Date of Graduation

1990

Document Type

Dissertation/Thesis

Abstract

Investigations of treatment compliance among pediatric cancer patients have indicated that noncompliance to treatment is a significant problem in this population. Some researchers have suggested that compliance to treatment may be significantly influenced by the complexity of the treatment regimen. The purpose of this investigation was to: (a) develop and assess the efficacy of a prospective parent self-monitoring measure to assess compliance to the entire treatment regimen, (b) develop two physician-completed measures to assess the complexity of childhood cancer treatment regimens, and (c) investigate the relationship between current and overall medical regimen complexity and compliance to treatment among a sample of pediatric oncology patients. Parents of children currently under going treatment for cancer self-monitored treatment delivery during one randomly assigned week each month for four months. The accuracy of parent-recording was assessed by comparing self-monitoring reports with two measures of medication administration and clinic records of attendance at scheduled outpatient clinic appointments and hospital admissions. Measures of treatment complexity were developed to assess the complexity of treatment administered during the investigation interval (the CTCQ) and to assess overall treatment complexity (the OTCQ) by interviewing pediatric oncologists and pediatric oncology nurse specialists about factors that influence the complexity of treatment. Parent compliance with the self-monitoring task was excellent (97%), and mean reported compliance with all areas of treatment was high. Agreement between parent-report of treatment administration and accuracy measures of adherence was moderate to high. The highest agreement was found between parent report and patient records of outpatient clinic attendance, while the lowest agreement was found between parent report of hospital admissions and medical chart review. The convergent validity of the CTCQ and OTCQ was investigated by correlating physician global ratings of current and overall treatment complexity with total current and overall treatment complexity scores. Correlations between physician ratings and total CTCQ and total OTCQ scores were moderately high. No significant relationships emerged between overall and current treatment complexity and compliance to treatment.

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