Health literacy variables related to parents' understanding of their child's cancer prognosis.

BACKGROUND: Obtaining an accurate understanding of a child's cancer prognosis can help parents make informed decisions about treatment. Research has shown that parents tend to overestimate their child's cancer prognosis relative to physicians. Thus, we examined whether the content of physician communication, parent sources of medical information, and parent demographic factors affected the association between oncologist and parent estimates of a child's cancer prognosis. PROCEDURE: Families were recruited 3-8 weeks after a child's new diagnosis or relapse of cancer. Parents (77 mothers; 42 fathers) completed questionnaires regarding their sources of medical information, age, and education. The child's oncologist reported on the content of their communication with parents regarding prognosis. Parents and oncologists estimated the child's chance of 5-year survival using a visual-analogue scale.
RESULTS: Mothers and fathers reported a more favorable prognosis for their child, which was on average about 30% higher than oncologists. Time since diagnosis was correlated with less discrepancy between physician and mother prognosis ratings, with a similar trend noted for fathers. Agreement between oncologists and parents was better for younger fathers, but it was unrelated to physician communication, sources of medical information, or other demographic factors.
CONCLUSIONS: Fathers' age may be important to their understanding of their child's cancer prognosis, but we did not find support for other factors related to prognosis literacy. Given the homogeneity of our sample, future research should assess differences in parents' prognosis knowledge across cancer diagnosis, race, ethnicity, and socioeconomic status (SES), which may aid in developing interventions to improve parent understanding.