Disparities in the delivery of pediatric oncology nursing care by country income classification: International survey results. Issue 6 (20th February 2019)

• Record Type: Journal Article
• Authors: Morrissey, Lisa; Lurvey, Megan; Sullivan, Courtney; Challinor, Julia; Forbes, Peter W.; Abramovitz, Linda; Afungchwi, Glenn M.; Hollis, Rachel; Day, Sara
• Is Part Of: Pediatric blood & cancer. Volume 66:Issue 6(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-02-20
• Subjects: disparities -- global -- low‐ and middle‐income countries -- nursing -- pediatric oncology; Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.27663
• Languages: English
• ISSNs: 1545-5009

Abstract

Abstract: Background: In 2014, a task force of the International Society of Paediatric Oncology (SIOP) Paediatric Oncology in Developing Countries Nursing Workgroup published six baseline standards to provide a framework for pediatric oncology nursing care in low‐ and lower‐middle income countries (L/LMIC). We conducted an international survey in 2016–2017 to examine the association between country income level and nurses' resporting of conformity to the standards at their respective institutions. Procedure: Data from a cross‐sectional web‐based survey completed by nurses representing 54 countries were analyzed (N = 101). Responses were clustered by relevance to each standard and compared according to the 2017 World Bank–defined country income classification (CIC) of hospitals. Results: CIC and nurse‐to‐patient ratios in inpatient wards were strongly associated ( P < 0.0001). Nurses in L/LMIC prepared chemotherapy more often ( P < 0.0001) yet were less likely to have access to personal protective equipment such as nitrile gloves ( P = 0.0007) and fluid‐resistant gowns ( P = 0.011) than nurses in high‐resource settings. Nurses in L/LMIC were excluded more often from physician/caregiver meetings to discuss treatment options ( P = 0.04) and at the time of diagnosis ( P = 0.002). Key educational topics were missing from nursing orientation programs across all CICs. An association between CIC and the availability of written policies ( P = 0.009) was found. Conclusions: CIC and the ability to conform to pediatric oncology baseline nursing standards were significantly associated in numerous elements of the baseline standards, a likely contributor to suboptimal patient outcomes in L/LMIC. To achieve the goal of high‐quality cancer care for children worldwide, nursing disparities must be addressed.