{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:29:37Z","timestamp":1789565377752,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Information exchange is a core component of communication that has been understudied globally. This study sought to examine eight core functions of communication, including information exchange, among caregivers of children with cancer in Pakistan, a middle-income country with &amp;gt;8,000 new cases of childhood cancer each year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional survey was administered to 200 caregivers of children with cancer at two major centers in Pakistan. Surveys contained socio-demographic characteristics and questions related to priorities and experiences for communication and information exchange. Surveys were verbally administered from March-November 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While over 90% of caregivers prioritized all eight functions of pediatric cancer communication, significantly fewer (p&amp;lt;0.001) experienced each function. Caregivers wanted to know likelihood of cure (99.5%) and late effects (97%), but how they wanted to receive information varied. Most caregivers (&amp;gt;90%) understood what type of treatment their children would receive; fewer correctly identified diagnosis (77%), location (81%), or treatment duration (71%). Caregivers of patients with leukemia were more likely to have a complete understanding of their child\u2019s diagnosis and treatment (p&amp;lt;0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pakistani caregivers express many of the same communication needs noted in other settings, with similar challenges and larger gaps in care. Interventional work should focus on maximizing human resources, ensuring complete information exchange, and empowering caregivers.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1616467","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T04:16:50Z","timestamp":1757391410000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Communication practices and information exchange for caregivers of children with cancer in Pakistan"],"prefix":"10.3389","volume":"15","author":[{"given":"Dylan E.","family":"Graetz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Wardell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambreen","family":"Hameed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afia","family":"tul Quanita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atoofa","family":"Najmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safwan","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Shafiq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Naheed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shabnam","family":"Munir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gia","family":"Ferrara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Staples","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meenakshi","family":"Devidas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Rodriguez-Galindo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sima","family":"Jeha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer W.","family":"Mack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Ahmer Hamid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alia","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Rafie Raza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3028","article-title":"Parental trust in health care\u2013a prospective study from the Children\u2019s Cancer Hospital in Egypt","volume":"22","author":"El Malla","year":"2013","journal-title":"Psychooncology"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28399","article-title":"Care experiences that foster trust between parents and physicians of children with cancer","volume":"67","author":"Mack","year":"2020","journal-title":"Pediatr Blood Cancer"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2015.0472","article-title":"Don\u2019t try to cover the sky with your hands\u201d: parents\u2019 Experiences with prognosis communication about their children with advanced cancer","volume":"19","author":"Nyborn","year":"2016","journal-title":"J Palliat Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5725","article-title":"Understanding hope at diagnosis: A study among Guatemalan parents of children with cancer","volume":"12","author":"Williams","year":"2023","journal-title":"Cancer Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2009.57","article-title":"Peace of mind and sense of purpose as core existential issues among parents of children with cancer","volume":"163","author":"Mack","year":"2009","journal-title":"Arch Pediatr Adolesc Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24360","article-title":"Measuring therapeutic alliance between oncologists and patients with advanced cancer: the Human Connection Scale","volume":"115","author":"Mack","year":"2009","journal-title":"Cancer"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30909-4","article-title":"Estimating the total incidence of global childhood cancer: a simulation-based analysis","volume":"20","author":"Ward","year":"2019","journal-title":"Lancet Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135230","article-title":"Magnitude of treatment abandonment in childhood cancer","volume":"10","author":"Friedrich","year":"2015","journal-title":"PloS One"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33222","article-title":"Pediatric cancer communication in low- and middle-income countries: A scoping review","volume":"126","author":"Graetz","year":"2020","journal-title":"Cancer"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26727","article-title":"Communication in pediatric oncology: State of the field and research agenda","volume":"65","author":"Sisk","year":"2018","journal-title":"Pediatr Blood Cancer"},{"key":"B11","volume-title":"Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering [NIH Publication No. 07-6225]","author":"Epstein","year":"2007"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-1193","article-title":"Communication in pediatric oncology: A qualitative study","volume":"146","author":"Sisk","year":"2020","journal-title":"Pediatrics"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34160","article-title":"A proposed global framework for pediatric cancer communication research","volume":"128","author":"Graetz","year":"2022","journal-title":"Cancer"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1200\/GO.21.00232","article-title":"Communication priorities and experiences of caregivers of children with cancer in Guatemala","volume":"7","author":"Graetz","year":"2021","journal-title":"JCO Glob Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.5326","article-title":"Communication about prognosis between parents and physicians of children with cancer: parent preferences and the impact of prognostic information","volume":"24","author":"Mack","year":"2006","journal-title":"J Clin Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26818","article-title":"Predictors of treatment abandonment for patients with pediatric cancer at Indus Children Cancer Hospital, Karachi, Pakistan","volume":"65","author":"Siddiqui","year":"2018","journal-title":"Pediatr Blood Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1200\/GO.22.00124","article-title":"Development and adaptation of a patient-centered communication survey for parents of children with cancer in Guatemala","volume":"8","author":"Graetz","year":"2022","journal-title":"JCO Glob Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.6110","article-title":"Hope and prognostic disclosure","volume":"25","author":"Mack","year":"2007","journal-title":"J Clin Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.32.0507","article-title":"Parents\u2019 roles in decision making for children with cancer in the first year of cancer treatment","volume":"29","author":"Mack","year":"2011","journal-title":"J Clin Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2017.02.011","article-title":"Psychometric evaluation and design of patient-centered communication measures for cancer care settings","volume":"100","author":"Reeve","year":"2017","journal-title":"Patient Educ Couns"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30685","article-title":"Designing and validating novel communication measures for pediatric, adolescent, and young adult oncology care and research: The PedCOM measures","volume":"70","author":"Sisk","year":"2023","journal-title":"Pediatr Blood Cancer"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1393908","article-title":"Functions of patient-and family-centered pediatric cancer communication in Pakistan. Original research","volume":"14","author":"Graetz","year":"2024","journal-title":"Front Oncol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2016.013334","article-title":"Assessing patient-centered communication in cancer care: measures for surveillance of communication outcomes","volume":"12","author":"Street","year":"2016","journal-title":"J Oncol Pract"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21703","article-title":"The guardians\u2019 perspective on paediatric cancer treatment in Malawi and factors affecting adherence","volume":"51","author":"Israels","year":"2008","journal-title":"Pediatr Blood Cancer"},{"key":"B25","article-title":"Challenges of children with cancer and their mothers: A qualitative research","volume":"19","author":"Reisi-Dehkordi","year":"2014","journal-title":"Iranian J Nurs midwifery Res"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.04.078","article-title":"The day one talk","volume":"22","author":"Mack","year":"2004","journal-title":"J Clin Oncol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1200\/edbk_238181","article-title":"Effective communication for newly diagnosed pediatric patients with cancer: considerations for the patients, family members, providers, and multidisciplinary team","volume":"39","author":"Dobrozsi","year":"2019","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.neo.2022.100851","article-title":"Interdisciplinary care of children with diffuse midline glioma","volume":"35","author":"Coleman","year":"2023","journal-title":"Neoplasia"},{"key":"B29","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1200\/OP.22.00471","article-title":"Care fragmentation, faulty communication, and documentation lapses derail a treatment plan","volume":"19","author":"Roberts","year":"2023","journal-title":"JCO Oncol Pract"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2023-002481","article-title":"Improving handoff with the implementation of I-PASS at a tertiary oncology hospital","volume":"12","author":"Franco Vega","year":"2023","journal-title":"BMJ Open Qual"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1616467\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T04:16:51Z","timestamp":1757391411000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1616467\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":30,"alternative-id":["10.3389\/fonc.2025.1616467"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1616467","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]},"article-number":"1616467"}}