Abstract:
Childhood cancer is an important public health concern worldwide. Globally
2,000,000 new cases of childhood cancer occur per year, 80% of which befall to low- and
middle-income countries (LMIC). Moreover, 90% of childhood cancer related deaths occur
in LMIC. The available evidence speaks about high percentages of curability and
survivorship from childhood cancer in high income countries.
According to the Ministry of Health, the total number of childhood cancer cases
registered in Armenia between 2004 and 2013 was 714. The National Center for Oncology
after V.A. Fanarjian identified the most common types of childhood cancers in Armenia: hematopoetic and lymphatic system cancers (40%), brain and nervous system cancers
(15%), bone tissue malignancies (11%) and kidney cancers (7%) from 2004 to 2014.
Childhood cancer treatment is considered to be difficult and long-lasting. Healthcare
professionals are faced with various challenges during the provision of childhood cancer
treatment. The literature suggests that insufficient resources for patient care and
psychological support, difficulties when providing information to the patients and their
families due to emotional aspects, are among the challenges that health care providers deal with.
This qualitative study aims to understand the needs and challenges faced during the
provision of pediatric oncology care from the perspective of physicians treating childhood
cancer. The study was conducted through semi-structured in-depth interviews with selected
study participants. Purposive sampling technique was used for choosing the study
participants. The study population included physicians dealing with childhood cancer: a)
pediatric hematologists/oncologists, b) radiotherapists, c) pediatric surgeons and d) general
chemotherapists. Three study instruments were developed based on the literature review, designed and adapted for the specific groups of respondents for whom they were intended, and translated into the Armenian language. Data were collected until saturation was
reached. Qualitative conventional content analysis method with a deductive approach was
used for analyzing the data from the in-depth interviews.
Study findings suggest several needs in the provision of childhood cancer care such
as: qualified staff shortages; need for quality trainings for staff especially for pediatric
surgeons, pediatrician from ICUs; need for better hospital conditions; and unavailable
resources (medication, equipment, cancer registry system) in Armenia. According to the
study findings the challenges for physicians in the childhood cancer care delivery included:
difficulties in communication with patients and their family members related to the bad
news, tiredness, depressions, sleepless nights, heavy workload and inadequate salaries.