Health Care Providers In Response Research Articles

Patients’ Emotional Talk During Surveillance Cystoscopy for Non-muscle Invasive Bladder Cancer: Opportunities for Improving Communication

ObjectivesTo examine the emotional communication that takes place between patients and healthcare providers (HCPs) during surveillance cystoscopy for non-muscle invasive bladder cancer (NMIBC). MethodsParticipants were 57 patients with a diagnosis of NMIBC attending for surveillance cystoscopy and 10 health care professionals (HCPs). Cystoscopy procedures were audio-recorded and transcribed verbatim. Two approaches to analysis of transcriptions were undertaken: (1) a template analysis; and (2) Verona Coding Definitions of Emotional Sequences. ResultsCommunication during cystoscopy generally comprised of ‘social/small talk’, ‘results of the cystoscopy’ and ‘providing instructions to the patient’. Emotional talk was present in 41/57 consultations, with 129 emotional cues and concerns expressed by patients. Typically patients used hints to their emotions rather than stating explicit concerns. The majority (86%) of HCPs responses to the patient did not explicitly mention the patient’s emotional concern or cue. Urology trainees were less likely than other HCPs to provide space for patients to explore their emotional concerns (t=-1.78, p<0.05). ConclusionsEmotional communication was expressed by the majority of patients during cystoscopy. While all HCPs responded to patients’ emotional communication, there were a number of missed opportunities to ‘pick-up’ on patients’ emotional cues and improve communication. Urologists need to be aware of the nuances of patients’ emotional communication. Learning to identify and respond appropriately to emotional cues may improve communication with patients.

Framework for Classifying Explainable Artificial Intelligence (XAI) Algorithms in Clinical Medicine.

Artificial intelligence (AI) applied to medicine offers immense promise, in addition to safety and regulatory concerns. Traditional AI produces a core algorithm result, typically without a measure of statistical confidence or an explanation of its biological-theoretical basis. Efforts are underway to develop explainable AI (XAI) algorithms that not only produce a result but also an explanation to support that result. Here we present a framework for classifying XAI algorithms applied to clinical medicine: An algorithm's clinical scope is defined by whether the core algorithm output leads to observations (eg, tests, imaging, clinical evaluation), interventions (eg, procedures, medications), diagnoses, and prognostication. Explanations are classified by whether they provide empiric statistical information, association with a historical population or populations, or association with an established disease mechanism or mechanisms. XAI implementations can be classified based on whether algorithm training and validation took into account the actions of health care providers in response to the insights and explanations provided or whether training was performed using only the core algorithm output as the end point. Finally, communication modalities used to convey an XAI explanation can be used to classify algorithms and may affect clinical outcomes. This framework can be used when designing, evaluating, and comparing XAI algorithms applied to medicine.

Factors Related to Drug Overdose Deaths in Ohio

Background: Drug overdoses have had a devastating impact on public health in Ohio. Improving our understand-ing of the relationships between factors that are associated with drug overdose deaths can enhance the quality of public policy and health care reach in Ohio. Methods: Utilizing data from the Centers for Disease Control and Prevention (CDC) and University of Wisconsin Population Health Institute, this research seeks to quantify the associations between the drug overdose rate for counties in Ohio with various factors via statistical regressions. Results: The overwhelming majority of drug/alcohol overdose deaths during the years 2017-2019 were uninten-tional. Drug overdose deaths and life expectancy are strongly associated. Communities with higher overdose rates have lower life expectancies. Socioeconomic status and health care factors, such as mental distress and physical inactivity, are significantly correlated with increased drug overdose deaths. Household income is significantly correlated with increased access to health care, implying that communities of lower socioeconomic status may lack adequate access to quality care and suffer from increased overdose deaths. Conclusion: The data indicate the importance of access to health care and health care providers in response to drug overdoses in Ohio. Health care access is currently proportional to income; higher income households have a greater proportion of insured, as well as a greater number of primary care physicians. Thus, implementing policies that support health care infrastructure should be prioritized to increase the capacity of treatment in under-resourced (low-income and low socioeconomic status) communities.

The Impact of Cancer Relapse and Poor Patient Outcomes on Health Care Providers Practicing in the Oncology Field.

Devastating cancer-related events are not uncommon, and these events have weakened communication performance and induced stress among health care providers (HCPs), particularly physicians. This study aimed to investigate the perspective of HCPs emotionally affected by poor clinical outcomes due to the failure of cancer therapy. A cross-sectional, online survey was conducted over 3months among HCPs practicing in the field of oncology in Saudi Arabia, comprising physicians, pharmacists, and nurses. Data were analyzed using Statistical Package for Social Sciences version 26.0. A P-value <.05 was considered statistically significant. This study demonstrated a positive correlation between HCPs' length of experience and emotional impact of treatment failure, albeit this was not statistically significant (P = .071). Analysis of their perspective toward failure of cancer therapies revealed a significant impact of occupation and sex (P = .014 and P = .047, respectively). Moreover, occupation played a significant role in shaping the viewpoint of HCPs toward the need for conducing further research to test the appropriateness of treatment protocols on local patients (P = .022). Despite the emotional responses of HCPs to suboptimal clinical outcomes, factors such as work burnout, lack of concentration and patience, work or personal problems, and under appreciation were frequently identified as triggers of such outcomes. Our results revealed that poor clinical outcomes observed among cancer patients are emotional triggers for HCPs practicing in the oncology field. The emotional response is often perceived negatively, and can potentially lead to a decline in the quality of care provided to these patients.

Factors Affecting Patient Adherence to Inhalation Therapy: An Application of SEIPS Model 2.0.

This study aims to explore factors that affect patient adherence to inhalation therapy by applying a patient-centered approach. We conducted a qualitative study to identify the factors that influence adherent behaviors among asthma/COPD patients. 35 semi-structured interviews with patients, and 15 semi-structured interviews with healthcare providers (HCPs) who manage asthma/COPD patients were conducted. The SEIPS 2.0 model was applied as a conceptual framework for guiding the interview content and analysis of the interview data. Based on the findings of this study, a conceptual framework of patient adherence in asthma/COPD during inhalation therapy was constructed including five themes: person, task, tool, physical environment, and culture and society. Person-related factors include patient ability and emotional experience. Task-related factors refer to task type and frequency and flexibility. Tool-related factors are the type of inhalers and usability of inhalers. Physical environment-related factors include home environment and COVID-19 situation. Culture and social related factors consist of two aspects: cultural beliefs and social stigma. The findings of the study identified 10 influential factors that impact on patient adherence to inhalation therapy. A SEIPS-based conceptual model was constructed based on the responses of patients and HCPs to explore the experiences of patients engaging in inhalation therapy and interacting with inhalation devices. In particular, new insight about factors of emotional experience, physical environment and traditional cultural beliefs were found crucial for patients with Asthma/COPD to conduct patients' adherent behaviors.

Emergency Department Virtual Happy Hour: A Novel Approach to Peer Group Support During a Pandemic.

Introduction Communities responded to the coronavirus disease 2019 (COVID-19) pandemic with mandatory social-distancing regulations. Pandemic and disaster research shows that social isolation can often cause negative emotions and medical provider burnout. The primary objective of this study was to create and evaluate a novel wellness program, the Happy Hour Wellness Initiative (HHWI), based on peer support group concepts to foster resilience for emergency healthcare providers in response to a novel disaster. Methods The study was performed at a large emergency department with physicians, advanced practice providers, and staff invited to attend weekly "virtual happy hour" sessions. Participants individually opted into each of the six weekly sessions, with no obligation to attend. The program was designed based on the tenets of a peer support group and implemented by video conferencing. Participants completed a demographic questionnaire and answered open-ended questions after the six-session HHWI ended. Results Of the 40 survey respondents, 30% reported feeling stressed and 40% felt isolated at the early declaration of the pandemic. Regarding the HHWI, 90% of participants had no expectations from the HHWI, but 90% reported that their favorite part of the initiative was the feeling of togetherness. Most participants (95%) requested a continuation of the HHWI, even if not by a video-conferencing platform, and 90% reported feeling sad after the HHWI ended. Conclusion The emergency department HHWI was a welcome opportunity for employees to combat stress and anxiety brought on by the COVID-19 pandemic and social distancing. The initiative fostered team building, comradery, group advocacy, stress relief, and cheerfulness. The initiative was so greatly welcomed as a tool for wellness that almost all participants recommended that the HHWI should be available, not just in times of hardship, but year-round. The HHWI has provided a new approach to promote wellness in emergency care providers using a peer support group.

In ongoing efforts to vaccinate communities against COVID-19, pharmacists must address fear and misinformation

In ongoing efforts to vaccinate communities against COVID-19, pharmacists must address fear and misinformation

Intimate partner violence: What women can expect and what they really go through

Domestic abuse is a serious problem for married women in India (IPV). It is vital that women take use of accessible healthcare services if we want to lower the maternal death rate. Indian women's physical encounter with rape is examined in eight Empowered Action Group (EAG) states. For women living in EAG states, the rate of physical IPV is expected to be greater than in non-EAG states. The 2005-2006 India National Family Health Survey includes 65,587 women (NFHS-3). According to a logistic model, living in an EAG state lowers your risk of experiencing physical IPV in the last year. This is not what we expected. The best way to deal with domestic abuse is still up for debate among medical professionals. This article describes a review of qualitative research that aims to address the following two questions: How do women who have experienced domestic violence rate the treatment they get from medical professionals? Second, what do women who have been abused by their spouses seek from their healthcare providers in response to their disclosures?

Experiences, Challenges, and Coping Strategies of Frontline Healthcare Providers in Response to the COVID-19 Pandemic in Kelantan, Malaysia

IntroductionIn the fight against the COVID-19 pandemic, frontline healthcare providers who are engaged in the direct diagnosis, treatment, and care of patients face a high risk of infection and inadequate protection from contamination, overwork, frustration, and exhaustion. These impose significant psychological and mental health concerns for frontline healthcare providers.ObjectivesThis study aimed to explore the experiences and challenges faced and coping strategies adopted by frontline healthcare providers in response to the COVID-19 pandemic in Kelantan, Malaysia.MethodologyThis phenomenological approach to qualitative study used a telephone-based in-depth interview that followed a semistructured interview guide. The number of frontline healthcare providers was based on saturation theory. All the participants recruited fulfilled the inclusion and exclusion criteria from May to July 2020 in Raja Perempuan Zainab II Hospital. All interviews were audio recorded and transcribed verbatim. Thematic data analysis using NVIVO version 10 was performed.ResultThe 10 respondents involved in this study consisted of doctors, medical assistants, and nurses. The findings were divided into four main themes: invaluable experiences during the pandemic, challenges, coping strategies, and future expectations. The providers responded well in facing the disease even though they felt psychologically disturbed at the initial phase of the COVID-19 pandemic.ConclusionHealthcare providers perceived themselves as being more resilient and less vulnerable to psychological impacts than they were before the pandemic.

The needs of clients coming to counselling following second harm: A Q methodology study

AbstractSecond harm is the added psychological distress from an inadequate response by healthcare providers in response to medical errors or neglect. This inadequate response may require patients to seek counselling. The counselling needs of patients who have experienced second harm have received limited research attention. This Q methodology study addresses this gap in knowledge in order to further inform counselling practice.MethodsParticipants sorted 42 pre‐determined statements online followed by interviews to establish the rationale for the sorting pattern choices. Data from the online sort were analysed using factor analysis to establish the viewpoints expressed. The interview data added to the interpretation of the viewpoints.FindingsThrough a factor analysis, two ‘viewpoints’ and 11 counselling needs were identified. Nine of these needs were generic to the counselling relationship and two specific to second harm. This study concluded that people seeking counselling following second harm have needs beyond those expected from a general counselling relationship. These included not being blamed for what happened and a need for the counsellor to be able to demonstrate that they are able to understand the impact of harm.Implications for practiceThe needs identified in this study as being generic can give counsellors confidence in working with clients that have experienced second harm, knowing that many of the needs identified are not unique. Counsellors can also be confident that those needs that are unique can be understood through extending their knowledge of the topic and listening to those that have been harmed.

Childhood acute lymphoblastic leukemia treatment in an academic hospital in Kenya: Treatment outcomes and health-care providers' perspectives.

Early deaths and treatment nonadherence are major reasons for low childhood acute lymphoblastic leukemia (ALL) survival in low- and middle-income countries. This study assessed treatment outcomes of children presenting with ALL and evaluated perspectives of health-care providers (HCP) on ALL treatment at a Kenyan academic hospital. This was a combined retrospective medical records and cross-sectional questionnaire study. Treatment outcomes of 136 children diagnosed with ALL between 2010 and 2016 were collected. Questionnaires were completed by 245 HCP (response rate, 86%) between September and October 2016. Childhood ALL treatment outcomes were death (30%), progressive or relapsed disease (26%), abandonment (24%), and event-free survival (20%). Of all deaths, 80% were early deaths (prior or during induction), whereas 20% occurred in remission. Probability of event-free survival at three years was 18%. Only 57% of HCP believed childhood ALL can be cured, with more doctors (96%) than other HCP (45%) believing in curability of ALL (P<0.001). The majority of HCP (96%) thought that experienced doctors should put more time and effort into making parents understand the diagnosis and necessity to complete treatment. According to HCP, reasons for protocol nonadherence included parental financial difficulties (94%) and use of alternative treatment (79%). Event-free survival for ALL in Kenya is low. The primary reason for treatment failure is early death from treatment-related complications. More efforts should be directed toward improving supportive care strategies. In the opinion of HCPs, improved communication with parents and supervision of junior staff will improve ALL treatment outcomes.

Depressive symptoms among frontline and non-frontline healthcare providers in response to the COVID-19 pandemic in Kelantan, Malaysia: A cross sectional study.

BackgroundHealthcare providers are vulnerable in the fight against COVID-19 and may experience significant psychological and mental health consequences. This study aimed to compare the levels of depressive symptoms among frontline and non-frontline healthcare providers in response to the COVID-19 pandemic.MethodsA comparative cross-sectional study was conducted in two government hospitals managing COVID-19-related cases in Kelantan, Malaysia from May to July 2020 to identify and compared depressive symptoms levels of frontline and non-frontline healthcare providers. Convenient sampling was applied in the selection of eligible participants and those diagnosed as having any psychiatric illnesses were excluded. The self-administered questionnaires for the Malay versions of the Hospital Anxiety and Depression Scale to measure depressive symptoms score and the Medical Outcome Study Social Support Survey to measure social support score as an important confounder. A descriptive analysis, independent t-test and ANCOVA were performed using SPSS version 26.ResultsA total of 306 respondents from healthcare providers were recruited which 160 were frontline healthcare providers and 146 were non-frontline healthcare providers. The level of depressive symptoms (HADS score >8) was 27.5% for the frontline healthcare providers and 37.7% for the non-frontline healthcare providers. The mean depressive symptoms score for the non-frontline healthcare providers was 0.75 points higher than that of the frontline healthcare providers after adjusting for gender, duration of employment and social support.ConclusionNon-frontline healthcare providers are also experiencing psychological distress during the COVID-19 pandemic even though they do not have direct contact with COVID-19 patients.

Health care provider's responses to children's resistance to peripheral vein cannulation: A qualitative observational study.

Health care and treatment should be voluntary, but restraint is often used during treatment of children. Knowledge about how health care providers respond to preschool children's resistance is lacking and can help understand current paediatric care in hospitals. The aim of the present article was to provide knowledge about how healthcare providers respond to preschool children's resistance during the clinical procedure of peripheral vein cannulation. An explorative qualitative research design was developed for this study. Observations with video recording were used to collect data. Eight nurses and seven physicians participated in the study (n=15). Their responses to preschool children's (n=6) resistance were studied during 14 attempts of peripheral vein cannulation. Consolidated criteria for reporting qualitative research (COREQ) were used. The healthcare providers made 380 responses to children's resistive expressions, interpreted within four main types, responses to acknowledge the child, responses to distract the child, responses to persuade the child and responses to reject the child. All main types of responses were used by both nurses and physicians. Regardless of the amount of resistance the children expressed, all children received distracting and acknowledging responses. Rejecting responses were used approximately twice as much in the implementation phase as in the preparation phase. Distraction, persuasion and rejection began in the preparation phase and increased in the implementation phase. The main types and sub-types of responses showed how healthcare providers use a wide array of responses to meet children's resistance during peripheral vein cannulation. The results can enable health care providers to become aware of their own practices during peripheral vein cannulation and other clinical procedures and to elaborate on their use of responses that can be considered intrinsically less child-friendly.

What influences healthcare providers' prescribing decisions? Results from a national survey.

Prior U.S. Food and Drug Administration (FDA) surveys with healthcare providers (HCPs) have focused on attitudes toward direct-to-consumer advertising and have not specifically examined professionally-targeted prescription drug promotion. Similarly, there are no recent national surveys of HCPs examining their interactions with the pharmaceutical industry. The goal of this study was to use a national sample of HCPs to examine exposure to professionally-targeted prescription drug promotions and interactions with industry, and knowledge, attitudes and practices related to FDA approval of prescription drugs. An online national survey was conducted with 2000 HCPs representing primary care physicians (PCPs), specialists (SPs), physician assistants (PAs), and nurse practitioners (NPs). The sample was randomly drawn from WebMD's Medscape subscriber network, stratified by HCP group, and designed to yield target numbers of completed surveys in each group. Weights were computed to correct for unequal selection probabilities, differential response rates, and differential coverage and used to generalize completed surveys to a national population of PCPs, SPs, NPs, and PAs. Exposure and attention to pharmaceutical promotions and contact with industry were significantly associated with reported increase in pharmaceutical industry influence on decisions about prescription drugs. SPs were significantly more likely to prescribe off-label and serve as opinion leaders for the pharmaceutical industry compared to other provider groups. Findings indicate pharmaceutical promotions directed at HCPs occur in many forms and are disseminated through multiple channels. By using a nationally representative sample of HCPs, this study provides population-level estimates for exposure and attention to prescription drug promotion and contact with industry and evidence for their influence on prescriber decisions. Findings from this study will help to inform FDA of HCP responses to and impacts of prescription drug promotion.

Do discontinuities in marginal reimbursement affect inpatient psychiatric care in Germany?

This paper examines the behaviour of mental health care providers in response to marginal payment incentives induced by a discontinuous per diem reimbursement schedule with varying tariff rates over the length of stay. The analyses use administrative data on 12,627 cases treated in 82 psychiatric hospitals and wards in Germany. We investigate whether substantial reductions in marginal reimbursement per inpatient day led to strategic discharge behaviour once a certain length of stay threshold is exceeded. The data do not show gaps and bunches at the duration of treatment when marginal reimbursement decreases. Using logistic regression models, we find that providers did not react to discontinuities in marginal reimbursement by significantly reducing inpatient length of stay around the threshold. These findings are robust in terms of different model specifications and subsamples. The results indicate that if regulators aim to set incentives to decrease LOS, this might not be achieved by cuts in reimbursement over LOS.

Evolving Treatment Patterns in Chronic Lymphocytic Leukemia Among Experts and Community Practitioners: Analysis of an Online Decision Support Tool

Evolving Treatment Patterns in Chronic Lymphocytic Leukemia Among Experts and Community Practitioners: Analysis of an Online Decision Support Tool

Sexual and reproductive health mobile apps: results from a cross-sectional values and preferences survey to inform World Health Organization normative guidance on self-care interventions

ABSTRACT Mobile application (app) platforms have the potential to advance sexual and reproductive health (SRH). Yet there is a dearth of knowledge regarding global perspectives from healthcare providers on how SRH mobile apps are being leveraged in their healthcare practice. In 2019 the World Health Organization (WHO) developed a consolidated guideline on self-care interventions for SRH. To inform this guideline, we conducted a global values and preferences survey. This study aimed to (a) understand the awareness, access, and uptake of SRH mobile apps; (b) examine how many healthcare provider (HCP) participants provided linkages, referrals and information to clients regarding SRH mobile apps; and (c) among HCP, assess how many felt confident and informed regarding SRH mobile apps. We hosted a cross-sectional web-based survey on the WHO Department of Reproductive Health and Research website and shared the survey with SRHR listservs. There were 825 survey participants, 360 whom identified as healthcare providers (HCP). Approximately one-third of HCP participants had provided a referral/information to their clients about sexual or reproductive health apps. While 40.8% of HCP felt confident and informed about sexual health apps, half (47.4%) reported needing more information, and 15.6% expressed interest in receiving training to use in practice. While 42.6% of HCPs felt confident and informed about reproductive health apps, 45.7% needed more information, and 15.1% were interested in further training. There was also an open-ended question for HCP to share their thoughts about self-care SRH interventions. Specifically regarding SRH apps, HCP responses revealed the importance of considering: (a) security and confidentiality; (b) potential benefits of SRH apps for underserved groups (i.e. youth, rural communities); (c) community engagement; (d) health benefits; and (e) and online training for HCP on SRH mobile apps. Findings signal interest and opportunities for training and engaging HCP in using mobile apps to advance SRH.

Observational vignette study to examine patient and healthcare provider perceived impact of asthma-related exacerbations in the US

Background: Little is known about how patients and healthcare providers (HCPs) perceive the impact of asthmarelated exacerbations. This study examined the impact of asthma-related exacerbations on patients’ lives from these different perspectives. Methods: Web-based surveys were administered to a US sample of adult patients with asthma, and HCPs. Participants reviewed six vignettes describing two hypothetical patients with asthma (25-year-old/single/unemployed/ no dependents; and 45-year-old/married/employed/two young children) experiencing mild, moderate, or severe exacerbations and rated the impact on eight measures: EuroQoL-5 Dimensions (mobility, self-care, usual activities, pain/ discomfort, and anxiety/depression), sleep, household costs, and medical costs. The proportions reporting impact for each measure were calculated for each vignette; and patient responses were compared with HCP responses. Results: 302 patients with asthma and 300 HCPs completed the survey. As exacerbation severity increased, a higher proportion of patients and HCPs reported impact of exacerbations on patients with asthma. Compared with HCPs, a greater proportion of patients reported problems with pain/discomfort related to mild and moderate exacerbations. Compared with patients, HCPs were more likely to indicate sleep impact, mobility problems, and financial burden across all exacerbation severity levels; self-care problems with moderate and severe exacerbations; and problems with usual activities and anxiety/depression for severe exacerbations. Conclusions: Understanding the distinctions between how patients and HCPs perceive the impact of exacerbations is important for optimizing patient care. HCPs may be less aware of patient’s concerns about exacerbation-related pain/ discomfort. Studies are needed to further understand patient-HCP interactions regarding asthma-related exacerbations.

Communication about Traditional Complementary and Alternative Medicine (TCAM) in childhood cancer: A comparison between Dutch and Indonesian health-care providers at academic hospitals

ObjectivesCommunication about Traditional Complementary and Alternative Medicine (TCAM) use is important in both Western and Eastern countries to prevent interference with conventional cancer treatment. This study compares communication about TCAM of health-care providers (HCP) involved in childhood cancer care in Netherlands and Indonesia. MethodCross-sectional study at Dutch and Indonesian academic hospital using semi-structured questionnaires. ResultsOverall 342 HCP participated: 119 Dutch and 223 Indonesian HCP (response rate 80% and 87%). HCP have negative perspectives about TCAM according to more Dutch (80%) than Indonesian (42%) HCP (p < 0.001). More Dutch (97%) HCP think cancer patients use TCAM than Indonesian (75%) HCP (p = 0.001). Less Dutch (36%) than Indonesian (65%) HCP ask parents, during routine history taking, if they use TCAM in their child (p < 0.001). In both settings, most HCP (98%, 90% respectively) consider it important that parents inform them if their child uses TCAM (p = 0.004). Parents do not disclose their TCAM use to doctors according to 75% of Dutch and 84% of Indonesian HCP (p = ns). Parents are afraid of receiving less care from doctors if they disclose their interest in or use of TCAM according to more Indonesian (74%) than Dutch (42%) HCP (p < 0.001). Parents actually receive less care from doctors if they disclose their interest in or use of TCAM according to more Indonesian (40%) than Dutch (2%) HCP (p < 0.001). More Dutch (46%) than Indonesian (30%) HCP never openly discuss TCAM with parents (p = 0.002). ConclusionDutch HCP have more negative perspectives and communicate less openly about TCAM with parents than Indonesian HCP. In both settings HCP realize that their patients use TCAM and do not disclose this. Doctors need to initiate and facilitate open discussions about TCAM with parents, without retributing families after TCAM disclosure.

Novel synergistic immune modulating activity of a medicinal mushroom formulation

Communication about Traditional Complementary and Alternative Medicine (TCAM) use is important in both Western and Eastern countries to prevent interference with conventional cancer treatment. This study compares communication about TCAM of health-care providers (HCP) involved in childhood cancer care in Netherlands and Indonesia.Cross-sectional study at Dutch and Indonesian academic hospital using semi-structured questionnaires.Overall 342 HCP participated: 119 Dutch and 223 Indonesian HCP (response rate 80% and 87%). HCP have negative perspectives about TCAM according to more Dutch (80%) than Indonesian (42%) HCP (p < 0.001). More Dutch (97%) HCP think cancer patients use TCAM than Indonesian (75%) HCP (p = 0.001). Less Dutch (36%) than Indonesian (65%) HCP ask parents, during routine history taking, if they use TCAM in their child (p < 0.001). In both settings, most HCP (98%, 90% respectively) consider it important that parents inform them if their child uses TCAM (p = 0.004). Parents do not disclose their TCAM use to doctors according to 75% of Dutch and 84% of Indonesian HCP (p = ns). Parents are afraid of receiving less care from doctors if they disclose their interest in or use of TCAM according to more Indonesian (74%) than Dutch (42%) HCP (p < 0.001). Parents actually receive less care from doctors if they disclose their interest in or use of TCAM according to more Indonesian (40%) than Dutch (2%) HCP (p < 0.001). More Dutch (46%) than Indonesian (30%) HCP never openly discuss TCAM with parents (p = 0.002).Dutch HCP have more negative perspectives and communicate less openly about TCAM with parents than Indonesian HCP. In both settings HCP realize that their patients use TCAM and do not disclose this. Doctors need to initiate and facilitate open discussions about TCAM with parents, without retributing families after TCAM disclosure.