Parental Views on the Advantages and Disadvantages of the Oncology Out-patient Department in Comparison to the Inpatient Oncology Clinic

Background: The treatment of paediatric cancer can take place in the in-patient hospital ward or in the out-patient setting, both of which have advantages and disadvantages. Aim: To assess parental opinions on the advantages and disadvantages of a paediatric oncology out-patient setting in comparison to the in-patient oncology ward. Method: The study sample consisted of 44 parents whose children had been diagnosed and were being treated for cancer in an Athens children’s hospital with an oncology ward and an oncology out-patient department between May and August 2010. The response rate was 81.5%. Statistical analysis was made using the Statistical Package for Social Sciences (SPSS) v. 19, and test results were considered significant at an alpha level of 0.05. The study was approved by the Ethical Committee of the hospital and informed consent was obtained from each parent. Results: Mothers comprised 88.6% of the sample. The mean age of the patients was 7.6±4.7 years. The parents reported that they can maintain their daily routine and family life when their children are attending the out-patient department for treatment (x2=24.86, p<0.001 and x2=32.91, p<0.001, respectively). They also preferred the out-patient setting because the young patients can participate in their usual activities (x2=8.14, p=0.02). The children were reported to be happier and less anxious and scared when they were attending daily clinic for oncology treatment, rather than being hospitalized (x2=25.86, p<0.001). The parents considered that oncology ward was preferable for developing relations with other patients and parents (x2=27.59, p<0.001) and the medical and nursing staff (x2=21.32, p<0.001). In addition, the information given by the medical staff was reported to be better and the sense of security higher in the in-patient oncology ward than in the out-patient setting (x2=20.46, p<0.001 and x2=29.08, p<0.001, respectively), and the in-patient oncology ward was better adapted to the needs of the young patients (x2=15.39, p<0.001). No significant difference was found for overall parental preference about the setting of treatment (x2=0.1, p=0.88). Demographic factors which were found to have a statistically significant association with parental preferences were maternal age, the patient’s gender, the phase of treatment and place of residence (p<0.05). Conclusions: According to their parents, the out-patient setting for treatment of children with cancer has many advantages. Improvements in the numbers of medical and nursing staff and in the organization of the daily out-patient clinic could result in the best quality of care for young patients with cancer.