Pediatric Oncology Care Providers' Attitudes On and Perceptions of Assent

Purpose The purpose of this study was to describe pediatric oncology careproviders’ attitudes and perceptions regarding including pediatric patients in decision-making discussions for cancer treatment. Methods Potential participants were identified via institutional staff listings and recruited via internal email addresses. Of 27 eligible participants, 16 completed an anonymous online survey consisting of 12 questions, yielding a response rate of 59 percent. Results Of the 16 careproviders surveyed, 75 percent strongly agreed that it is valuable to include pediatric patients in decision-making discussions. Those who did not find value in the practice still reported using multiple methods to assess for understanding and agreement in a child. Almost two-thirds (62.5 percent) began including children in decision making between the ages of seven and nine. All 16 careproviders indicated that they would proceed with cancer treatment if the child did not agree, but the illness was imminently life threatening, and the parents gave permission. Barriers reported in the study included the child’s developmental level, differences in primary spoken language, parental preference, and the child’s age. Conclusion Careproviders at our institution self-report to be practicing in line with the recommendations of the American Academy of Pediatrics. Next steps might include exploring ways for careproviders to educate parents on the rationale for including children in decision-making discussions. Additionally, finding effective strategies to identify and remove language barriers may improve communication.