Volume 21, Issue 4 (Pajouhan Scientific Journal, Autumn 2023)                   Pajouhan Sci J 2023, 21(4): 285-294 | Back to browse issues page

Research code: 9808286320
Ethics code: IR.UMSHA.REC.1398.659


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Nikkhah A, Esfahani H, Matinnia N, Yazdi-Ravandi S, farhanchi A. Ethical Experiences of Pediatric Oncologists in Dealing with Parents of Children with Cancer: A Qualitative Study. Pajouhan Sci J 2023; 21 (4) :285-294
URL: http://psj.umsha.ac.ir/article-1-1034-en.html
1- Student Research Committee, Hamadan University of Medical Science, Hamadan, Iran
2- Department of Pediatric Hematology and Oncology, Hamadan University of Medical Science, Hamadan, Iran
3- Department of Nursing, Hamedan Branch, Islamic Azad University, Hamedan, Iran
4- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
5- Department of Anesthesiology and Special Care, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran , afarhanchi1970@yahoo.com
Abstract:   (1117 Views)
Background and Objectives: Pediatric cancer poses significant challenges for physicians, giving rise to numerous ethical dilemmas during diagnosis and treatment of affected children. This study explored the ethical experiences of pediatric oncologists across various phases of patient care and their interaction with patients’ families.
Materials and Methods: This qualitative study was performed by purposive sampling method, involving pediatric oncologists from different provinces of Iran. Research data were gathered through semi-structured interviews, continuing until saturation of codes was achieved among new participants. Research data were extracted using MAXQDA 10 software and categorized by qualitative content analysis with the agreement of the research team.
Results: Through 11 interviews conducted with pediatric oncologists representing 10 provinces in Iran, 158 initial codes were extracted. Following code analysis and classification, three main themes were identified, encompassing a total had 10 sub-themes. The main themes included parental reactions, therapeutic challenges, family communication strategies, and the physicians' inner experiences.
Conclusion: The findings of this study showed a broad spectrum of ethical and clinical experiences of pediatric oncologists in Iran, with influences from geographical, religious, and demographic factors. The study underscores the need for tailored educational programs, protocols, and guidelines to improve the ethical performance knowledge of these physicians in alignment with the cultural, geographical, and religious conditions of Iran.
Full-Text [PDF 1093 kb]   (568 Downloads)    
Type of Study: Research Article | Subject: Medicine & Clinical Sciences
Received: 2023/07/11 | Accepted: 2023/11/26 | Published: 2023/12/1

References
1. Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin. 2014;64(2):83-103. [DOI:10.3322/caac.21219] [PMID]
2. American cancer society: Cancer facts and figures. Atlanta, Ga. 2001.
3. Kochanek KD, Miniño AM, Murphy SL, Xu J, Kung H-C. Deaths: final data for 2009. National Vital Statistics Reports. 2011; 60(3).
4. Howlader N, Noone A, Krapcho M, Neyman N, Aminou R, Waldron W, et al. SEER Cancer Statistics Review, 1975-2008. Bethesda, MD: National Cancer Institute; 2011; 2011:140-3.
5. Arnetz BB. Psychosocial challenges facing physicians of today. Soc Sci Med. 2001; 52(2): 203-13. [DOI:10.1016/S0277-9536(00)00220-3] [PMID]
6. Sherman AC, Edwards D, Simonton S, Mehta P. Caregiver stress and burnout in an oncology unit. Palliat Support Care. 2006;4(1):65-80. [DOI:10.1017/S1478951506060081] [PMID]
7. Murali K, Makker V, Lynch J, Banerjee S. From Burnout to Resilience: An Update for Oncologists. Am Soc Clin Oncol Educ Book. 2018;38:862-72. [DOI:10.1200/EDBK_201023] [PMID]
8. Kristensson-Hallstrom I, Elander G. Parents' experience of hospitalization: different strategies for feeling secure. Pediatric nursing. 1997;23(4):361-8.
9. Jordan A, Eccleston C, Crombez G. Parental functioning in the context of adolescent chronic pain: a review of previously used measures. Journal of pediatric psychology. 2008;33(6):640-59. [DOI:10.1093/jpepsy/jsm139] [PMID]
10. Holm KE, Patterson JM, Gurney JG. Parental involvement and family-centered care in the diagnostic and treatment phases of childhood cancer: results from a qualitative study. J Pediatr Oncol Nurs. 2003; 20(6):301-13. [DOI:10.1177/1043454203254984] [PMID]
11. Ringnér A, Jansson L, Graneheim UH. Parental experiences of information within pediatric oncology. J Pediatr Oncol Nurs. 2011; 28(4):244-51. [DOI:10.1177/1043454211409587] [PMID]
12. Stenmarker M, Hallberg U, Palmérus K, Márky I. Being a messenger of life‐threatening conditions: Experiences of pediatric oncologists. Pediatr Blood Cancer. 2010; 55(3):478-84. [DOI:10.1002/pbc.22558] [PMID]
13. Ruhe KM, Wangmo T, De Clercq E, Badarau DO, Ansari M, Kühne T, et al. Putting patient participation into practice in pediatrics-results from a qualitative study in pediatric oncology. Eur J Pediatr. 2016;175(9):1147-55. [DOI:10.1007/s00431-016-2754-2] [PMID]
14. Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs HJSo. Qualitative content analysis: A focus on trustworthiness. SAGE Open. 2014;4(1). [DOI:10.1177/2158244014522633]
15. Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New directions for program evaluation. 1986; 1986(30):73-84. [DOI:10.1002/ev.1427]
16. Shenton AK. Strategies for ensuring trustworthiness in qualitative research projects. Education for information. 2004; 22(2):63-75. [DOI:10.3233/EFI-2004-22201]
17. Eke G, Akani N. Treatment of Childhood Cancer in Southern Nigeria: Parents Perspective. Psychology. 2019; 9(11):458-464. [DOI:10.17265/2159-5542/2019.11.003]
18. Renner LA, McGill D. Exploring factors influencing health-seeking decisions and retention in childhood cancer treatment programmes: perspectives of parents in Ghana. Ghana medical journal. 2016; 50(3):149-56. DOI: 10.4314/gmj.v50i3.6 [DOI:10.4314/gmj.v50i3.6] [PMID] []
19. Saifan A, Masa'Deh R, Hall C, Collier J. Experiences of Jordanian mothers and fathers of children with cancer. Journal of American Science. 2014;10(8):29-39.
20. Jadidi R A, Hekmatpou D, Eghbali A, Memari F. The experiences of parents of children with leukemia: A qualitative research. J Arak Uni Med Sci. 2013; 15(9) :28-40.
21. Winne M, Cashavelly B, Annese C, Nagle B, Shiga T, Chisari RG, et al. Implementation of 2 nurse practitioner inpatient models. JONA. 2012;42(2):110-6. [DOI:10.1097/NNA.0b013e3182433831] [PMID]
22. Golden JR. A nurse practitioner patient care team: implications for pediatric oncology. J Pediatr Oncol Nurs. 2014;31(6):350-6. [DOI:10.1177/1043454214531455] [PMID]
23. Howard SC, Davidson A, Luna‐Fineman S, Israels T, Chantada G, Lam CG, et al. A framework to develop adapted treatment regimens to manage pediatric cancer in low‐and middle‐income countries: the Pediatric Oncology in Developing Countries (PODC) Committee of the International Pediatric Oncology Society (SIOP). Pediatr Blood Cancer. 2017;64:e26879. [DOI:10.1002/pbc.26879] [PMID]
24. Mojen LK, Rassouli M, Eshghi P, Sari AA, Karimooi MH. Palliative care for children with cancer in the Middle East: A comparative study. Indian J Palliat Care. 2017;23(4):379. [DOI:10.4103/IJPC.IJPC_69_17] [PMID] []
25. Biniaz RB, Goudarzi M, Sahmani M, Moghaddasi MH, Dehghanifard A, Vatanmakanian M, et al. Challenges in the treatment of Iranian patients with leukemia in comparison with developed countries from the perspective of specialists. Archives of Advances in Biosciences. 2014;5(4).
26. Granek L, Barrera M, Scheinemann K, Bartels U. Pediatric oncologists' coping strategies for dealing with patient death. J Psychosoc Oncol. 2016;34(1-2):39-59. [DOI:10.1080/07347332.2015.1127306] [PMID]
27. Shapiro RS, Simpson DE, Lawrence SL, Talsky AM, Sobocinski KA, Schiedermayer DL. A survey of sued and nonsued physicians and suing patients. Arch Intern Med. 1989;149(10):2190-6. [DOI:10.1001/archinte.1989.00390100028008] [PMID]
28. Gadjradj PS, Ghobrial JB, Harhangi BS. Experiences of neurological surgeons with malpractice lawsuits. Neurosurg Focus. 2020;49(5):E3. [DOI:10.3171/2020.8.FOCUS20250] [PMID]
29. Ghalandarpoor SM, Asghari F, Kaviyani A, Daeemi M. Disclosing medical error: the attitude and practice of surgeons and surgery residents. IJMEHM. 2011;4(3):61-8.
30. Mukherjee S, Beresford B, Glaser A, Sloper P. Burnout, psychiatric morbidity, and work‐related sources of stress in paediatric oncology staff: A review of the literature. Psychooncology. 2009;18(10):1019-28. [DOI:10.1002/pon.1534] [PMID]
31. Spinetta JJ, Jankovic M, Ben Arush MW, Eden T, Epelman C, Greenberg ML, et al. Guidelines for the recognition, prevention, and remediation of burnout in health care professionals participating in the care of children with cancer: report of the SIOP Working Committee on Psychosocial Issues in Pediatric Oncology. Med Pediatr Oncol. 2000;35(2):122-5. https://doi.org/10.1002/1096-911X(200008)35:2<122::AID-MPO7>3.0.CO;2-J [DOI:10.1002/1096-911X(200008)35:23.0.CO;2-J] [PMID]
32. Sisk BA, Schulz G, Kaye EC, Baker JN, Mack JW, DuBois JM. Conflicting goals and obligations: Tensions affecting communication in pediatric oncology. Patient Educ Couns. 2022;105(1):56-61. [DOI:10.1016/j.pec.2021.05.003] [PMID] []
33. Moody K, Kramer D, Santizo RO, Magro L, Wyshogrod D, Ambrosio J, et al. Helping the helpers: mindfulness training for burnout in pediatric oncology-a pilot program. J Pediatr Oncol Nurs. 2013;30(5):275-84. [DOI:10.1177/1043454213504497] [PMID]
34. Dougherty E, Pierce B, Ma C, Panzarella T, Rodin G, Zimmermann C. Factors associated with work stress and professional satisfaction in oncology staff. Am J Hosp Palliat Care. 2009;26(2):105-11. [DOI:10.1177/1049909108330027] [PMID]
35. Laine C, Davidoff F. Patient-centered medicine: a professional evolution. JAMA. 1996;275(2):152-6. https://doi.org/10.1001/jama.1996.03530260066035 [DOI:10.1001/jama.275.2.152] [PMID]
36. Charles C, Whelan T, Gafni A. What do we mean by partnership in making decisions about treatment? BMJ. 1999;319(7212):780-2. [DOI:10.1136/bmj.319.7212.780] [PMID] []
37. Whitney SN, Ethier AM, Frugé E, Berg S, McCullough LB, Hockenberry M. Decision making in pediatric oncology: who should take the lead? The decisional priority in pediatric oncology model. J Clin Oncol. 2006;24(1):160-5. [DOI:10.1200/JCO.2005.01.8390] [PMID]
38. Mayers AM, Svartberg M. The manifestation and management of staff countertransference on a pediatric AIDS team. Bulletin of the Menninger Clinic. 1996;60(2):206.

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2025 CC BY-NC 4.0 | Pajouhan Scientific Journal

Designed & Developed by : Yektaweb