Nurse-initiated Conversations for Early Integration of Palliative Care in Pediatric Oncology

Facilitating Early Integration of Palliative Care in Pediatric Oncology: Development and Implementation of a Nurse-initiated Conversation Program for Pediatric Cancer Patients and Their Families

This study aims to develop and implement a pediatric palliative care (PPC) program. It is an open-label, randomized trial (2:1 randomization) in pediatric oncology department of Children's Hospital of Fudan University. The intervention group will receive Nurse-initiated Conversations for Early Integration of Palliative Care in Pediatric Oncology (NiCE). The control group will receive routine PPC (will be scheduled to meet with the PPC team only when participants themselves, their families, or the attending oncologist requested an appointment). The intervention will take 6 months.

Early integration of PPC, endorsed by a number of international societies, is well supported by evidence on providing multi-layer relief in children and their families over the course of any life-threatening illness. This study will leverage oncology nurses' role, culturally adapt the well-recognized St. Jude Children's Individualized Care Planning and Coordination (ICPC) Model to develop and evaluate a nurse-initiated conversation program to facilitate early integration of palliative care in pediatric oncology care.

Inclusion Criteria:

• Children within eight weeks of initial oncologic diagnosis or within eight weeks of relapse/recurrent disease diagnosis
• Children speaking Chinese
• Children's family caregivers accompanying the child in the hospital (only one family member is eligible to take this role under current hospital policy)
• Children's family caregivers speaking Chinese
• Health care providers who are taking care of the eligible children, including but not limited to physicians, nurses, and social workers

Exclusion Criteria:

- Children who, in the opinion of their physician, are not capable mentally or verbally of participating in the survey or interview