The PERCEIVE Study: Pediatric Oncology Nurses’ Perspectives on Roles as Psychosocial Interventionists

Outcomes 1. Learners will identify potential opportunities related to their clinician roles that may facilitate psychosocial resources for families facing childhood cancer.2. Learners will demonstrate increased knowledge related to systemic obstacles in the provision of psychosocial care for African American families with children diagnosed with cancer. Key Message Nurses have the collective voice to wield systemic change particularly as African American experiences in pediatric psychosocial research have been systematically excluded. To mitigate some of the healthcare inequities African Americans face, this presentation will address potential gaps in pediatric oncology nurses’ role as interventionist to invigorate discussions about challenges when providing psychosocial care to African American families. Context Pediatric oncology nurses have the greatest potential to identify changes in parent psychosocial health that would benefit from intervention and provide psychosocial care given their longitudinal presence.1-3 To date, there has been almost no research focused on requisite knowledge and skills to deliver nurse-led psychosocial interventions to African American parents who face disparate distress due to structural racism (e.g., single-parent households, racial discrimination, income poverty, and unemployment). Objectives To elicit pediatric oncology nurses’ perspectives on their role as interventionists while providing psychosocial care to African American families of children with cancer. Methods Guided by tenets of grounded theory, we conducted a multisite qualitative study employing constant comparative inductive analysis. Audio-recorded 30-60 minute focus groups and individual interviews were conducted via secure video conference with purposively sampled pediatric oncology nurses. Results Collectively, 22 pediatric oncology nurses (mean [SD] age, 36 [8.6] years; 22 females [100%]) participated in 2 focus groups (4 participants each) and 14 individual interviews. Most were White (n=19, 86%), non-Hispanic (n=21, 95%), full-time (n=16, 72%), and bachelors-prepared (n=20, 91%) with an average of 12 years in pediatric oncology. Four overarching themes emerged: 1) Recognizing structurally differential care (historical trauma, race discordant care, implicit/explicit biases, stigmatizing language) 2) Facilitation of psychosocial resources and care team dynamics (longitudinal space, creating safe spaces, open communication with families), 3) Building back African American families’ fragmented trust (holistic care, appreciating African American families’ experiences) and 4) Inadequacies to psychosocial care provision (lack of nursing experience, competing work demands, difficulty with serious illness conversation). These experiences bolstered or obstructed their psychosocial care provision to African American families with children diagnosed with cancer. Conclusion Nurses identified potential areas for nurse-targeted interventions (e.g., enhancement of nurse-parent interactions, mitigating interpersonal racism,4 learning serious illness conversation) to disrupt factors contributing to disparities in pediatric psychosocial care. Keywords Communication