European Journal of Oncology Nursing (2006) 10, 198–206 Parental decision making in pediatric cancer end-of-life care: Using focus group methodology as a prephase to seek participant design input Deborah Tomlinson a,Ã , Michael Capra b , Janet Gammon b , Jocelyne Volpe b , Maru Barrera b , Pamela S. Hinds c , Eric Bouffet b , Mark L. Geenberg b , Sylvain Baruchel b , Hilary A. Llewellyn-Thomas d , Lillian Sung a a Population Health Sciences, Hospital for Sick Children, 123 Edward Street, Toronto, Ont., Canada M5G 1E2 b Hospital for Sick Children, 555 University Avenue, Toronto, Ont., Canada c Nursing Research, St. Jude Children’s Research Hospital, 332 N. Lauderdale, Memphis, TN 38105, USA d Department of Community & Family Medicine, Dartmouth Medical School, Dartmouth College, Center for the Evaluative Clinical Sciences, Hanover, NH, 03755, USA KEYWORDS Pediatric palliative care; Parental decision making; End-of-life decision making; Focus group metho- dology Summary The ultimate aim of our research program is to provide strategies that facilitate parental decision-making for parents of children with cancer receiving end-of-life care. As a first step to develop this program, we needed insight into parents’ reactions and opinions about the research methods planned for a larger study. In particular, we needed their opinions about the general experience of making the decision between palliative cytotoxic chemotherapy and supportive care alone and the factors that parents regard as important when making this decision. In addition, we wished to know whether the methodology proposed for the future study was easy to understand and whether it might cause unnecessary emotional trauma. Finally, we asked their opinions regarding the appropriate target sample of parents to include in the future study. Qualitative data about these issues were collected using focus group methodology involving seven participants. The comments made during the focus group discussions were content-analyzed for common themes. The results from the focus group discussion led to particular modifications in the proposed design and interview strategies planned for the future larger study. We found it was extremely beneficial to include a focus group pre-phase in a study that will interview parents in a high sensitivity area. & 2005 Elsevier Ltd. All rights reserved. Zusammenfassung Das Hauptziel unseres Forschungsprogramms besteht darin, Strategien zu empfehlen, die den Eltern von terminal krebskranken Kindern das ARTICLE IN PRESS www.elsevier.com/locate/ejon 1462-3889/$ - see front matter & 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.ejon.2005.11.003 Ã Corresponding author. Tel.: +1 416 813 7654x2628; fax: +1 416 813 5979. E-mail address: deborah.tomlinson@sickkids.ca (D. Tomlinson).