Impact of the COVID-19 pandemic on pediatric oncology providers globally: A mixed-methods study

Elizabeth R. Sniderman; Dylan E. Graetz; Asya Agulnik; Radhikesh Ranadive; Yuvanesh Vedaraju; Yichen Chen; Meenakshi Devidas; Guillermo L. Chantada; Laila Hessissen; Rashmi Dalvi; Kathy Pritchard-Jones; Carlos Rodriguez-Galindo; Daniel C. Moreira; Nancy S. Bolous; Cyrine E. Haidar; Laure Bihannic; Diana Sa da Bandeira; Jade Xiaoqing Wang; Dongfang Li; Flavia Graca; Aksana Vasilyeva; Harry Lesmana

doi:10.1002/cncr.34090

Impact of the COVID-19 pandemic on pediatric oncology providers globally: A mixed-methods study

Elizabeth R. Sniderman, Dylan E. Graetz, Asya Agulnik, Radhikesh Ranadive, Yuvanesh Vedaraju, Yichen Chen, Meenakshi Devidas, Guillermo L. Chantada, Laila Hessissen, Rashmi Dalvi, Kathy Pritchard-Jones, Carlos Rodriguez-Galindo, Daniel C. Moreira, Nancy S. Bolous, Cyrine E. Haidar, Laure Bihannic, Diana Sa da Bandeira, Jade Xiaoqing Wang, Dongfang Li, Flavia GracaAksana Vasilyeva, Harry Lesmana

Houston Methodist

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Background: Coronavirus disease 2019 (COVID-19) disrupted pediatric oncology care globally, increasing demands on health care providers (HCPs) who adapted to continue care. This study sought to characterize the pandemic's impact on pediatric oncology HCPs worldwide. Methods: A 60-item survey focused on changes to clinical care, resources, and effects on clinicians. A diverse subgroup of institutions was purposefully selected for focus groups that explored teamwork, communication, and changes to care delivery. Results: The survey included 311 responses from 213 institutions representing 79 countries. Sixteen institutions participated in 19 multidisciplinary focus groups in 8 languages. Decreased clinical staff availability was cited by 51% of institutions as a major impact. Staffing modifications included decreased provider availability (66% of institutions), roles or responsibility changes, and transfer outside the specialty. Physical effects included frequent COVID-19 illness; 8% of respondents reported HCP deaths. Fifty percent of providers did not have the necessary personal protective equipment. HCPs also experienced psychological distress and financial concerns. Findings indicated more frequent impact on nurses than other providers. Impacts were described across all hospital resource levels, with staffing modifications more frequent in countries with higher COVID-19 incidence (P <.001) and mortality rate (P =.004). Focus groups revealed negative impacts were stabilized by increased teamwork, communication, contributions outside usual roles, policies aimed at optimizing safety, and feeling that they were contributing. Conclusions: COVID-19 had a profound impact on the pediatric oncology workforce, creating challenging modifications to staffing and resulting in physical, psychological, and financial distress. Despite these challenges, HCPs caring for children with cancer came together to continue to provide high-quality care.

Original language	English (US)
Pages (from-to)	1493-1502
Number of pages	10
Journal	Cancer
Volume	128
Issue number	7
DOIs	https://doi.org/10.1002/cncr.34090
State	Published - Apr 1 2022

Keywords

coronavirus disease 2019 (COVID-19)
delivery of health care
global
health care personnel
pediatric oncology
workforce

ASJC Scopus subject areas

Oncology
Cancer Research

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10.1002/cncr.34090

Cite this

Sniderman, E. R., Graetz, D. E., Agulnik, A., Ranadive, R., Vedaraju, Y., Chen, Y., Devidas, M., Chantada, G. L., Hessissen, L., Dalvi, R., Pritchard-Jones, K., Rodriguez-Galindo, C., Moreira, D. C., Bolous, N. S., Haidar, C. E., Bihannic, L., Sa da Bandeira, D., Wang, J. X., Li, D., ... Lesmana, H. (2022). Impact of the COVID-19 pandemic on pediatric oncology providers globally: A mixed-methods study. Cancer, 128(7), 1493-1502. https://doi.org/10.1002/cncr.34090

Sniderman, ER, Graetz, DE, Agulnik, A, Ranadive, R, Vedaraju, Y, Chen, Y, Devidas, M, Chantada, GL, Hessissen, L, Dalvi, R, Pritchard-Jones, K, Rodriguez-Galindo, C, Moreira, DC, Bolous, NS, Haidar, CE, Bihannic, L, Sa da Bandeira, D, Wang, JX, Li, D, Graca, F, Vasilyeva, A & Lesmana, H 2022, 'Impact of the COVID-19 pandemic on pediatric oncology providers globally: A mixed-methods study', Cancer, vol. 128, no. 7, pp. 1493-1502. https://doi.org/10.1002/cncr.34090

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title = "Impact of the COVID-19 pandemic on pediatric oncology providers globally: A mixed-methods study",

abstract = "Background: Coronavirus disease 2019 (COVID-19) disrupted pediatric oncology care globally, increasing demands on health care providers (HCPs) who adapted to continue care. This study sought to characterize the pandemic's impact on pediatric oncology HCPs worldwide. Methods: A 60-item survey focused on changes to clinical care, resources, and effects on clinicians. A diverse subgroup of institutions was purposefully selected for focus groups that explored teamwork, communication, and changes to care delivery. Results: The survey included 311 responses from 213 institutions representing 79 countries. Sixteen institutions participated in 19 multidisciplinary focus groups in 8 languages. Decreased clinical staff availability was cited by 51\% of institutions as a major impact. Staffing modifications included decreased provider availability (66\% of institutions), roles or responsibility changes, and transfer outside the specialty. Physical effects included frequent COVID-19 illness; 8\% of respondents reported HCP deaths. Fifty percent of providers did not have the necessary personal protective equipment. HCPs also experienced psychological distress and financial concerns. Findings indicated more frequent impact on nurses than other providers. Impacts were described across all hospital resource levels, with staffing modifications more frequent in countries with higher COVID-19 incidence (P <.001) and mortality rate (P =.004). Focus groups revealed negative impacts were stabilized by increased teamwork, communication, contributions outside usual roles, policies aimed at optimizing safety, and feeling that they were contributing. Conclusions: COVID-19 had a profound impact on the pediatric oncology workforce, creating challenging modifications to staffing and resulting in physical, psychological, and financial distress. Despite these challenges, HCPs caring for children with cancer came together to continue to provide high-quality care.",

keywords = "coronavirus disease 2019 (COVID-19), delivery of health care, global, health care personnel, pediatric oncology, workforce",

author = "Sniderman, \{Elizabeth R.\} and Graetz, \{Dylan E.\} and Asya Agulnik and Radhikesh Ranadive and Yuvanesh Vedaraju and Yichen Chen and Meenakshi Devidas and Chantada, \{Guillermo L.\} and Laila Hessissen and Rashmi Dalvi and Kathy Pritchard-Jones and Carlos Rodriguez-Galindo and Moreira, \{Daniel C.\} and Bolous, \{Nancy S.\} and Haidar, \{Cyrine E.\} and Laure Bihannic and \{Sa da Bandeira\}, Diana and Wang, \{Jade Xiaoqing\} and Dongfang Li and Flavia Graca and Aksana Vasilyeva and Harry Lesmana",

note = "Publisher Copyright: {\textcopyright} 2022 American Cancer Society",

year = "2022",

month = apr,

day = "1",

doi = "10.1002/cncr.34090",

language = "English (US)",

volume = "128",

pages = "1493--1502",

journal = "Cancer",

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TY - JOUR

T1 - Impact of the COVID-19 pandemic on pediatric oncology providers globally

T2 - A mixed-methods study

AU - Sniderman, Elizabeth R.

AU - Graetz, Dylan E.

AU - Agulnik, Asya

AU - Ranadive, Radhikesh

AU - Vedaraju, Yuvanesh

AU - Chen, Yichen

AU - Devidas, Meenakshi

AU - Chantada, Guillermo L.

AU - Hessissen, Laila

AU - Dalvi, Rashmi

AU - Pritchard-Jones, Kathy

AU - Rodriguez-Galindo, Carlos

AU - Moreira, Daniel C.

AU - Bolous, Nancy S.

AU - Haidar, Cyrine E.

AU - Bihannic, Laure

AU - Sa da Bandeira, Diana

AU - Wang, Jade Xiaoqing

AU - Li, Dongfang

AU - Graca, Flavia

AU - Vasilyeva, Aksana

AU - Lesmana, Harry

PY - 2022/4/1

Y1 - 2022/4/1

N2 - Background: Coronavirus disease 2019 (COVID-19) disrupted pediatric oncology care globally, increasing demands on health care providers (HCPs) who adapted to continue care. This study sought to characterize the pandemic's impact on pediatric oncology HCPs worldwide. Methods: A 60-item survey focused on changes to clinical care, resources, and effects on clinicians. A diverse subgroup of institutions was purposefully selected for focus groups that explored teamwork, communication, and changes to care delivery. Results: The survey included 311 responses from 213 institutions representing 79 countries. Sixteen institutions participated in 19 multidisciplinary focus groups in 8 languages. Decreased clinical staff availability was cited by 51% of institutions as a major impact. Staffing modifications included decreased provider availability (66% of institutions), roles or responsibility changes, and transfer outside the specialty. Physical effects included frequent COVID-19 illness; 8% of respondents reported HCP deaths. Fifty percent of providers did not have the necessary personal protective equipment. HCPs also experienced psychological distress and financial concerns. Findings indicated more frequent impact on nurses than other providers. Impacts were described across all hospital resource levels, with staffing modifications more frequent in countries with higher COVID-19 incidence (P <.001) and mortality rate (P =.004). Focus groups revealed negative impacts were stabilized by increased teamwork, communication, contributions outside usual roles, policies aimed at optimizing safety, and feeling that they were contributing. Conclusions: COVID-19 had a profound impact on the pediatric oncology workforce, creating challenging modifications to staffing and resulting in physical, psychological, and financial distress. Despite these challenges, HCPs caring for children with cancer came together to continue to provide high-quality care.

AB - Background: Coronavirus disease 2019 (COVID-19) disrupted pediatric oncology care globally, increasing demands on health care providers (HCPs) who adapted to continue care. This study sought to characterize the pandemic's impact on pediatric oncology HCPs worldwide. Methods: A 60-item survey focused on changes to clinical care, resources, and effects on clinicians. A diverse subgroup of institutions was purposefully selected for focus groups that explored teamwork, communication, and changes to care delivery. Results: The survey included 311 responses from 213 institutions representing 79 countries. Sixteen institutions participated in 19 multidisciplinary focus groups in 8 languages. Decreased clinical staff availability was cited by 51% of institutions as a major impact. Staffing modifications included decreased provider availability (66% of institutions), roles or responsibility changes, and transfer outside the specialty. Physical effects included frequent COVID-19 illness; 8% of respondents reported HCP deaths. Fifty percent of providers did not have the necessary personal protective equipment. HCPs also experienced psychological distress and financial concerns. Findings indicated more frequent impact on nurses than other providers. Impacts were described across all hospital resource levels, with staffing modifications more frequent in countries with higher COVID-19 incidence (P <.001) and mortality rate (P =.004). Focus groups revealed negative impacts were stabilized by increased teamwork, communication, contributions outside usual roles, policies aimed at optimizing safety, and feeling that they were contributing. Conclusions: COVID-19 had a profound impact on the pediatric oncology workforce, creating challenging modifications to staffing and resulting in physical, psychological, and financial distress. Despite these challenges, HCPs caring for children with cancer came together to continue to provide high-quality care.

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KW - delivery of health care

KW - global

KW - health care personnel

KW - pediatric oncology

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EP - 1502

JO - Cancer

JF - Cancer

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ER -

Impact of the COVID-19 pandemic on pediatric oncology providers globally: A mixed-methods study

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