need in terms of information. Understanding the course of these announcements gives us another point of view at the issues involved in this announcement. Proposals to support pediatric oncologists in this difficult moment can be suggested: communication support tool, work in pairs and discussion group.

摘要

宣布耐药性对儿科肿瘤学家来说很复杂，因为他们必须提供大量医学信息，同时还要考虑对父母的重大情绪影响。这项研究旨在了解这些公告目前是如何进行的，以及儿科肿瘤学家如何在对治疗有抵抗力的情况下调整提供给每个家庭的信息。对 15 名儿科肿瘤学家（66.7% 的女性，平均年龄 44.7 岁）进行了半结构化访谈。对访谈进行了录音，并进行了主题内容分析。耐药性的宣布是有压力的，因为它们没有很好地编纂，难以预测，而且儿科肿瘤学家在如何最好地表现和选择哪些词方面有很多问题。他们中的大多数人认为，严重程度，甚至疾病的不治之症，以及提供替代治疗方法都是要传递的信息的重要组成部分。儿科肿瘤学家描述了他们如何调整他们的沟通以适应每个家庭，特别是与父母的问题有关，以及他们在公告期间的反应。他们还需要适应他们之前可能与家人的熟人，以及之前的交流。最后，儿科肿瘤学家在估计父母对信息的需求时承认他们的主观性。了解这些公告的经过，可以让我们对本公告涉及的问题有另一种看法。可以提出在这个困难时刻支持儿科肿瘤学家的建议：交流支持工具、结对工作和讨论组。和提供治疗替代方案是传递信息的重要组成部分。儿科肿瘤学家描述了他们如何调整他们的沟通以适应每个家庭，特别是与父母的问题有关，以及他们在公告期间的反应。他们还需要适应他们之前可能与家人的熟人，以及之前的交流。最后，儿科肿瘤学家在估计父母对信息的需求时承认他们的主观性。了解这些公告的经过，可以让我们对本公告涉及的问题有另一种看法。可以提出在这个困难时刻支持儿科肿瘤学家的建议：交流支持工具、结对工作和讨论组。和提供治疗替代方案是传递信息的重要组成部分。儿科肿瘤学家描述了他们如何调整他们的沟通以适应每个家庭，特别是与父母的问题有关，以及他们在公告期间的反应。他们还需要适应他们之前可能与家人的熟人，以及之前的交流。最后，儿科肿瘤学家在估计父母对信息的需求时承认他们的主观性。了解这些公告的经过，可以让我们对本公告涉及的问题有另一种看法。可以提出在这个困难时刻支持儿科肿瘤学家的建议：交流支持工具、结对工作和讨论组。