br family is an obligation listed in
family is an obligation listed in numerous national and interna-tional charters. It meets the requirement of transparency linked to the development of medicine. It is an extremely difficult task, especially in the field of oncology . The announcement of the diagnosis represents an important opportunity to secure the therapeutic alliance between physician and patient; but in pediatrics, this alliance is made up of at least three partners: the physician, the child, and the child’s parents . A self-assessment of the FAGPO physicians, of which we are members, indicated shortcomings in the information given to GW 4869 ; an African guide on the announcement of child cancer was published and given to the caregivers of the group’s experimental units. This guide, based on the experience of families and African medical
0929-693X/ C 2019 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Couitche´re´ L, et al. Analysis of diagnosis announcements in Abidjan pediatric oncology unit 2 years after introduction of the African Pediatric Cancer Announcement Guideline. Archives de Pe´diatrie (2019), https://doi.org/10.1016/ j.arcped.2019.06.006
teams, also integrated the expertise of Western associations having worked on this issue . How is the diagnosis announced in the pediatric oncology unit of Abidjan 2 years after the provision of this guide? Few African studies address the issue of informing patients and their families [5–8]. With the aim of improving the relationship between caregivers and children affected by cancer, we carried out this work to analyze the characteristics of the diagnostic announcement made to families and to compare them with those from data in the literature.
This was a cross-sectional survey carried out from March 1 to July 3, 2016 in the pediatric oncology unit of the Treichville Teaching Hospital in Abidjan, Ivory Coast. We interviewed the relatives accompanying the children in the same unit in which the diagnostic announcement was made. The children were aged between and 18 years, undergoing treatment, or undergoing long-term follow-up for solid tumors or leukemias. The survey concerned: the relatives accompanying the children who had been in care for at least 1 month, present at the time of diagnosis, at the initiation of treatment, and during the hospital stays. The accompanying persons were contacted by telephone and asked to take part in the survey. An appointment was made after obtaining their agreement to participate in the study. The oral interview with each accompanying person was conducted using a structured questionnaire by a trainee student obtaining a specialization diploma in pediatrics. The questionnaire was tested and modified to establish the final version. The parents who did not speak French fluently were assisted by an interpreter. Written consent was required from each parent. The sample size, calculated with the formula e2 p q/i2 with a hospital prevalence of 3% and an accuracy of 5%, was 45. In total, 107 children were monitored during the study period. There were 88 eligible accompanying persons, of whom 69 (78%) participated, while 19 were excluded for refusal or unavailability of the parent or interpreter. The interview consisted of three items:
sociodemographic data of the accompanying persons: identity, place of residence, education level;
characteristics of the announcement of the diagnosis and treatment, which provided information on: the general frame-work of the announcement, the actors, the content of the information, and the difficulties encountered;
information about the sick child;
we added a comments section to allow families to express themselves freely.
The data were entered using the software Excel 6.0 (Microsoft). Statistical analysis was performed using the software Epi info version 7. A descriptive analysis was carried out initially. Links between the answers obtained regarding information to the child and the characteristics of the interviewees were examined by means of a chi-squared test. The significance threshold was set at 5%.
The average duration of the interview with and without an interpreter was 45 min and 30 min, respectively. The limits for participation in the survey with regard to the date of diagnosis varied from 2 to 13 months with an average of 5.35 months. The characteristics of the interviewees and their children are reported in Table 1 and Table 2.
Characteristics of interviewees.
Characteristics N (%)
3.1. Individuals benefiting from the announcement
3.2. Place of the announcement