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Commentary on : Parent's accounts of obtaining a diagnosis of childhood cancer by Dixon-Woods et al

Kelly, Daniel M. 2002. Commentary on : Parent's accounts of obtaining a diagnosis of childhood cancer by Dixon-Woods et al. Evidence Based Nursing 5 (1) , p. 28. 10.1136/ebn.5.1.28

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This qualitative study by Dixon-Woods et al raises several issues of direct relevance to practitioners who work with children and adolescents with cancer. Parents' knowledge about their children and their usual health patterns emerged as a crucial source of information concerning the presence of cancer. The reluctance of some doctors to take symptoms seriously may stem from the perception that childhood malignancies are rare. The conflict which then arose when parents demanded further action indicates the importance of appreciating the value of “lay” knowledge when it comes to assessing children's health. Professional knowledge is usually privileged in such situations, but this study shows that this can lead to a delay in investigations and reaching a definitive diagnosis. Such delays may then result in a lack of trust between professionals and parents, which may be difficult to recover. The study also confirms the value of using qualitative research approaches to obtain evidence about people's detailed perceptions of healthcare services. It is a good example of a practical issue being illuminated by asking people directly about their perceptions of what happened to them. Other factors that were highlighted include the dangers of medical staff lacking expertise in childhood and adolescent cancers. Recent policy changes in the UK have argued that cancer should be treated only in designated centres where the necessary skills, equipment, and experience are available. The researchers provide direct evidence why such an approach should be advocated. The problem remains unanswered, however, about how to prevent unnecessary delays between the recognition of symptoms and cancer detection. This may require those in primary care to value a parent's instinctive knowledge of their children, so that fewer cases of cancer fall through the net. Such a message must obviously be balanced against reacting to the fears of parents who may simply be over anxious about their children. It is good to see research that focuses on the reality of cancer care and provides evidence of how a system can be improved. Similarly, research that explores adolescents' particular needs is also long overdue. Those involved in primary health and cancer care are likely to find this study thought provoking.

Item Type: Article
Status: Published
Schools: Healthcare Sciences
Subjects: R Medicine > R Medicine (General)
R Medicine > RT Nursing
Additional Information: Commentary on: Parents' accounts of obtaining a diagnosis of childhood cancer /Dixon-Woods M, Findlay M, Young B, et al.. The Lancet, Volume 357, Issue 9257, Pages 670 - 674, 3 March 2001 doi:10.1016/S0140-6736(00)04130-1
Publisher: RCN Publishing
ISSN: 1367-6539
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Last Modified: 04 Jun 2017 02:53

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