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

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

Feraco AM; Ananth P; Dussel V; Al-Sayegh H; Ma C; Rosenberg AR; Feudtner C; Wolfe J

Journal of Pain and Symptom Management

2020

Childhood Cancer; Interdisciplinary Care; Interprofessional Healthcare Teams; Multidisciplinary Care; Pediatric Oncology; Psychosocial Oncology; Team-Delivered Care

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

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