Get access

Hospital-based home care for children with cancer: Feasibility and psychosocial impact on children and their families

Authors

  • Helena Hansson RN, MHS.PhD,

    Corresponding author
    1. Research Unit Women's and Children's Health, The Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
    2. Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
    • Research Unit Women's and Children's Health 7821, The Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen DK-2100, Denmark.
    Search for more papers by this author
  • Hanne Kjærgaard RM, PhD,

    1. Research Unit Women's and Children's Health, The Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
    Search for more papers by this author
  • Christoffer Johansen MD, PhD,

    1. Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, the Danish Cancer Society, Copenhagen, Denmark
    Search for more papers by this author
  • Inger Hallström RN, PhD,

    1. Faculty of Medicine, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
    Search for more papers by this author
  • Jane Christensen MSc,

    1. Department of Statistics and Epidemiology, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
    Search for more papers by this author
  • Marianne Madsen RN, MPH,

    1. Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
    Search for more papers by this author
  • Kjeld Schmiegelow MD, PhD

    1. Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
    Search for more papers by this author

  • Conflict of interest: Nothing to declare.

Abstract

Background

To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer.

Procedure

A HBHC program was carried out with 51 children (0–18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety, and cost. A controlled trial was conducted to assess children's health-related quality of life (HRQOL) using the parent-reported and self-reported PedsQL Generic Core Scale and PedsQL Cancer Module, and the psychosocial impact on the family by PedsQL Family Impact Module comprising a subsample of 28 children and 43 parents in the home care group, and 47 children and 66 parents receiving standard hospital care.

Results

All parents in the HBHC program were satisfied and preferred home care. There were no serious adverse events associated with HBHC, and costs did not increase. When adjusting for age, gender, diagnosis and time since diagnosis, we found significant higher HRQOL scores in parent-reported physical health (P = 0.04; 95% confidence interval (CI): −0.2–19.5) and worry (P = 0.04; 95% CI: −0.4–20.6) in the home-care group indicating better physical health and less worry for children in the home-care group. No significant difference was found in the Family Impact Module.

Conclusion

This study indicates that HBHC is a feasible alternative to hospital care for children with cancer, and is greatly preferred by parents. Specific aspects of children's HRQOL may be improved with HBHC and the psychosocial burden on the family does not increase. Pediatr Blood Cancer 2013; 60: 865–872. © 2013 Wiley Periodicals, Inc.

Ancillary