Health‐care providers' perspectives on childhood cancer treatment in Manado, Indonesia
Published online on May 23, 2013
Abstract
Background
Childhood cancer survival in low‐income countries is low.
Objective
Our study investigated health‐care providers' perspectives on childhood cancer treatment in Indonesia. Their health beliefs and attitudes toward parental financial difficulties, protocol adherence, parental education, and communication were explored.
Methods
A self‐administered questionnaire was filled in by 222 health‐care providers (156 doctors, 51 nurses, 6 social workers, 9 administrators)
Results
Health of children with cancer is beyond doctor's control and determined by luck, fate or God according to 35% of health‐care providers, 30% were uncertain about this statement, and 35% disagreed. Combination of chemotherapy and alternative treatment is best to achieve cure according to 15% of health‐care providers, 50% were uncertain, and 35% disagreed. Prosperous parents adhere better with treatment (67%). Doctors adhere better with cancer treatment for prosperous patients (55%). When dealing with poor families, less elaborate explanation is given (62%), more difficult vocabulary is used (49%), and less cooperation is offered (46%). Reasons for non‐adherence with treatment protocol were as follows: financial difficulties parents (82%), side‐effects (77%), lack of motivation parents (75%), and inadequate drugs supply at pharmacy (70%). Information about cancer and treatment makes parents more afraid or depressed about future, and parents prefer not to know according to 27% of health‐care providers, 20% were uncertain, and 53% disagreed. Communication with parents is hindered by differences in status and social hierarchical structures (83%).
Conclusions
Health‐care providers' beliefs about childhood cancer treatment are characterized by much uncertainty and contradiction. This likely affects adherence of health‐care providers, parents, and childhood cancer treatment outcome. Copyright © 2013 John Wiley & Sons, Ltd.