Attitude of health-care providers toward childhood leukemia patients with different socio-economic status

Pediatr Blood Cancer. 2008 May;50(5):1001-5. doi: 10.1002/pbc.21324.


Background: Treatment results differ significantly between poor and prosperous children with leukemia in Indonesia. The objective of this study was to determine whether parental socio-economic status influences beliefs, attitude, and behavior of health-care providers (hcp) treating childhood leukemia in Indonesia.

Procedure: A self-administered semi-structured questionnaire was filled in by 102 hcp (69 doctors, 28 nurses, 2 psychologists, 2 hematology technicians, 1 administrator).

Results: Most hcp (98%) asked parents about their financial situation. The decision to start treatment was influenced by parental socio-economic status (86%), motivation of parents (80%), and motivation of doctors (76%). Health-care providers stated that prosperous patients comply better with treatment (64%), doctors comply better with treatment for the prosperous (53%), most patients cannot afford to complete treatment (58%), less extensive explanations are given toward poor families (60%), and communication is impeded by differences in status (67%). When dealing with prosperous families a minority of hcp stated that they pay more attention (27%), work with greater accuracy (24%), take more interest (23%), and devote more time per visit (22%). Most hcp denied differences in the quality of medical care (93%) and the chances of cure (58%) between poor and prosperous patients.

Conclusions: Beliefs, attitude, and behavior of hcp toward poor versus prosperous patients appeared to differ. These differences may contribute to the immense drop-out rate and slight chances of survival among poor patients with leukemia in developing countries.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel*
  • Child
  • Cross-Sectional Studies
  • Culture
  • Educational Status
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Indonesia / epidemiology
  • Nurses / psychology
  • Poverty
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / epidemiology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / psychology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Socioeconomic Factors
  • Surveys and Questionnaires