Communication and trust in the care provided to a dying parent: a nationwide study of cancer-bereaved youths

J Clin Oncol. 2013 Aug 10;31(23):2886-94. doi: 10.1200/JCO.2012.46.6102. Epub 2013 Jul 15.

Abstract

Purpose: To assess children's trust in the care provided to a dying parent during the final week of life in relation to end-of-life medical information about disease, treatment, and death.

Methods: This nationwide population-based survey included 622 (73%) of 851 youths who, 6 to 9 years earlier, at age 13 to 16 years, lost a parent to cancer. We asked about the children's reception of end-of-life professional information and trust in the care provided. We also asked about depression and several potential risk factors of distrust in the care provided.

Results: A majority (82%) reported moderate/very much trust in the care provided. Compared with children who received end-of-life medical information before their loss, the risk of distrust in the care provided was higher in those who received no information (risk ratio [RR], 2.5; 95% CI, 1.5 to 4.1), in those who only received information afterward (RR, 3.2; 95% CI, 1.7 to 5.9), and in those who did not know or remember if end-of-life medical information was provided (RR, 1.7; 95% CI, 1.1 to 2.5). Those reporting distrust in the care provided had an RR of 2.3 (95% CI, 1.5 to 3.5) for depression. Furthermore, the risk of distrust in the care provided was higher among children reporting poor efforts to cure (RR, 5.1; 95% CI, 3.6 to 7.3), and/or a poor relationship with the surviving parent (RR, 2.9; 95% CI, 2.0 to 4.1).

Conclusion: Our study suggests that children's trust in the care provided to a dying parent was highest when they received end-of-life medical information before their loss.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attitude to Death
  • Communication*
  • Female
  • Humans
  • Male
  • Neoplasms / psychology*
  • Neoplasms / therapy*
  • Parent-Child Relations
  • Parents*
  • Patient Education as Topic / methods*
  • Patient Education as Topic / standards
  • Psychology, Adolescent
  • Stress, Psychological / therapy
  • Terminal Care / methods*
  • Terminal Care / psychology
  • Terminal Care / standards
  • Trust*