• Psychosocial Care Needs of Children with Cancer and Their Families: Perceptions and Experiences of Omani Oncologists and Nurses

      Al Balushi, Amal Juma; Johantgen, Mary E.; Mooney-Doyle, Kim (2019)
      Background: Much evidence demonstrates the psychosocial impact of childhood cancer on children and their families. While many health care systems are evolving to integrate psychosocial services into clinical care, barriers exist that must be understood before changes can be implemented in systems new to this care. Oncologists and nurses are on the front lines of care and have unique perspectives about the needs of their patients and families. Objectives: The purposes of this study were: 1) describe the experiences and perceptions of pediatric oncology physicians and nurses in Oman regarding the psychosocial care needs of children with cancer and their families; and 2) describe the barriers and facilitators to providing psychosocial care. Methods: A qualitative, phenomenological study was conducted. Purposive sampling strategy was used to recruit 26 oncologists and nurses with experience caring for children with cancer and their families. Individual, semi-structured interviews were conducted and recorded. Colaizzi's method of data analysis was utilized to inductively determine themes, clusters, and categories. Data saturation was achieved, and methodical rigor was established. Result: Four themes emerged from the data. The first was “perceived need for care beyond medicine.” The oncologists and nurses recognized that more psychosocial assessment, care, and services were needed. The second theme was “recognition of pediatric oncology as a challenging clinical practice area,” which had two subthemes: emotional burden and challenging situations. Participants described the challenges they faced trying to meet the needs of children and extended families. The third theme was “barriers to providing effective psychosocial care,” which had three subthemes: barriers related to the health care system, barriers related to health care providers, and barriers related to infrastructure and environment. The fourth theme was “providing optimal supportive care within the available facilities,” which had two subthemes: supportive care and facilitating factors. Cultural and community factors were highlighted. Conclusion: As the pediatric oncology services in Oman mature, clinicians are eager to develop the psychosocial assessments and needed services. Future research is needed to elicit the perspectives of Omani children with cancer and their families. Resources will be needed from higher authorities to design, implement, and evaluate the recommended changes.