Providing Ethical Care for Children with Cancer: Nurses’ Perspectives

Reza Saidi1,, Haydeh Heidari

Abstract


Background: Diagnosing a child with cancer is one of the most intense and challenging experiences that a family can face. Caring for children with cancer is one of the most challenging areas of the nursing profession, technically and emotionally, and nurses face various ethical issues in this regard. This study aims to explore nurses’ perceptions of providing ethical care for children with cancer.

Materials and Methods: This study applied a qualitative design and a purposive sampling method. Participants included 21 nurses with experience in caring for children with cancer. Data were collected using semi‑structured interviews and analyzed using inductive content analysis.

Results: Data analysis revealed three categories and seven subcategories. First, barriers to providing ethical care (subcategories: parents making decisions instead of the child, cultural misinterpretations, and reference to fortune‑tellers). Second, facilitators of providing ethical care (subcategories: family hopefulness and parents’ religious background). Third, approaches for providing ethical care (subcategories: the necessity of conducting research in the field of cultural backgrounds and the establishment of ethical‑religious committees).

Conclusions: This study presents some significant barriers, facilitators, and approaches to providing ethical care for children with cancer. These results are based on nurses’ experiences and perceptions. All healthcare professionals can use our results to provide high‑quality and ethical care for children with cancer.

 


Keywords


Ethics, neoplasms, nursing care, pediatrics

Full Text:

PDF

References


Talebi M, Ghasemzadeh S, Arjmandi K, Vakili S. Effectiveness of child centered play therapy on resiliency of Children with leukemia cancer. Iran J Pediat Nurs 2022;8:47 55.

Steliarova Foucher E, Colombet M, Ries LA, Moreno F, Dolya A, Bray F, et al. International incidence of childhood cancer, 2001–10: A population based registry study. Lancet Oncol 2017;18:719 31.

Alahmad G. Informed consent in pediatric oncology: A systematic review of qualitative literature Cancer Control 2018;25:1 8.

Sadeghi Z, Mikaeili N, Atadokht A. The effectiveness of laugh therapy on anxiety and hopelessness children whit cancer. Iran J Cancer Care 2021;2:45 53.

Alahmad G, AlSaqabi M, Alkamli H, Aleidan M. Ethical challenges in consent procedures involving pediatric cancer patients in Saudi Arabia: An exploratory survey. Dev World Bioeth 2022;22:140 51.

Enskär K. Being an expert nurse in pediatric oncology care: Nurses’ descriptions in narratives. J Pediat Oncol Nurs 2012;29:151 60.

Bartholdson C, Lützén K, Blomgren K, Pergert P. Experiences of ethical issues when caring for children with cancer. Cancer Nurs 2015;38:125 32.

Park M, Suh EE, Yu S Y. Uncertainty and nursing needs of parents with pediatric cancer patients in different treatment phases: A cross sectional study. Int J Environ Res Public Health 2021;18:1 14.

Nukpezah RN, Khoshnavay Fomani F, Hasanpour M, Nasrabadi AN. A qualitative study of Ghanaian pediatric oncology nurses’ care practice challenges. BMC Nurs 2021;20:1 10.

Bayoumi MH, Kamel FF, Fathalla AA. Guideline education program about nursing ethics in pediatric oncology unit: Effect on nurses’ knowledge and practice. IOSR J Nurs Heal Sci 2017;6:1 9.

Alahmad G, Al Kamli H, Alzahrani H. Ethical challenges of pediatric cancer care: Interviews with nurses in Saudi Arabia. Cancer Control 2020;27:1 8.

Shadi D, Bashiri S, Mezerji NMG, Tehrani TH. Assessment of nurses’ ethical performance from the perspective of mothers and nurses in pediatric wards of beast hospital, Hamadan, 2019. Clin Ethics 2020;16:240 5.

Dos Santos MR, da Silva LT, de Araújo MM, Ferro TA, Silva IN, Szylit R. Ethical and moral conflicts in the nursing care of pediatric patients with cancer and their families. Cancer Nurs 2022;4:1 10.

Rapoport A, Morrison W. No child is an island: Ethical considerations in end of life care for children and their families. Curr Opin Support Palliat Care 2016;10:196 200.

Bartholdson C, Sandeberg Ma, Lützén K, Blomgren K, Pergert P. Healthcare professionals’ perceptions of the ethical climate in paediatric cancer care. Nurs Ethics 2016;23:877 88.

Beykmirza R, Nikfarid L, Atashzadeh Shoorideh F, Nasiri M. Nursing adherence to ethical codes in pediatric oncology wards. Nurs Ethics 2019;26:924 36.

Kadivar M, Mardani Hamooleh M. Exploration of moral necessities in the field of children’s cancer. Iran J Med Ethics Hist Med 2015;8:1 8.

Ventovaara P, AF Sandeberg M, Petersen G, Blomgren K, Pergert P. A cross‐sectional survey of moral distress and ethical climate–Situations in paediatric oncology care that involve children’s voices. Nurs Open 2022;2022:2108 16.

Baysal E, Sari D, Erdem H. Ethical decision making levels of oncology nurses. Nurs Ethics 2019;26:2204 12.

Pye K. Exploring moral distress in pediatric oncology; A sample of registered practitioners. Issues Compr Pediatr Nurs 2013;36:248 61.

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004;24:105 12.

Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs 2008;62:107 15.

Speziale HS, Streubert HJ, Carpenter DR. Qualitative Research in Nursing: Advancing the Humanistic Imperative. Lippincott Williams and Wilkins 2011.

Salvador Á, Crespo C, Roberto MS, Barros L. Do parents of children with cancer want to participate in treatment decision making? Support Care Cancer 2020;28:1059 67.

Banerjee AT, Watt L, Gulati S, Sung L, Dix D, Klassen R, et al. Cultural beliefs and coping strategies related to childhood cancer: The perceptions of South Asian immigrant parents in Canada. J Pediat Oncol Nurs 2011;28:169 78.

Walubita M, Sikateyo B, Zulu JM. Challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia. BMC Health Serv Res 2018;18:1 7.

Yeh CH. Religious beliefs and practices of Taiwanese parents of pediatric patients with cancer. Cancer Nurs 2001;24:476 82.

Naidoo D, Gurayah T, Kharva N, Stott T, Trend SJ, Mamane T, et al. Having a child with cancer: African mothers’ perspective. S Afr J Occup Ther 2016;46:49 54.

Conway MF, Pantaleao A, Popp JM. Parents’ experience of hope when their child has cancer: Perceived meaning and the influence of health care professionals. J Pediat Oncol Nurs 2017;34:427 34.

Mesquita AC, Chaves ÉdCL, Barros GAMD. Spiritual needs of patients with cancer in palliative care: An integrative review. Curr Opin Support Palliat Care 2017;11:334 40.

Borjalilu S, Shahidi S, Mazaheri MA, Emami AH. Spiritual care training for mothers of children with cancer: Effects on quality of care and mental health of caregivers. Asian Pac J Cancer Prev 2016;17:545 52.

Moridi G, Valiee S, Fathi M, Nikbakht Nasrabadi A, Khaledi S. Parents’ experience of pediatric cancer: A qualitative study. Chronic Dis J 2018;6:214 24.

Fathollah Zadeh E, Parry Y, Eshghi P. Hope in Iranian mothers of children with cancer: A descriptive correlational study. Support Care Cancer 2021;29:3697 705.

Stewart JL, Pyke Grimm KA, Kelly KP. Making the right decision for my child with cancer: The parental imperative. Cancer Nurs 2012;35:419 28.

Bozkurt G, İnal S, Yantiri L, Alparslan Ö. Relationship between coping strategies, religious attitude, and optimism of mothers of children with cancer. J Transcult Nurs 2019;30:365 70.

Abdoljabbari M, Sheikhzakaryaee N, Atashzadeh Shoorideh F. Taking refuge in spirituality, a main strategy of parents of children with cancer: A qualitative study. Asian Pac J Cancer Prev 2018;19:2575 80.

Bartholdson C, AF Sandeberg M, Molewijk B, Pergert P. Does participation in ethics discussions have an impact on ethics decision making? A cross sectional study among healthcare professionals in paediatric oncology. Eur J Oncol Nurs 2021;52:101950.


Refbacks

  • There are currently no refbacks.