Prognosis Communication in Pediatric Oncology: A Systematic Review
Estera Boeriu,
Alexandra Borda,
Eunice Miclea,
Amalia-Iulia Boeriu,
Dan Dumitru Vulcanescu,
Iulia Cristina Bagiu,
Florin George Horhat,
Alexandra Flavia Kovacs,
Cecilia Roberta Avram,
Mircea Mihai Diaconu,
Luiza Florina Vlaicu,
Otniel Dorian Sirb,
Smaranda Teodora Arghirescu
Affiliations
Estera Boeriu
Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
Alexandra Borda
Department of Oncology and Haematology, “Louis Turcanu” Emergency Clinical Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
Eunice Miclea
Department of Oncology and Haematology, “Louis Turcanu” Emergency Clinical Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
Amalia-Iulia Boeriu
Anaesthesiology and Intensive Care Department, Klinikum Rechts der Isar Der Technischen, Universitat Munchen, Ismaninger Street 22, 81675 Munchen, Germany
Dan Dumitru Vulcanescu
Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
Iulia Cristina Bagiu
Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
Florin George Horhat
Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
Alexandra Flavia Kovacs
Department of Oncology, Onco-Help Association, Ciprian Porumbescu Street 56-59, 300239 Timisoara, Romania
Cecilia Roberta Avram
Department of Residential Training and Post-University Courses, “Vasile Goldis” Western University, Liviu Rebreanu Street 86, 310414 Arad, Romania
Mircea Mihai Diaconu
Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
Luiza Florina Vlaicu
Department of Social Assistance, Faculty of Sociology and Psychology, Western University, Vasile Parvan Boulevard 4, 300223 Timisoara, Romania
Otniel Dorian Sirb
Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
Smaranda Teodora Arghirescu
Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
Background: While communication plays an important role in medicine, it also often represents a challenge when the topic at hand is the prognosis of a high-risk condition. When it comes to pediatric oncology, the challenge becomes even greater for physicians who have to adapt their discourse to both the child and their family. Methods: Following the PRISMA guidelines, an advanced search on PubMed, Scopus and the Cochrane Library was performed, from 1 January 2017 to 31 October 2022. Demographic data for caregivers, pediatric patients and physicians were extracted, as well as diagnosis, prognosis, presence at discussion, emotional states and impact on life, trust, decision roles, communication quality and other outcomes. Results: A total of 21 articles were analyzed. Most studies (17) focused on caregivers, while only seven and five studies were focused on children and physicians, respectively. Most parents reported high trust in their physicians (73.01%), taking the leading role in decision making (48%), moderate distress levels (46.68%), a strong desire for more information (78.64%), receiving high-quality information (56.71%) and communication (52.73%). Most children were not present at discussions (63.98%); however, their desire to know more was expressed in three studies. Moreover, only two studies observed children being involved in decision making. Most physicians had less than 20 years of experience (55.02%) and reported the use of both words and statistics (47.3%) as a communication method. Conclusions: Communication research is focused more on caregivers, yet children may understand more than they seem capable of and want to be included in the conversation. More studies should focus on and quantify the opinions of children and their physicians. In order to improve the quality of communication, healthcare workers should receive professional training.
