Experiences of Health Care Professionals in Navigating Challenges of Pediatric Cancer Recurrence.
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Background: The recurrence of cancer in pediatric hematology-oncology is a distressing event for patients, families, and health care professionals (HCPs). Despite advances in treatment, cancer recurrence poses significant emotional and communication challenges for nurses and physicians. Objectives: This qualitative study explores the experiences of nurses and physicians in pediatric hematology-oncology when faced with children's cancer recurrence, focusing on their emotions, communication strategies, and approaches to patient care. Design: A descriptive, in-depth interview approach was used. Data were collected through semi-structured interviews, transcribed verbatim, and analyzed using Braun and Clarke's six-phase thematic analysis. Setting/Subjects: Eleven physicians and 11 nurses from various pediatric hematology-oncology units in Türkiye. Measurements: Data were collected with sociodemographic information form and semi-structured interview form that developed based on the literature. Results: Three themes emerged: (1) Challenge of handling feelings, (2) Challenge of communication with children and families, and (3) Need to change treatment and care practices. HCPs reported a range of emotions, including sadness, helplessness, failure, guilt, fear, and hopelessness. Communication strategies were adapted based on the child's age and developmental level, focusing on maintaining hope while being realistic. Empathetic and flexible approaches to treatment were emphasized, often involving more patient-centered care and considerations for palliative care. Conclusions: The recurrence of cancer in pediatric patients significantly impacts HCPs, who experience profound emotional challenges and adapt their communication and care strategies to support the child and family. The study highlights the need for tailored interventions and training to enhance HCPs' emotional coping and communication in pediatric oncology.