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 tow ards individual families was field tested to assess its correlation wi th 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 pa rents, estimated appointment adherence and child's degree of illness i n 18 children being treated for cancer. The 35 cohabitating parents we re assessed for marital discord and parental-estimated appointment adh erence. Actual appointment adherence was determined by clinic chart re view. Physician-estimated adherence varied systematically with each ph ysician and degree of the patient's morbidity. Factors related to actu al adherence include: physician's discomfort in working with parents, father's estimate of home-treatment adherence, with a statistical tren d for distance travelled to be inversely related to adherence. Neither marital discord nor parent-estimated adherence was related to appoint ment adherence. Results are discussed in terms of implications for fac ilitating adherence.