Physician/nurse attitudes and treatment adherence in children with cancer: A pilot study and new instrument

A new instrument designed to assess the treatment team's attitudes towards individual families was field tested to assess its correlation with missed appointments. We hypothesized that positive attitudes about families would be associated with high treatment adherence as measured by appointment keeping. The oncologists rated ease of working with parents, estimated appointment adherence and child's degree of illness in 18 children being treated for cancer. The 35 cohabitating parents were assessed for marital discord and parental-estimated appointment adherence. Actual appointment adherence was determined by clinic chart review. Physician-estimated adherence varied systematically with each physician and degree of the patient's morbidity. Factors related to actual adherence include: physician's discomfort in working with parents, father's estimate of home-treatment adherence, with a statistical trend for distance travelled to be inversely related to adherence. Neither marital discord nor parent-estimated adherence was related to appointment adherence. Results are discussed in terms of implications for facilitating adherence.