• J Pain Symptom Manage · Feb 2025

    Uncovering Structurally Differential Care: Pediatric Oncology Nurses' Perspectives Caring for African American Families.

    • Ijeoma Julie Eche-Ugwu, Teri Aronowitz, Elizabeth G Broden, Alexandra Merz, Ariel Vernadakis, Karen Bullock, Joanne Wolfe, and Angela M Feraco.
    • The Phyllis Cantor Center for Research in Nursing and Patient Care, Dana-Farber Cancer Institute, Boston MA; Harvard Medical School, Boston, MA. Electronic address: Ijeomaj_eche@dfci.harvard.edu.
    • J Pain Symptom Manage. 2025 Feb 5.

    BackgroundPsychosocial intervention studies aimed at reducing stress among parents of children with cancer have historically included insufficient samples of African American parents. Pediatric oncology nurses are uniquely positioned to identify and address parent psychosocial needs. However, research exploring their perspectives to serve as psychosocial interventionists specifically for African American families of children with cancer is limited.ObjectiveTo explore the perspectives of pediatric oncology nurses on their role as psychosocial interventionists for African American families navigating childhood cancer.MethodsWe conducted 32 remote individual interviews and 2 focus groups (n = 4 each) with 40 pediatric oncology nurses from three pediatric cancer centers and a large pediatric oncology nursing organization. Using Corbin and Strauss' Grounded Theory methodology, we used constant comparative analysis to generate a theory based on the nurses' perspectives.ResultsOur emergent theory - Structurally Differential Care - had two major themes (psychosocial resource facilitators and psychosocial resource obstructors). Psychosocial resource facilitators: 1) appreciating families' experiences, 2) longitudinal presence, 3) open communication, 4) holistic care, and 5) safe spaces mitigated structurally differential care. Nurses also identified: 1) difficulty with serious illness conversation, 2) lack of nursing experience, and 3) competing work demands as psychosocial resource obstructors that intensify structurally differential care.ConclusionsThis sample of pediatric oncology nurses described experiences that either bolstered or obstructed their psychosocial care provision, signaling potential opportunities for nurse-targeted interventions that may reduce factors contributing to disparities in the psychosocial care for African American families of children with cancer.Copyright © 2025. Published by Elsevier Inc.

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