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Analysis of diagnosis announcements in Abidjan pediatric oncology unit 2 years after introduction of the African Pediatric Cancer Announcement Guideline
a Pediatric Unit, Teaching Hospital of Treichville, Fe´lix Houphoue¨t Boigny University, Abidjan, Coˆte d’Ivoire
b Department of Pediatric Hematology-Oncology, Timone Children’s Hospital, Aix-Marseille University and APHM, 13005 Marseille, France c Department of Public Health, Department of computing and biostatistics, Fe´lix Houphoue¨t Boigny University, Abidjan, Coˆte d’Ivoire
Introduction: Announcing the diagnosis allows the therapeutic alliance between physicians and patients to be sealed and it prevents abandonment of treatment. To compensate for the deficit in information received by the families, the Franco-African Group of Pediatric Oncology (FAGPO) has published an ‘‘African Pediatric Cancer Announcement Guide’’ for the group’s pediatric oncology units.
Objective: To analyze the announcements made to parents and children 2 years after the provision of this guide.
Methods: Cross-sectional survey conducted from March to July 2016. In total, 69 parents of children followed up in the pediatric oncology unit of Abidjan were interviewed regarding the characteristics of the announcement that was made to them and the information given to the sick child.
Results: Of all the accompanying individuals, 91% reported having benefited from the announcement made with empathy, mainly by a physician. In approximately one quarter of the cases the information had been given to a third party. The main barriers to information were: the negative experiences of parents, the medical terminology, and communication problems. The sick child was rarely informed. Discussion: The information given was in accordance, in content and form, with the data from Western and African literature. The lack of information given to the child has a dual explanation: the primacy of the community over the individual advocated by African culture and the non-integration of the rights of children in the current code of ethics.
Conclusion: The information provided could be improved by practical training of physicians in the technique of breaking bad news to patients and their families and the use of a code of ethics in accordance with the principle of autonomy.
C 2019 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.
The activities of the Franco-African Group of Pediatric Oncology (FAGPO) have led to improvements in the care of children with cancer in Francophone Africa . However, the increase in survival rates has raised other problems: delays in consultation, lack of long-term follow-up, the abandonment of treatment. Treatment abandonment is attributed to the low resources of families, the difficulties in accessing care, and the lack of information to the families . Providing information to the sick child and his/her
* Corresponding author.
E-mail address: line.couitcher[email protected] (L. Couitche´re´).