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Abstract

Background

Childhood cancer often entails long-term treatment, with various side effects that affect the nutritional status of patients. Nurses play a pivotal role in assessing and promoting nutritional support. Therefore, we aimed to explore the experiences of clinical nurses assessing and promoting optimal nutrition supportive care during pediatric cancer treatment.

Method

Four focus groups involving 22 clinical nurses were conducted at the four tertiary hospitals in Norway treating children with cancer. Analysis was guided by Braun and Clarke's reflexive thematic approach. The study adhered to the consolidated criteria for reporting qualitative research.

Results

Four themes were created. Nurses employed a holistic approach to plan and integrate nutritional care in collaboration with families, dietitians, doctors, and other professionals. Barriers in nutritional oncology care identified were treatment side effects, time constraints, and inadequate use of guidelines. Nurses experienced difficulties discussing overweight conditions with patients.

Discussion

Our study offers insight into the importance of close collaboration with every single family, thus promoting family-centered care for assessing and promoting optimal nutritional status during treatment for pediatric oncology. Nurses must have a broad perspective on what constitutes optimal nutritional care. Using guidelines in a systematic manner is crucial to prevent malnutrition during childhood cancer treatment.

Keywords

nutritional care childhood cancer family-centered care

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References

Aarthun

Akerjordet

(2014). Parent participation in decision-making in health-care services for children: An integrative review. Journal of Nursing Management, 22(2), 177–191.

Arpe

M. L.

Rørvig

Kok

Mølgaard

Frandsen

T. L.

(2015). The association between glucocorticoid therapy and BMI z-score changes in children with acute lymphoblastic leukemia. Support Care in Cancer, 23(12), 3573–3580. https://doi.org/10.1007/s00520-015-2718-5

Bratteteig

Anderssen

S. A.

Rueegg

C. S.

Ruud

Torsvik

I. K.

Kriemler

Grydeland

(2022). Device-measured physical activity and cardiovascular disease risk in adolescent childhood cancer survivors. A physical activity in childhood cancer survivors (PACCS) study. Frontiers in Pediatrics, 10,Article 977365. https://doi.org/10.3389/fped.2022.977365

Braun

Clarke

(2022). Thematic analysis—A practical guide (F. Maher, Ed.). Sage Publications.

Christensen

M. E.

Haahr

Olsen

P. R.

Rose

H. K.

Norlyk

(2021). Love, joy and necessity—A phenomenological study of food and meals in adolescents and young adults with cancer receiving high-emetogenic chemotherapy. European Journal of Oncology Nursing, 54,Article 102020. https://doi.org/10.1016/j.ejon.2021.102020

Chua

W. L.

Legido-Quigley

P. Y.

McKenna

Hassan

N. B.

Liaw

S. Y.

(2019). Seeing the whole picture in enrolled and registered nurses’ experiences in recognizing clinical deterioration in general ward patients: A qualitative study. International Journal of Nursing Studies, 95, 56–64. https://doi.org/10.1016/j.ijnurstu.2019.04.012

Cohen

Goddard

Brierley

M.-E.

Bramley

Beck

(2021). Poor diet quality in children with cancer during treatment. Journal of Pediatric Oncology Nursing, 38(5), 313–321. https://doi.org/10.1177/10434542211011050

Connor

Dean

McNett

Tydings

D. M.

Shrout

Gorsuch

P. F.

Hole

Moore

Brown

Melnyk

B. M.

Gallagher‐Ford

(2023). Evidence‐based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews on Evidence-Based Nursing, 20(1), 6–15. https://doi.org/10.1111/wvn.v20.1

Diakatou

Vassilakou

(2020). Nutritional status of pediatric cancer patients at diagnosis and correlations with treatment, clinical outcome and the long-term growth and health of survivors. Children, 7(11),Article 218.

10.

Egnell

Närhinen

Merker

Jonsson

Ó. G.

Lepik

Niinimäki

Schmiegelow

Stabell

Klug Albertsen

Vaitkeviciene

Ranta

Harila-Saari

(2022). Changes in body mass index during treatment of childhood acute lymphoblastic leukemia with the Nordic ALL2008 protocol. European Journal of Haematology, 109(6), 656–663. https://doi.org/10.1111/ejh.13848

11.

Freedman

J. L.

Beeler

D. M.

Bowers

Bradford

Cheung

Y. T.

Davies

Dupuis

L. L.

Elgarten

C. W.

Jones

T. M.

Jubelirer

Miller

T. P.

Patel

Phillips

C. A.

Wardill

H. R.

Orsey

A. D.

(2023). Supportive care in pediatric oncology: Opportunities and future directions. Cancers, 15(23), 5549. https://doi.org/10.3390/cancers15235549

12.

Helfo. (2019). Helfo, the Norwegian Health Economics Administration. Directorate of Health. https://www.helfo.no/om-helfo/om-helfo/about-helfo

13.

Heyman

Bacon

Baruchel

Bierings

Brito

Büchner

Haas

V. d.

Moerloose

B. D.

Duarte

Escherich

Flood

Halfon-Domenech

Hallböök

Hancock

Horstmann

Hough

Ifversen

Juhlin

., Malone

Zimmermann

. (2020). ALLTogether1 Protocol final (NCT04307576). ClinicalTrials.gov https://www.clinicaltrials.gov/study/NCT04307576?cond=Acute%20Lymphoblastic%20Leukemia&rank=8

14.

Johnson

Abraham

Conway

Simmons

Edgman-Levitan

Sodomka

Schlucter

Ford

(2008). Partnering with patients, residents, and families: A resource for leaders of hospitals, ambulatory care settings, and long-term care communities. Institute for Patient- and Family-Centered Care.

15.

Keller

M. C.

Needham

Holden

Engelke

Foy

Hart

Hinderer

(2024). We are done! Now what? Exploring end of treatment needs of childhood cancer survivors and their parents. Journal of Pediatric Hematology/Oncology Nursing, 41(2), 96–106. https://doi.org/10.1177/27527530231194598

16.

Krueger

R. A.

Casey

M. A.

(2015). Focus groups. A practical guide for applied research (5th ed.). Sage Publications.

17.

Ladas

E. J.

Sacks

Meacham

Henry

Enriquez

Lowry

Hawkes

Dadd

Rogers

(2005). A multidisciplinary review of nutrition considerations in the pediatric oncology population: A perspective from Children's Oncology Group. Nutrition in Clinical Practice, 20(4), 377–393. https://doi.org/10.1177/0115426505020004377

18.

Linder

L. A.

Wawrzynski

S. E.

(2018). Staff perceptions of symptoms, approaches to assessment, and challenges to assessment among children with cancer. Journal of Pediatric Oncology Nursing, 35(5), 332–341. https://doi.org/10.1177/1043454218767888

19.

Lulloff

A. J.

Vessey

J. A.

Bashore

Gregas

(2019). Nutrition-related clinical decision making of pediatric oncology nurses. Journal of Pediatric Oncology Nursing, 36(5), 352–360. https://doi.org/10.1177/1043454219844233

20.

Lumivero. (2023). NVivo 14 software program. QSR International.

21.

Martinez

E. E.

Mehta

N. M.

(2021). Nutrition therapy and outcomes in hospitalized children. Journal of Parenteral and Enteral Nutrition, 45(7), 1392–1394. https://doi.org/10.1002/jpen.2253

22.

Mehta

N. M.

Skillman

H. E.

Irving

S. Y.

Coss-Bu

J. A.

Vermilyea

Farrington

E. A.

McKeever

Hall

A. M.

Goday

P. S.

Braunschweig

(2017). Guidelines for the provision and assessment of nutrition support therapy in the pediatric critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Journal of Parenteral and Enteral Nutrition, 41(5), 706–742. https://doi.org/10.1177/0148607117711387

23.

Mulrooney

(2022). Understanding obesity and addressing stigma: The role of healthcare professionals. Nursing Standard, 37(12), 61–65. https://doi.org/10.7748/ns.2022.e11962

24.

Murphy

A. J.

White

Elliott

S. A.

Lockwood

Hallahan

Davies

P. S. W.

(2015). Body composition of children with cancer during treatment and in survivorship. The American Journal of Clinical Nutrition, 102(4), 891–896. https://doi.org/10.3945/ajcn.114.099697

25.

Muscaritoli

Arends

Bachmann

Baracos

Barthelemy

Bertz

Bozzetti

Hutterer

Isenring

Kaasa

Krznaric

Laird

Larsson

Laviano

Muhlebach

Oldervoll

Ravasco

Solheim

T. S.

Strasser

Bischoff

S. C.

(2021). ESPEN practical guideline: Clinical nutrition in cancer. Clinical Nutrition, 40(5), 2898–2913. https://doi.org/10.1016/j.clnu.2021.02.005

26.

NORDCAN. (2024). Incidence all cancer 0-19 in 2020 . Association of the Nordic Cancer Registries. https://nordcan.iarc.fr/en

27.

Polit

D. F.

Beck

C. T.

(2021). Nursing research—Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.

28.

Roug

L. I.

Jarden

Wahlberg

Hjalgrim

L. L.

Hansson

(2023). Ambiguous expectations of parent caregiving for the child and adolescent with cancer at the hospital and at home—An ethnographic study. Journal of Pediatric Hematology and Oncology Nursing, 40(2), 100–110. https://doi.org/10.1177/27527530221140065

29.

Statistics Norway (SSB). (2024). Statistics Norway—Norwegian population https://www.ssb.no/en/statbank/table/07459

30.

Teixeira

I. X.

de Oliveira Lopes

M. V.

Diniz

C. M.

(2021). Nutritional deficits in children with cancer: A situation-specific theory. International Journal of Nursing Knowledge, 32(1), 29–36. https://doi.org/10.1111/2047-3095.12287

31.

Thibault

Abbasoglu

Ioannou

Meija

Ottens-Oussoren

Pichard

Rothenberg

Rubin

Siljamaki-Ojansuu

Vaillant

M. F.

Bischoff

S. C.

(2021). ESPEN guideline on hospital nutrition. Clinical Nutrition, 40(12), 5684–5709. https://doi.org/10.1016/j.clnu.2021.09.039

32.

Wang

Tan

J.-Y.

Liu

X.-L.

Zhao

(2023). Barriers and enablers to implementing clinical practice guidelines in primary care: An overview of systematic reviews. BMJ Open, 13(1),Article e062158. https://doi.org/10.1136/bmjopen-2022-062158

33.

World Medical Association (WMA). (1964). Declaration of Helsinki - Ethical principles for medical research involving human subjects. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/