Difficult situations and moral questions raised during moral case deliberations in Swedish childhood cancer care – A qualitative nationwide study

Weiner, Charlotte; Pergert, Pernilla; Castor, Anders; Molewijk, Bert; Bartholdson, Cecilia

doi:10.1016/j.ejon.2022.102189

Cited by 4 publications

(8 citation statements)

References 45 publications

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“…29,30 Likewise, Hansson et al (2022) reported that supporting parents contributes to their adaptation and resilience and creates a peaceful environment where they are more willing to participate in caring for their children in oncology units. 31 According to Weiner et al (2022), one of the ethical challenges in caring for children with cancer is supporting their families in coping with the psychological tension of their child's illness and persuading them to participate in care. 3 Lopez et al (2022) reported that, following their child's cancer diagnosis, the parents of children with cancer experience helplessness and despair, which is an obstacle to caregiving, and thus require extensive psychological and social support.…”

Section: Discussionmentioning

confidence: 99%

“…2 Children with cancer experience pain, illness, change in their appearance, fatigue, and inability to play and socialize with their peers. [1][2][3] The families of children with cancer, especially their parents, are faced with various forms of tension (sadness, depression, anxiety, and fear of the future), as well as the difficulties of caring for their sick child and the associated financial burden, which can adversely affect interaction in families. 3,4 Care providers in pediatric oncology units are also faced with numerous challenges in caring for this population of patients.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] The families of children with cancer, especially their parents, are faced with various forms of tension (sadness, depression, anxiety, and fear of the future), as well as the difficulties of caring for their sick child and the associated financial burden, which can adversely affect interaction in families. 3,4 Care providers in pediatric oncology units are also faced with numerous challenges in caring for this population of patients. In their interactions with children with cancer and their families, the care providers in pediatric oncology units have to deal with not only feelings of sadness, dismay, and bereavement, but also work overload, large numbers of patients, and shortage of pediatric oncology nurses.…”

Section: Introductionmentioning

confidence: 99%

“…In their interactions with children with cancer and their families, the care providers in pediatric oncology units have to deal with not only feelings of sadness, dismay, and bereavement, but also work overload, large numbers of patients, and shortage of pediatric oncology nurses. [3][4][5] In addition, the unstable conditions of children with cancer and their families have an impact on providing precise and honest information, observing justice in healthcare, and managing professional boundaries in the interactions between the care providers and the patients and their families. [3][4][5][6] Thus, the care providers in pediatric oncology units experience not only care-related challenges, but many ethical challenges.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] In addition, the unstable conditions of children with cancer and their families have an impact on providing precise and honest information, observing justice in healthcare, and managing professional boundaries in the interactions between the care providers and the patients and their families. [3][4][5][6] Thus, the care providers in pediatric oncology units experience not only care-related challenges, but many ethical challenges. 6 Ethical challenges are ethical dilemmas which arise from conflicts between values, which change a situation or issue to an ethical challenge.…”

Section: Introductionmentioning

confidence: 99%

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Ethical challenges as perceived by nurses in pediatric oncology units

Mohammadi,

Naderi,

Nikrouz

et al. 2023

Nurs Ethics

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Background Providing care to children with cancer is one of the most challenging areas of ethical care for nurses. Few studies have addressed nurses’ perception of the barriers to giving ethical care in oncology departments. Thus, it is essential that the ethical challenges in caregiving as perceived by oncology nurses be investigated. Objective The present study was conducted to investigate the ethical challenges as perceived by nurses in pediatric oncology units in the south of Iran. Research design The present study is a qualitative work of research with a conventional content analysis design. Data were collected via individual semi-structured interviews. The collected data were analyzed using the qualitative content analysis method. Participants and research context The participants were 21 nurses from pediatric oncology units in state hospitals who were selected by purposeful sampling. Sampling continued until the data were saturated. The study lasted from April to October 2022. Findings Three main themes, promoting psychological safety in the children, respect for the dignity of the children, and expansion of support for families, and nine subthemes were extracted from the data. Ethical considerations The study’s protocol was approved by the Research Ethics Committee of the University of Medical Sciences and ethical principles were followed throughout the study. Discussion and conclusion From the nurses’ perspective, the major ethical challenges in providing ethical care in pediatric oncology units were reducing tension toward promoting the patients’ psychological safety, showing respect for the identity and dignity of the children with cancer, and expanding support of the patients’ families. By creating the right cultural and professional context and establishing proper protocols, healthcare policymakers and administrators can take effective steps toward eliminating the barriers to providing ethical care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ethical challenges as perceived by nurses in pediatric oncology units

Mohammadi,

Naderi,

Nikrouz

et al. 2023

Nurs Ethics

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Sheltering in chaos: parents’ experiences when facing moral challenges in childhood cancer care

Weiner,

Pergert,

Castor

et al. 2023

Ethics & Behavior

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Ethical concerns when recruiting children with cancer for research: Swedish healthcare professionals’ perceptions and experiences

et al. 2023

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Background Research is crucial to improve treatment, survival and quality of life for children with cancer. However, recruitment of children for research raises ethical challenges. The aim of this study was to explore and describe ethical values and challenges related to the recruitment of children with cancer for research, from the perspectives and experiences of healthcare professionals in the Swedish context. Another aim was to explore their perceptions of research ethics competence in recruiting children for research. Methods An explorative qualitative study using semi-structured interviews with key informants. Seven physicians and ten nurses were interviewed. Interviews were analysed using inductive qualitative content analysis. Results The respondents’ ethical challenges and values in recruitment mainly concerned establishing relationships and trust, meeting informational needs, acknowledging vulnerability, and balancing roles and interests. Ensuring ethical competence was raised as important, and interpersonal and communicative skills were highlighted. Conclusion This study provides empirical insight into recruitment of children with cancer, from the perspectives of healthcare professionals. It also contributes to the understanding of recruitment as a relational process, where aspects of vulnerability, trust and relationship building are important, alongside meeting informational needs. The results provide knowledge on the complexities raised by paediatric research and underpin the importance of building research ethics competence to ensure that the rights and interests of children with cancer are protected in research.

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Difficult situations and moral questions raised during moral case deliberations in Swedish childhood cancer care – A qualitative nationwide study

Cited by 4 publications

References 45 publications

Ethical challenges as perceived by nurses in pediatric oncology units

Ethical challenges as perceived by nurses in pediatric oncology units

Sheltering in chaos: parents’ experiences when facing moral challenges in childhood cancer care

Ethical concerns when recruiting children with cancer for research: Swedish healthcare professionals’ perceptions and experiences

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