Exploring Pediatric Oncology Care Practices Influencing the Relationships Among Children, Caregivers, and Health Care Providers: A Multi-Institutional Study From Pakistan

PURPOSEThe quality of relationships between health care professionals (HCPs) and patients is an important factor influencing people's experiences with their health systems. In Pakistan, pediatric oncologists highlight the need for effective communication to support relationships between HCPs an...

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Main Authors: Shahzadi Resham, Sadaf Altaf, Farwa Ayub, Areesh Bhatti, Areeba Syed, Rida Iqbal, Afia Tul Quanita, Clariana Vitória Ramos de Oliveira, Zehra Fadoo, Naureen Mushtaq, Uzma Imam, Muhammad Rafie Raza, Aisha Khizar Yousafzai
Format: Article
Language:English
Published: American Society of Clinical Oncology 2025-04-01
Series:JCO Global Oncology
Online Access:https://ascopubs.org/doi/10.1200/GO-24-00347
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author Shahzadi Resham
Sadaf Altaf
Farwa Ayub
Areesh Bhatti
Areeba Syed
Rida Iqbal
Afia Tul Quanita
Clariana Vitória Ramos de Oliveira
Zehra Fadoo
Naureen Mushtaq
Uzma Imam
Muhammad Rafie Raza
Aisha Khizar Yousafzai
author_facet Shahzadi Resham
Sadaf Altaf
Farwa Ayub
Areesh Bhatti
Areeba Syed
Rida Iqbal
Afia Tul Quanita
Clariana Vitória Ramos de Oliveira
Zehra Fadoo
Naureen Mushtaq
Uzma Imam
Muhammad Rafie Raza
Aisha Khizar Yousafzai
author_sort Shahzadi Resham
collection DOAJ
description PURPOSEThe quality of relationships between health care professionals (HCPs) and patients is an important factor influencing people's experiences with their health systems. In Pakistan, pediatric oncologists highlight the need for effective communication to support relationships between HCPs and children and families. Existing communication toolkits on the basis of the evidence from high-income countries are ineffective and culturally unsuitable in the context of low- and middle-income countries. Therefore, we aim to describe how characteristics of current pediatric oncology care practices for children with life-threatening illnesses (LTIs) influence their relationships and communication about illness and treatment.MATERIALS AND METHODSA phenomenological qualitative study was conducted. In-depth interviews (N = 60) were conducted with children (8-18 years) with LTI receiving treatment at one of three pediatric oncology units in Karachi, their families, and HCPs. Themes were generated after inductive coding.RESULTSFive themes were identified, and four key findings are highlighted. First, HCPs valued effective communication. Practices were influenced by the sociocultural environment using a range of approaches, often without formal training, to respond to local needs. Second, families and HCPs were concerned about treatment-related fears, leading to reluctance in sharing illness information with children regardless of age. Third, both groups felt that disclosing diagnosis, involving families and children in treatment plans, and age-appropriate communication would strengthen the therapeutic alliance. Finally, HCPs emphasized the importance of faith and a multidisciplinary team approach in enhancing therapeutic relationships.CONCLUSIONThe need for effective communication with children with LTI and families while respecting sociocultural norms will allow for trust building and stronger therapeutic alliances.
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publisher American Society of Clinical Oncology
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spelling doaj-art-a4b61e9ebdbf40e28e26a8928f9c1c9b2025-08-20T03:08:22ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-04-011110.1200/GO-24-00347Exploring Pediatric Oncology Care Practices Influencing the Relationships Among Children, Caregivers, and Health Care Providers: A Multi-Institutional Study From PakistanShahzadi Resham0Sadaf Altaf1Farwa Ayub2Areesh Bhatti3Areeba Syed4Rida Iqbal5Afia Tul Quanita6Clariana Vitória Ramos de Oliveira7Zehra Fadoo8Naureen Mushtaq9Uzma Imam10Muhammad Rafie Raza11Aisha Khizar Yousafzai12Department of Paediatrics and Child Health, The Aga Khan University, Karachi, PakistanDepartment of Oncology, The Aga Khan University, Karachi, PakistanDepartment of Oncology, The Aga Khan University, Karachi, PakistanMedical College, The Aga Khan University, Karachi, PakistanDepartment of Oncology, The Aga Khan University, Karachi, PakistanDepartment of Oncology, The Aga Khan University, Karachi, PakistanDepartment of Pediatric Oncology, The Indus Hospital, Karachi, PakistanSchool of Nursing, University of Nevada, Las Vegas, NVDepartment of Oncology, The Aga Khan University, Karachi, PakistanDepartment of Oncology, The Aga Khan University, Karachi, PakistanNational Institute of Child Health, Karachi, PakistanDepartment of Pediatric Oncology, The Indus Hospital, Karachi, PakistanGlobal Health and Population, Harvard T.H. Chan School of Public Health, Boston, MAPURPOSEThe quality of relationships between health care professionals (HCPs) and patients is an important factor influencing people's experiences with their health systems. In Pakistan, pediatric oncologists highlight the need for effective communication to support relationships between HCPs and children and families. Existing communication toolkits on the basis of the evidence from high-income countries are ineffective and culturally unsuitable in the context of low- and middle-income countries. Therefore, we aim to describe how characteristics of current pediatric oncology care practices for children with life-threatening illnesses (LTIs) influence their relationships and communication about illness and treatment.MATERIALS AND METHODSA phenomenological qualitative study was conducted. In-depth interviews (N = 60) were conducted with children (8-18 years) with LTI receiving treatment at one of three pediatric oncology units in Karachi, their families, and HCPs. Themes were generated after inductive coding.RESULTSFive themes were identified, and four key findings are highlighted. First, HCPs valued effective communication. Practices were influenced by the sociocultural environment using a range of approaches, often without formal training, to respond to local needs. Second, families and HCPs were concerned about treatment-related fears, leading to reluctance in sharing illness information with children regardless of age. Third, both groups felt that disclosing diagnosis, involving families and children in treatment plans, and age-appropriate communication would strengthen the therapeutic alliance. Finally, HCPs emphasized the importance of faith and a multidisciplinary team approach in enhancing therapeutic relationships.CONCLUSIONThe need for effective communication with children with LTI and families while respecting sociocultural norms will allow for trust building and stronger therapeutic alliances.https://ascopubs.org/doi/10.1200/GO-24-00347
spellingShingle Shahzadi Resham
Sadaf Altaf
Farwa Ayub
Areesh Bhatti
Areeba Syed
Rida Iqbal
Afia Tul Quanita
Clariana Vitória Ramos de Oliveira
Zehra Fadoo
Naureen Mushtaq
Uzma Imam
Muhammad Rafie Raza
Aisha Khizar Yousafzai
Exploring Pediatric Oncology Care Practices Influencing the Relationships Among Children, Caregivers, and Health Care Providers: A Multi-Institutional Study From Pakistan
JCO Global Oncology
title Exploring Pediatric Oncology Care Practices Influencing the Relationships Among Children, Caregivers, and Health Care Providers: A Multi-Institutional Study From Pakistan
title_full Exploring Pediatric Oncology Care Practices Influencing the Relationships Among Children, Caregivers, and Health Care Providers: A Multi-Institutional Study From Pakistan
title_fullStr Exploring Pediatric Oncology Care Practices Influencing the Relationships Among Children, Caregivers, and Health Care Providers: A Multi-Institutional Study From Pakistan
title_full_unstemmed Exploring Pediatric Oncology Care Practices Influencing the Relationships Among Children, Caregivers, and Health Care Providers: A Multi-Institutional Study From Pakistan
title_short Exploring Pediatric Oncology Care Practices Influencing the Relationships Among Children, Caregivers, and Health Care Providers: A Multi-Institutional Study From Pakistan
title_sort exploring pediatric oncology care practices influencing the relationships among children caregivers and health care providers a multi institutional study from pakistan
url https://ascopubs.org/doi/10.1200/GO-24-00347
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