br The findings of this study revealed that
The findings of this study revealed that families with hospitalized children with cancer require social support. Parents considered parent-to-parent support as helpful, reliable, and comforting. They expressed their desire to interact with other families facing similar ex-periences. Exchange of useful and practical information has been identi-fied as an important element of parent-to-parent support (Law, King, Stewart, & King, 2001; Sullivan-Bolyai & Lee, 2011). Another study fur-ther revealed that shared experience fostered a sense of belonging and support, enhanced the confidence of families to cope with the situation, and reduced their sense of isolation (Law et al., 2001).
The present and previous studies suggested that perceived similarity of experiences and mutuality of support formed the basis of an equitable parent-to-parent connection. Common experiences may enable families to fully understand each other and accept thoughts and behaviors with-out judgment. Self-help groups, the most common parent-to-parent connection, are becoming increasingly popular in North America and the UK (Law et al., 2001). Parent-to-parent connection offers a unique form of support that may complement nursing services to a certain ex-tent. However, in this study, there was only one informal self-help group in one of the four participating oncology departments. Future studies are warranted to identify the obstacles for the establishment of a self-help group, and connect families for mutual support.
Not disclosing unfavorable information
As evident with this theme, parents shielded their hospitalized chil-dren and other family members from unfavorable information, as well as avoiding discussions with friends. In BAY-598 to the UK and USA, the disclosure of the diagnosis of cancer to children is rare in China (Parsons et al., 2007). This is similar to the practice observed in Japan, where parents prefer to withhold the truth regarding diagnosis (Watanabe, Nunes, & de Abreu, 2014). Usually, pediatric oncologists rely on parents to make a decision regarding the timing, method, and type of information to be shared with their children. However, a num-ber of parents did not wish to disclose the diagnoses to their children. In present study, parents felt that their children would be unable to comprehend the provided information. The proportion of parents who
were hesitant to disclose information was not determined in this study, and depended on the age of the patient. This is consistent with a study conducted in Japan, where disclosure of the diagnosis by the parents depended on the age of their children and level of development (Watanabe et al., 2014). Overall, the decisions made by parents regard-ing the disclosure of information related to the disease appeared to be influenced by their perceptions of their children's maturity.
In China, the treatment environment may not facilitate the non-disclosure requests by parents because the hospital departments are often identified with the terms ‘oncology’ or ‘hematology’. Hospitalized children may infer the diagnosis from information, such as the name of the department. This may not necessarily protect them from fear or worry. On the contrary, it may result in a misunderstanding that the ill-ness is a dangerous secret that should not be discussed. A previous study found that the psychological adjustment of children and their families could be improved by disclosing the diagnosis in the early stages of the treatment (Slavin, O'Malley, Koocher, & Foster, 1982). Discussing a life-threatening illness with children is a complex task. A suggested ap-proach is to involve the children in the parent-doctor communications. This allows the doctor to deliver the news to the child in the presence of the parents. However, the personal preferences of parents need to be respected. Permanent change of practice or advice without careful con-sideration of the clients' readiness may lead to strong resistance or neg-ative emotional responses. Additional studies investigating the effect and implications of not disclosing unfavorable information as a coping strategy are warranted. Such studies would inform clinicians regarding the direction to follow, and help them advise parents accordingly.