Stress among pediatric oncology staff. A systematic review

Abstract

Cancer is considered one of the dominant life-threatening diseases in children. Working in the field of pediatric oncology, although rewarding, can be a source of stress and emotional burden for health care providers. The aim of this systematic review was to summarise the evidence regarding the occupational stress of health care providers working with pediatric cancer patients. Extensive search of the Pubmed and Scopus databases was performed to identify studies relevant to the topic. Initial search retrieved 657 studies. The reviewing investigators, after applying the inclusion/exclusion criteria, extracted data to critically appraise the quality of evidence. The final step of search concluded in 23 studies of heterogeneous design. Results revealed two main domains of which occupational stress derived from i) the interaction of the health care provider with the patient and the family, and ii) several organisational factors, such as hierarchical structures, experience, workload, and low organisational support. Literature on the stress of pediatric oncology staff is limited. The rather small sample sizes of the studies, the heterogeneity of methodological design, the lack of assessment from a sociological point of view, as well as the limited psychometric instruments adapted to pediatric oncology staff, make the validity of the results questionable. Further research is warranted to obtain a more accurate view of the field, to identify a cause-effect relation between work-related stress and pediatric oncology staff, and, more importantly, to guide future recommendations on support systems and stress management training within pediatric oncology settings.

NICU nurses' moral distress surrounding the deaths of infants

“…27 A systematic review was done to capture and categorize pediatric oncology staffs’ stress and revealed two domains of stressor—(a) organizational issues such as workload, limited time, lack of communication with colleagues, and lack of supplies and staffing; and (b) interaction between staffs and patient or families such as communications on care trajectories with conflicted points of view, witnessing pain and patient loss, etc. 26 Although similar results have been seen, this study could report more detailed and variety of situations which pediatric nurses experience as many of the previous studies have used such instruments to examine the nurses’ moral distress level, which have limitations of discovering detailed situations that are not listed in the instruments. As the need for pediatric-appropriate instruments has been reported in previous studies, this study’s results will provide fundamental knowledge to future studies related to instrument development.…”

“…Some situations were similar to those found in previous studies conducted on pediatric nurses. 25,26 One study that was conducted in pediatric oncology settings in Sweden used an instrument to measure the level of moral distress and highlighted that nurses experienced morally distressing situations more frequently than medical doctors and nursing assistants. 25 The study identified lack of competence and continuity of care and inadequate staffing of nurses as contributing factors to morally distressing situations.…”

The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards—A National Survey

“…Based on a literature review, several studies have shown that pediatric oncology nurses are exposed to high stress. Some studies point to differences between nurses and doctors [34]. To our knowledge, studies directly comparing the pediatric palliative care experiences of doctors and nurses working in pediatric oncology departments are limited, and could be an essential focus in the future.…”

Religiosidade/espiritualidade no câncer infantojuvenil: implicações psicossociais para crianças/adolescentes adoecidos, familiares/cuidadores e equipe de saúde

“…Uma interação íntima entre crianças, pais e equipe de oncologia pediátrica geralmente é desenvolvida como parte do processo de hospitalização e, desse modo, é praticamente inevitável não se envolver emocionalmente com o que ocorre nesse contexto. Trabalhar na área da oncologia pediátrica e prestar assistência psicológica e médica em ambiente hospitalar pode ser uma experiência gratificante, contudo pode ser simultaneamente uma fonte de estresse e sobrecarga emocional para os profissionais de saúde (Zarenti et al, 2021).…”