When a child is given a terminal cancer diagnosis, their parents want to be included in decisions about care. They have to make choices repeatedly depending on how their child responds to treatment, which can lead to decisional regret. It may be beneficial for healthcare providers to gain a better understanding of parents’ priorities and values while making treatment decisions to facilitate more fruitful conversations with parents and develop more comprehensive strategies for supporting this group of families. The goal of this study was to better understand the factors that influence parents’ decision-making when it comes to their children’s cancer-directed therapy for a disease with a dismal prognosis. Following the guidelines laid out by the Joanna Briggs Institute, a comprehensive literature search was done, including a thorough examination of systematic reviews of qualitative, quantitative, and mixed methodologies studies. Articles were evaluated if they contained parents whose children were under the age of 18 when they received cancer-directed therapy for a childhood malignancy with a poor prognosis. There were 4 online resources investigated (CINAHL, Medline, PsychINFO, Web of Science Core Collections). All cited references and bibliographies from the full-text publications were also combed through. Synthesis and theme development were accomplished using summative content analysis. A total of 12 pieces of writing were included. Hope for a cure, dread of their kid dying, and uncertainty all played a role in parents’ decision-making. The perspectives of others, the child’s wishes, and religious or spiritual convictions were all viable sources of guidance in making decisions. Being a good parent, having a say in important matters, and having plenty of free time were highly prized by parents. People had different priorities within these principles, which might lead to tension and “trade-offs” when making choices. In childhood cancer cases with a bad prognosis, parental decision-making is nuanced and goes beyond simple values and preferences. While both parents have the same core beliefs and values, their individual perspectives and priorities shape the final outcome. When parents desire to keep their child on cancer-directed therapy but are also concerned about their child’s quality of life, they may find themselves at odds with themselves.

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03635-1

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