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Objective: The announcement of a resistance to treatment in pediatric oncology occurs within the framework of an established parent-pediatrician relationship. The aim of this study was to understand the parents' experience of this announcement and the relational and communicational factors likely to impact it., Method: A mixed-methods study was conducted in a pediatric oncology department with 15 parents of a child with treatment-resistant cancer, with an average age of 40.8years. The parents completed three questionnaires to assess their anxiety and depression (HADS) and their information needs (EORTC - QLQ Info 25 and PTPQ). Semi-structured interviews were conducted and a content analysis was performed., Results: The majority of parents have "suspected" or "proven" anxiety and/or depressive disorders. The experience of this announcement was influenced by the quality of the parent-pediatrician relationship, the perceived quality of the management, the anticipation of the announcement, the context of the announcement, and the experience of previous announcements. The parents interviewed were very satisfied with the informational exchanges. This satisfaction was underpinned by honest communication and by the responsiveness and availability of the pediatricians., Discussion: The establishment of a relationship of trust between the family and the pediatrician throughout the course of care plays a major role in the parents' experience of the announcement of resistance to treatment., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: The announcement of treatment resistance is a key moment in the management of children treated for cancer. Although nurses are present at various stages of this announcement, few studies have examined their role and experience. This study proposes to enhance understanding of the experience of nurses at this time of the pediatric cancer trajectory in France., Method: A qualitative study was conducted in two pediatric oncology departments. Semi-structured research interviews were conducted with seven pediatric nurses (five women) with an average age of 36.9 years., Results: Nurses report not being systematically present during announcements of treatment resistance but being present with the families before and after these announcements. Nurses described their role at this point in the management process as multifaceted. The emotional burden associated with these announcements is significant: nurses must manage their own emotions when faced with the discovery of resistance to treatment, those of the families, and must often answer difficult questions about the prognosis or end of life. In this context, teamwork is an important support., Discussion: Better awareness and recognition of the role of nurses and the associated emotional burden would enable them to fully carry out their missions., (Copyright © 2022 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Psycho-oncology is evolving in line with oncology progress and increasing complexity, but also with change in cancer care organization. Alongside the more traditional psycho-oncological interventions, such as the support or verbal psychotherapy of various inspirations (psychodynamic, integrative, systemic, existential) and body-mediated approaches, that allow the patient to be accompanied throughout his/her cancer care trajectory, psycho-oncology is now benefiting from the development of more structured interventions, often brief and targeted at a specific situation or symptom. This article reviews three of these new psychotherapeutic approaches, which are largely developed in the Anglo-Saxon world: the management of fear of recurrence by CBT third wave strategies, ACT therapy or, more recently, EMDR to answer to psychotraumatic situations. We describe here the principles, the main indications in oncology patients and the expected clinical benefits. It also presents tools such as Questionnaire Prompt Lists for optimizing the communication between patients and health professionals, which constitute a psychotherapeutic intervention by itself., (Copyright © 2022. Published by Elsevier Masson SAS.)

This literature review aims to explain how the emotions aroused by the announcement of bad news in pediatric oncology affect communication between parents and pediatric oncologists. In the first part, we summarize the parents' expectations regarding communication with the pediatrician at this critical time in their child's care. Then, in a second part, we specify the influence that the emotions of pediatric oncologists and parents during these announcements can have on parent-pediatrician communication. In this context, the emotions and defense mechanisms of pediatric oncologists, parental distress as expressed by parents and as perceived or feared by pediatricians, are discussed. For this synthesis, we have endeavoured to select studies including both mothers and fathers. On the basis of the observations carried out in this review, we conclude by suggesting avenues for the practical implications and for future research. The continuation of research including both parents appears necessary to allow for a closer adaptation of the reactions and needs of each parent, particularly at key moments in the child's care, such as the announcement of bad news. Encouraging exchanges on the emotions felt within the medical and care team, particularly with the department psychologist, could be an opportunity for pediatricians to question their experience of the announcement of bad news and could promote the circulation of emotions in the parent-pediatrician relationship and communication., (Copyright © 2021 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)