Chinese Providers' Perspectives on Early Integration of Palliative Care in Pediatric Oncology A Mixed-Methods Study

Background: Internationally, early integration of palliative care in pediatric oncology has been widely recognized. However, little is known about the perspective of Chinese providers in this regard. Objective: The aim of this study was to explore the perspective of Chinese providers on the early integration of palliative care in pediatric oncology. Methods: This was a convergent mixed -methods study with a survey among 141 Chinese providers (101 nurses, 38 oncologists, and 2 social workers) and 12 individual interviews (5 oncologists, 5 nurses, and 2 social workers). Results: Three categories existed by comparison and merging of quantitative and qualitative findings: (1) attitudes toward early integration of pediatric palliative care: 75% of the participants endorsed early integration because it would bring benefits to patients and their families- participants had concerns about misunderstandings of palliative care among other stakeholders; (2) patient -provider interactions relating to early integration: participants held contradictory views toward the impact on and influencers of early integration regarding patient -provider interactions; and (3) participants suggested a system to support early integration by addressing parents' misconceptions and providers' training, and institutional facilitation. Conclusions: Chinese pediatric oncology providers generally exhibit a reserved willingness toward the early integration of palliative care. They agree that palliative care would be beneficial but have concerns about providing structural support and addressing cultural influencers. Implications for Practice: Findings of this study emphasize the significance of convening stakeholders and establishing a pediatric palliative care-friendly system in a developing country, particularly by addressing structural support, resource allocation, clarified responsibilities, and capacity building.