National oncology and pediatric organizations view the integration of palliative care (PC) into the treatment of pediatric cancer as best practice. Even while mounting data indicated that embedded models enhanced the quality of care and quality of life for patients and their families, the best practices for PC integration were not well understood. For a study, researchers sought to introduce clinicians to the theoretical idea of an embedded care model; describe the perspectives and preferences of multidisciplinary clinicians regarding ideal models for PC integration in pediatric cancer care; and empower clinicians in co-designing a new institutional model through collaborative discussion of anticipated benefits and challenges of embedded model implementation.

In the study, 24 focus groups, divided by discipline and care teams, were conducted by trained facilitators. Using MAXQDA software, focus groups were audio-recorded, then transcribed for inductive content analysis.

Participating were 174 medical professionals (25 physicians, 30 advanced practice providers [APPs], 70 nurses, and 49 psychosocial clinicians). Clinicians from several disciplines expressed their belief that an embedded PC model would increase access to PC; nevertheless, the advantages and difficulties that each discipline described were unique. Early PC integration (APPs, physicians), normalizing PC as a crucial component of patient and family care (nurses, psychosocial clinicians), collaboration (physicians, psychosocial clinicians), and communication (apps, physicians, psychosocial clinicians) were all advantages (APPs, psychosocial). Insufficient funding, medical opposition (physicians, APPs, nurses), and uncertainty about the interdisciplinary roles were among the problems that were anticipated (APPs, nurses, psychosocial).

Pediatric doctors were aware of the potential advantages of an integrated PC approach. Multidisciplinary physicians presented distinctive opinions despite certain notions having some commonality, underscoring the need of integrating multiple viewpoints to guarantee that pediatric PC models were in line with the aims of many stakeholders.

Reference: jpsmjournal.com/article/S0885-3924(22)00745-X/fulltext