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Health literacy variables related to parents' understanding of their child's cancer prognosis

Authors

  • Kimberly S. Miller PhD,

    1. Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
    2. Department of Psychology, The Ohio State University, Columbus, Ohio
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  • Kathryn Vannatta PhD,

    1. Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
    2. Department of Psychology, The Ohio State University, Columbus, Ohio
    3. Department of Pediatrics, The Ohio State University, Columbus, Ohio
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  • Michael Vasey PhD,

    1. Department of Psychology, The Ohio State University, Columbus, Ohio
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  • Nicholas Yeager MD,

    1. Department of Pediatrics, The Ohio State University, Columbus, Ohio
    2. Nationwide Children's Hospital, Columbus, Ohio
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  • Bruce E. Compas PhD,

    1. Departments of Psychology and Human Development and Pediatrics, Vanderbilt University, Nashville, Tennessee
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  • Cynthia A. Gerhardt PhD

    Corresponding author
    1. Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
    2. Department of Psychology, The Ohio State University, Columbus, Ohio
    3. Department of Pediatrics, The Ohio State University, Columbus, Ohio
    • The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205-2696.
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  • Conflict of interest: This study was funded in part by the Research Institute at Nationwide Children's Hospital.

Abstract

Background

Obtaining an accurate understanding of a child's cancer prognosis can help parents make informed decisions about treatment. Research has shown that parents tend to overestimate their child's cancer prognosis relative to physicians. Thus, we examined whether the content of physician communication, parent sources of medical information, and parent demographic factors affected the association between oncologist and parent estimates of a child's cancer prognosis.

Procedure

Families were recruited 3–8 weeks after a child's new diagnosis or relapse of cancer. Parents (77 mothers; 42 fathers) completed questionnaires regarding their sources of medical information, age, and education. The child's oncologist reported on the content of their communication with parents regarding prognosis. Parents and oncologists estimated the child's chance of 5-year survival using a visual-analogue scale.

Results

Mothers and fathers reported a more favorable prognosis for their child, which was on average about 30% higher than oncologists. Time since diagnosis was correlated with less discrepancy between physician and mother prognosis ratings, with a similar trend noted for fathers. Agreement between oncologists and parents was better for younger fathers, but it was unrelated to physician communication, sources of medical information, or other demographic factors.

Conclusions

Fathers' age may be important to their understanding of their child's cancer prognosis, but we did not find support for other factors related to prognosis literacy. Given the homogeneity of our sample, future research should assess differences in parents' prognosis knowledge across cancer diagnosis, race, ethnicity, and socioeconomic status (SES), which may aid in developing interventions to improve parent understanding. Pediatr Blood Cancer 2012; 59: 914–918. © 2012 Wiley Periodicals, Inc.

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