Decisional Regret After Initial Treatment Decisions Among Parents of Children With Cancer

Key Points

  • Minority parents of children with cancer were more likely to have decisional regret than white parents.
  • Receipt of high-quality information and trust in the oncologist were associated with a reduced risk of regret.

Racial/ethnic minority parents were more likely to express regret about initial cancer treatment decisions for their children, according to a study reported in the Journal of Clinical Oncology. Mack et al found that factors associated with less decisional regret included receiving high-quality information and detailed prognostic information as well as trust in the oncologist.

Study Details

The study consisted of a survey of 346 parents of children with cancer within 12 weeks of their initial cancer treatment decision and the children’s physicians at Dana-Farber Cancer Institute/Boston Children’s Hospital and The Children’s Hospital of Philadelphia. The primary outcome measure was heightened regret measured by the Decisional Regret Scale.

Factors Associated With Regret

Overall, 54 parents (16%) met the criteria for heightened decisional regret. In multivariate analysis, race/ethnicity was associated with regret, with black (odds ratio [OR] = 6.55, 95% confidence interval [CI] = 2.30–18.7), Hispanic (OR = 2.15, 95% CI = 0.69–6.65), and ‘other race’ parents (OR = 4.68, 95% CI = 1.58–13.8) having a higher risk of regret vs white parents (P = .001 across categories). Regret was less likely to be expressed by parents who reported receiving high-quality information (OR = 0.45, P = .03) and detailed prognostic information (OR = 0.48, P = .04), who expressed complete trust in the oncologist (OR = 0.32, P = .001), and who held their own ideal role in decision-making (OR = 0.49, P = .04).

The investigators concluded: “Although many parents are satisfied with decisions made for their children with cancer, racial and ethnic minority parents are at heightened risk for regret. Clinicians may be able to reduce this risk by providing high-quality information, including prognostic information, involving parents in decision making in the ways they wish, and serving as trusted providers.”

The study was supported by an American Cancer Society Mentored Research Scholar Grant and an American Society of Clinical Oncology Career Development Award.

Jennifer W. Mack, MD, MPH, of the Dana-Farber Cancer Institute, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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