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Salamon E, Fodor É, Földesi E, Hauser P, Kriván G, Csanádi K, Garami M, Kovacs G, Csóka M, Tiszlavicz LG, Kiss C, Dergez T, Ottóffy G. The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards-A National Survey. CHILDREN (BASEL, SWITZERLAND) 2024; 11:178. [PMID: 38397290 PMCID: PMC10886866 DOI: 10.3390/children11020178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/16/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Our knowledge about the attitudes of healthcare staff to palliative care in pediatric oncology is scarce. We aimed to assess their perceptions of palliative care in Hungary and find answers to the question of how to provide good palliative care for children. METHOD Physicians (n = 30) and nurses (n = 43) working in the field of pediatric oncology (12 of them specialized in hospice care) were interviewed. Palliative care practice (communication, integration of palliative care, professionals' feelings and attitudes, and opportunities for improvement) was assessed by semi-structured interviews evaluated in a mixed quantitative and qualitative way by narrative categorical content analysis and thematic analysis. RESULTS All providers displayed high negative emotions, positive evaluations, and used many active verbs. Nurses showed higher levels of denial, more self-references, and were more likely to highlight loss. Physicians emphasized the importance of communication regarding adequate or inadequate palliative care. Hospice specialists showed a higher passive verb rate, a lower self-reference, a lower need for psychological support, and a greater emphasis on teamwork and professional aspects. CONCLUSION Our results show that nurses are more emotionally stressed than doctors in palliative care in pediatric oncology. To our knowledge, a study comparing doctors and nurses in this field has yet to be carried out. Our results suggest that pediatric oncological staff can positively evaluate a child's palliative care despite the emotional strain. Regarding hospices, professional practice in palliative care may be a protective factor in reducing emotional distress and achieving professional well-being.
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Affiliation(s)
- Eszter Salamon
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Pécs Medical School, József A. Street 7, 7623 Pécs, Hungary; (É.F.); (G.O.)
| | - Éva Fodor
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Pécs Medical School, József A. Street 7, 7623 Pécs, Hungary; (É.F.); (G.O.)
| | - Enikő Földesi
- Institute of Behavioural Sciences, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary
| | - Peter Hauser
- Pediatric Center, Semmelweis University, Tűzoltó utca 7–9, 1094 Budapest, Hungary; (P.H.)
- Velkey László Child’s Health Center, Borsod-Abaúj-Zemplén County Central Hospital and University Teaching Hospital, Szentpéteri kapu 72–76, 3526 Miskolc, Hungary
| | - Gergely Kriván
- Department for Pediatric Hematology and Hemopoietic Stem Cell Transplantation, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
| | - Krisztina Csanádi
- Hemato-Oncology Unit, Heim Pál National Pediatric Institute, 1089 Budapest, Hungary;
| | - Miklós Garami
- Pediatric Center, Semmelweis University, Tűzoltó utca 7–9, 1094 Budapest, Hungary; (P.H.)
| | - Gabor Kovacs
- Pediatric Center, Semmelweis University, Tűzoltó utca 7–9, 1094 Budapest, Hungary; (P.H.)
| | - Monika Csóka
- Pediatric Center, Semmelweis University, Tűzoltó utca 7–9, 1094 Budapest, Hungary; (P.H.)
| | | | - Csongor Kiss
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Tímea Dergez
- Institute of Bioanalysis, University of Pécs, 7624 Pécs, Hungary;
| | - Gábor Ottóffy
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Pécs Medical School, József A. Street 7, 7623 Pécs, Hungary; (É.F.); (G.O.)
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Alahmad G. Attitudes toward the Care of Children with Cancer in Saudi: An Exploratory Survey. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040693. [PMID: 37189942 DOI: 10.3390/children10040693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/28/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023]
Abstract
The ethical challenges of pediatric cancer care across Arab countries are not well addressed, despite medical advancements and increased awareness of children's rights. The ethical challenges related to pediatric cancer in Saudi Arabia were investigated by surveying 400 respondents at King Abdulaziz Medical City in Riyadh, Jeddah, and Dammam, Saudi Arabia, from four groups: pediatricians, medical students, nurses, and parents of children with cancer. Respondents' characteristics were surveyed across three outcomes: awareness of care, knowledge, and parent consent/child assent, developed from a systematic review and a qualitative analysis. A majority of respondents (89.0%) considered pediatric cancer different from adult cancer. Families considered alternative treatment, according to 64.3% of respondents, while 88.0% emphasized understanding the family's needs and values. Furthermore, 95.8% of respondents believed physicians should offer time for pedagogy, 92.3% viewed parental consent as essential, and 94.5% thought that sufficient discussion about the plan and type of treatment should precede consent. However, child assent showed lower levels of agreement, with only 41.3% and 52.5% agreeing with getting child assent and having a discussion. Finally, 56% agreed that parents might refuse suggested treatment, while only 24.3% agreed that the child could refuse it. In all these ethical considerations, nurses and physicians showed significantly more positive results compared with other groups.
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Affiliation(s)
- Ghiath Alahmad
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia
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