Parental role in paediatric cancer treatment decision making at Tikur Anbessa Specialized Hospital, Ethiopia: A mixed method study

Background: Parental preferences for involvement in treatment decision-making (TDM) in pediatric oncology can vary among passive, collaborative, and active roles, influenced by various factors.This study investigates the parental role in TDM for children with cancer in Ethiopia and identifies the key determinants of this role.Methods: This research employs a mixed-methods approach, combining a cross-sectional survey and phenomenological interviews.A total of 167 parents of children with cancer participated in the survey, utilizing the Control Preference Scale for Pediatrics (CPS-P) and the Krantz Health Opinion Survey (KHOS) to assess parental roles in TDM.Additionally, 11 in-depth interviews were conducted with selected parents.Logistic regression and thematic analysis were used to analyze the quantitative and qualitative data, respectively.Results: The findings reveal that Ethiopian parents predominantly prefer a passive role in TDM.Trust in healthcare providers and parental information preferences emerged as statistically significant predictors of this passive involvement.Other factors influencing parental decision-making included the quality of the parentprovider relationship, the child's clinical condition, parental beliefs about TDM, and knowledge of cancer.Conclusions: This study offers valuable insights into the parental role in TDM within Ethiopian pediatric oncology care, an area previously unexplored.Understanding parents' preferences in TDM is crucial for Ethiopian healthcare providers to align communication and amplify patient voices.The findings highlight the need to promote more active parental involvement in TDM by facilitating educational sessions, developing parental education guidelines, and providing accessible cancer information across diverse regions of the country.