Inclusion of children in the initial conversation about their cancer diagnosis: impact on parent experiences of the communication process

  • Sarah R. Brand McCarthyEmail author
  • Tammy I. Kang
  • Jennifer W. Mack
Original Article



Including children in medical conversations is considered the standard of care for children with cancer. However, previous qualitative research has raised concerns about how the child’s presence impacts the parent’s communication experience. The current study examines the frequency and impact of child presence during a serious medical conversation on the parent’s communication experience in pediatric oncology.


Three hundred sixty parents of children newly diagnosed with cancer completed questionnaires assessing the child’s presence during the initial conversation with the oncologist about diagnosis and treatment and parental communication experiences. Primary oncologists completed a survey question about the child’s prognosis.


Sixty-one percent of children were present during the initial conversation, with lowest rates among children aged 3–6 (44%) and 7–12 (44%). Child presence was not associated with parents’ reports that they received prognostic information (p = 0.20), high-quality information (p = 0.19), or high-quality communication about the child’s cancer (p = 1.0).


The parent’s communication experience is not diminished by the choice to include the child. Given the bioethical imperative to include children in conversations about serious illness whenever possible, this concern should not be used to exclude children, but rather to give parents additional time of their own when needed to fully process decisions.


Pediatric hematology/oncology Psychosocial Communication Parents 


Compliance with ethical standards

This study was approved by the Institutional Review Boards at the Dana-Farber Cancer Institute and Children’s Hospital of Philadelphia.

Conflict of interest

The authors have no conflicts of interest relevant to this article to disclose. The study PIs have full control of all primary data. The data is not in a public repository, but that requests for data access will be considered individually and data made available if appropriate using processes consistent with those of our institution and IRB. We will consider requests for data access from reviewers if needed, again in compliance with institutional and IRB policy.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric OncologyDana-Farber Cancer InstituteBostonUSA
  2. 2.Department of Psychiatry and PsychologyMayo ClinicRochesterUSA
  3. 3.Section of Pediatric Palliative CareTexas Children’s HospitalHoustonUSA

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