Bridging the gap in pediatric cancer rehabilitation care: a multi-perspective survey study.
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BACKGROUND: Rehabilitation is a fundamental pillar of supportive care in pediatric oncology, yet its delivery faces significant systemic barriers. Data on rehabilitation accessibility and provider readiness in Central Europe remain limited. OBJECTIVES: This study examined the rehabilitation needs of pediatric oncology patients aged 0-19 years both during and after treatment - including accessibility, barriers, and stakeholder readiness - from the perspectives of parents, physiotherapists, and rehabilitation physicians. METHODS: Three parallel questionnaire surveys were conducted among parents of children with cancer (N = 394), physiotherapists (N = 318), and rehabilitation physicians (N = 85), and analyzed using descriptive statistics, binary logistic regression, and inductive thematic analysis of open-ended responses. RESULTS: While 63.7% of parents reported their child required rehabilitation during active treatment, only 53.3% ultimately received it - an unmet need rate of 10.4% that rose to 13.3% after treatment completion. Lymphoma and spinal cord tumor patients showed the highest unmet need rates across both phases. Rehabilitation proved a long-term necessity: 29.5% of children required therapy for more than six months during treatment, rising to 47.6% post-treatment. A critical education gap was identified: 80% of physiotherapists and 74% of rehabilitation physicians rated their graduation-level knowledge as insufficient, a deficit persisting in nearly half of professionals in current practice. Qualitative analysis revealed structural barriers including informational deficits, insufficient regional infrastructure, and professional uncertainty regarding patient safety. Despite these hurdles, 66% of physiotherapists and 54% of physicians expressed interest in joining a specialized competence network (RehaSÍŤ). CONCLUSION: The findings confirm a substantial gap between chronic rehabilitation demand and healthcare system capacity. Professional reluctance reflects insufficient training rather than lack of motivation. Establishing targeted educational programs and a structured competence network such as RehaSÍŤ may be key to ensuring equitable access to high-quality supportive care.