Parent Perceptions of Team-Delivered Care for Children with Advanced Cancer: A report from the PediQUEST study.

TitleParent Perceptions of Team-Delivered Care for Children with Advanced Cancer: A report from the PediQUEST study.
Publication TypeJournal Article
Year of Publication2020
AuthorsFeraco AM, Ananth P, Dussel V, Al-Sayegh H, Ma C, Rosenberg AR, Feudtner C, Wolfe J
JournalJ Pain Symptom Manage
Date Published2020 May 22
ISSN1873-6513
Abstract

CONTEXT: Childhood cancer care is delivered by interprofessional healthcare teams however little is known about how parents perceive overall team-delivered care (TDC).

OBJECTIVES: We sought to describe parent perceptions of TDC and associated factors, including care rendered by individual clinicians, teamwork, information consistency, and patient and parent characteristics.

METHODS: Cross-sectional surveys were distributed to parents of 104 children with recurrent/refractory cancer enrolled in a multi-site symptom management trial. The primary outcome, TDC, was parent report of care quality delivered by the child's care team during the preceding 3 months. Likert scaled items (excellent/very good/good/fair/poor) queried care quality delivered by individual clinicians, perceived teamwork and other factors. Factors associated with parent perceptions of "excellent" TDC were identified using Fisher's Exact test.

RESULTS: Eighty-six parents (83%) responded. Over the preceding 3 months, 63% (n=54) of parents reported excellent TDC. However, only 47% (n=40) described their care team's teamwork as excellent. Approximately one-quarter (24%) described care rendered by their child's oncologist as less-than-excellent. Among parents who reported psychosocial clinician involvement (71%, n=60), only 43% described this care as excellent. Individually, excellent care from each clinician type (oncologist, psychosocial clinician, primary nurse) was associated with excellent TDC (all p≤0.001, no correction for multiple comparisons).

CONCLUSION: Among parents of children with advanced cancer, more than one-third report less-than-excellent TDC. Additionally, less than half report excellent teamwork, and ratings of care rendered by individual clinicians are highly variable. Findings suggest interventions are needed to enhance interprofessional teamwork in the care of children with advanced cancer.

DOI10.1016/j.jpainsymman.2020.05.019
Alternate JournalJ Pain Symptom Manage
PubMed ID32450115
Grant ListL40 CA231699 / CA / NCI NIH HHS / United States