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Disparities in the delivery of pediatric oncology nursing care by country income classification: International survey results
Author(s) -
Morrissey Lisa,
Lurvey Megan,
Sullivan Courtney,
Challinor Julia,
Forbes Peter W.,
Abramovitz Linda,
Afungchwi Glenn M.,
Hollis Rachel,
Day Sara
Publication year - 2019
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27663
Subject(s) - medicine , workgroup , pediatric oncology , developing country , oncology nursing , family medicine , nursing , nurse education , cancer , computer network , computer science , economics , economic growth
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.