Parents' opinions an the advantages and disadvantages of a pediatric oncology day hospital.

Aim. - The aim of this study was to assess parental opinions on the advanta ges and disadvantages of a pediatric oncology day hospital (DH) so that the structure can be better adapted to the children's needs and parents' expec tations and provide a potentially valid alternative to conventional hospita lization (CH). Methods. - Over a 15-day period, 39 parents of children treated at a DH wer e approached and asked to fill in a questionnaire on their opinion of the a dvantages and disadvantages of a DH compared to a CH. Results. - The results of this survey were significant The majority of pare nts preferred the DH to the CH (69% versus 15%). The illness was perceived as being less severe; and as the child was not continually in the CH contex t, he/she was able to forget the illness and the hospital to some extent, a nd was therefore not as anxious. The DH appeared to be better adapted to th e child's needs and facilitated the pursuit of normal family life and every day activities, but imposed constraints on social and professional activiti es. On the other hand, the CH provided a reassuring treatment context inclu ding more comprehensive information, and in particular a better integration of the child and careful monitoring of the disease within the oncology dep artment, and closer relations between the different parents visiting the ho spital. In spite of the high preference rate for the DH, in some instances certain disadvantages could outweigh the advantages, e.g., fatigue due to j ourneys to and from the hospital, or living too far away from the DH; a lac k of punctuality which meant that the parents were unable to plan their day with any certainty; insufficient comfort (noise, a limited number of rooms available); inadequate information; a lack of privacy; and the anxiety con nected with having to assume too much responsibility Conclusion. - Overall, if was concluded that the parents appeared to apprec iate the aims of the DH (i.e., limiting the treatment constraints imposed o n the patient and on the parents themselves, thereby maintaining the qualit y of family life, assuring adequate treatment, reducing cost of treatment). However, the authors consider that the DH has to be organized in such a wa y that it takes into account the following: the social aspects, i.e., livin g conditions, parents' social, economic and professional status; parents' a nd children's psychological traits, expectations; and access to a local car e system. The DH should also have sufficient means and staff at its disposa l. Without taking these factors into consideration, the DH and other altern atives to the CH will not be able to adequately care for the patients, or m eet the parents' expectations, and may even have a negative effect on the f amily. (C) 2000 Editions scientifiques et medicales Elsevier SAS.