Towards understanding problems in the parent-practitioner relationship when a child has cancer: meta-synthesis of the qualitative literature.

OBJECTIVE: This review aimed to synthesise qualitative research on problems in the parent-practitioner relationship in childhood cancer, to understand how these problems arise, how they are conceptualised and how they might be resolved.

METHODS: A systematic search of five electronic databases identified 2863 articles. After screening, 81 full text papers were assessed for eligibility, and four were included in the review. Six further papers were identified through searching reference lists and citation tracking. Synthesis of these 10 papers drew on the meta-study approach, involving analysis, comparison and integration of findings, methods and theoretical influences.

RESULTS: All papers but one conceptualised problems in the parent-practitioner relationship as conflict or relational problems, attributing these to differences between parents and practitioners in roles and perspectives, or in power and authority. The remaining paper focussed on parents' emotional needs as the basis for relationship problems. Our approach to synthesis exposed researchers' prior assumptions and the influence of these on the methods, analysis and findings of the studies.

CONCLUSIONS: The current literature gives little attention to how interpersonal problems with practitioners may reflect the emotional needs of parents. Understanding these problems as an expression of the distress and fear parents experienced because of their child's condition may offer new ways of helping parents. Future research needs to address the limitations of previous studies, including ensuring that the study design and analysis allow contextual factors and intrapersonal factors to be explored, and that researchers are open to their perspectives being altered by their data.