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Children Receiving Chemotherapy at Home: Perceptions of Children and Parents

University of Toronto, and Signy Hildur Eaton Chair in Paediatric Nursing Research, SickKids, Toronto, Ontario, Canada, b.stevens{at}utoronto.ca

Patricia McKeever, RN, PhD

CIHR Strategic Training Programme in Health Care, Technology and Place, University of Toronto

Madelyn P. Law, MA

University of Toronto and SickKids

Marilyn Booth, MHSc, RN

Child Health Systems, SickKids

Mark Greenberg, OC, MBChB, FRCP(C), FAAP

University of Toronto, and POGO Chair Childhood Cancer Control, University of Toronto

Stacey Daub, BA, RN

client services, Toronto Community Care Access Centre

Amiram Gafni, PhD

Centre for Health Economics & Policy Analyses, Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario

Janet Gammon, BScN, RN

Hematology & Oncology Programme, SickKids

Janet Yamada, MSc, RN

nursing research associate, SickKids

Iris Epstein, MN, RN

University of Toronto

The aim of this descriptive exploratory study was to determine the perspectives of parents and children with cancer on a home chemotherapy program. Qualitative analyses were used to organize data from 24 parents and 14 children into emerging themes. Themes included (1) financial and time costs, (2) disruption to daily routines, (3) psychological and physical effects, (4) recommendations and caveats, and (5) preference for home chemotherapy. When home chemotherapy was compared with hospital clinic-based chemotherapy, parents reported fewer financial and time costs and less disruption to their work and family schedules, and children reported more time to play/study, improved school attendance, and engagement in normal activities. Although some parents felt more secure with hospital chemotherapy, most found it more exhausting and stressful. At home, children selected places for their treatment and some experienced fewer side effects. Although some coordination/communication problems existed, the majority of parents and children preferred home chemo-therapy. Home chemotherapy treatment is a viable, acceptable, and positive health care delivery alternative from the perspective of parents and children with cancer.

Key Words: home care • chemotherapy • pediatric oncology

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