Patterns Identified in Parents’ Cancer Disclosure Practices

BACKGROUND: Family-centered care is fundamental in pediatric oncology, emphasizing holistic support for both the patient and their family throughout the cancer journey. However, disclosing a cancer diagnosis remains a complex and culturally sensitive process, with practices varying and being influenced by multiple factors. OBJECTIVES: This study aimed to explore parental disclosure patterns in children with cancer and identify influencing factors from both parent and child perspectives. METHODS: A descriptive qualitative study was conducted at a Chinese national children's medical center. Parents and children were recruited and interviewed, with data analyzed using thematic analysis to identify disclosure patterns and content analysis to explore influencing factors. RESULTS: Thirty-three participants (23 parents and 10 children) from 23 families were interviewed. Five distinct disclosure patterns were identified: "sharing it honestly," "revealing it gradually," "waiting for the right time," "keeping it to oneself," and "remaining silent indefinitely." Guided by the Social-Ecological Framework, we found disclosure patterns were influenced by individual (disease-related, child-related, and parental factors), interpersonal (family dynamics and close relationships), institutional (providers, care settings, and community), and societal (cultural norms and practice guidelines) factors. CONCLUSIONS: This study reveals the diverse and culturally influenced patterns of parental cancer disclosure, shaped by multilayered factors. Future research should focus on deepening understanding of these dynamics and identifying key elements to inform tailored interventions. IMPLICATIONS FOR PRACTICE: Healthcare providers can support families by tailoring approaches to disclosure patterns, addressing barriers, and fostering open communication, while advocating for culturally sensitive guidelines to strengthen parent-child relationships and provide quality care.