The implementation of pediatric oncology advanced practice nurse (s) roles in low- and middle-income countries (LMICs) presents opportunities and challenges. The authors explore the implications of ...pediatric oncology advanced practice nursing roles in Pakistan, Cameroon, Turkey, and Mexico. Potential benefits and drawbacks of advanced practice nursing roles, impacts on nursing care, and strategies for advanced practice nursing role development in LMIC settings are considered.
Information from scholarly articles, policy documents, and four LMIC pediatric oncology nurse expert perspectives on existing and imagined advanced practice nursing roles in pediatric oncology in LMIC were synthesized.
Current literature and policies point to efforts across LMICs to establish a wide variety of advanced nursing practices, not necessarily aligned with internationally accepted advanced practice nursing standards of practice or education. The LMIC nurses describe a wide range of national general nurse education and government advanced practice nurse recognition/licensing. Challenges to achieving or strengthening advanced practice nursing roles include, for example, healthcare professional resistance, government unwillingness to recognize/license advanced practice nurses, and lack of advanced practice nursing faculty. To promote a pediatric oncology advanced practice nursing role in LMICs requires navigating the national nursing scope of practice and nursing culture.
The strategic introduction of pediatric oncology advanced practice nursing roles in LMICs has the potential to significantly enhance patient care by, for example, addressing healthcare workforce shortages and facilitating timely care delivery. However, challenges related to role complexity, resistance from traditional healthcare structures, and role overlap must be considered. Tailoring these roles to local contexts and fostering stakeholder collaboration are essential for successful implementation.
The adoption of advanced practice nursing roles can lead to improved quality of care for pediatric oncology patients and their families in LMICs, where cancer care is challenging. The positive impact of pediatric oncology advanced practice nurses on patient outcomes and healthcare delivery cannot be discounted but must align with local nursing and healthcare culture and expectations.
Rationale: Approximately 8,000 new cases of pediatric cancer arise annually in Pakistan. However, there is a dire survival rate of 30–35% due to various factors, especially a lack of competent nurses ...in pediatric oncology care. Public-private partnerships (PPP) supported by a My Child Matters (MCM) Grant from Sanofi Espoir Foundation was granted to Indus Hospital & Health Network (IH&HN) to improve pediatric nursing standards.Methods: Starting in 2016, nurses from hospitals across Pakistan were enrolled in a continuing education program, which included a comprehensive, hands-on training component. A group chat was created following the training for communication and mentorship regarding challenges faced locally.Results: Seventy-seven pediatric oncology nurses were successfully trained by IH&HN over three years.Discussion: Challenges included lack of government funding, shortage of specialist nurses, frequent shifting of nurses away from pediatric care, and indifferent attitudes. Success of the project could have been maximized if trained nurses were motivated and retained by hospitals.Conclusion: Development and maintenance of PPP in national healthcare systems is essential to improve pediatric oncology nursing care.Key words: Public Private Partnership, pediatric cancer, pediatric oncology nurses, nursing care
Approximately 8,000 new cases of pediatric cancer arise annually in Pakistan. However, there is a dire survival rate of 30-35% due to various factors, especially a lack of competent nurses in ...pediatric oncology care. Public-private partnerships (PPP) supported by a My Child Matters (MCM) Grant from Sanofi Espoir Foundation was granted to Indus Hospital & Health Network (IH&HN) to improve pediatric nursing standards.
Starting in 2016, nurses from hospitals across Pakistan were enrolled in a continuing education program, which included a comprehensive, hands-on training component. A group chat was created following the training for communication and mentorship regarding challenges faced locally.
Seventy-seven pediatric oncology nurses were successfully trained by IH&HN over three years.
Challenges included lack of government funding, shortage of specialist nurses, frequent shifting of nurses away from pediatric care, and indifferent attitudes. Success of the project could have been maximized if trained nurses were motivated and retained by hospitals.
Development and maintenance of PPP in national healthcare systems is essential to improve pediatric oncology nursing care.
When patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision ...still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with "unrealized potential" for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it.
We distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.ResultWe had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How "developed" a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.Significance of resultsDespite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.
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