Healthcare professionals’ views of the experiences of children with cancer and their families living in Tasmania: an interpretive-descriptive study

The experience of pediatric cancer can be traumatic for children and their families. Living in rural, remote, and regional areas can add to the complexity of care and potential effects on this patient group. Children with cancer who live in rural, remote, and regional settings may be required to travel large distances and spend long periods of time away from home and their "normal" life during phases of treatment and illness. This can lead to further disruption of family life and to the child experiencing new routines and, eventually, difficulties adjusting to life after cancer. The island state of Tasmania is recognized as being rural, remote, and regional. For Tasmanian families who have a child with cancer, accessing both community and hospital-based services for medical treatment can involve complex travel arrangements. Patients may need to travel over a body of water to specialist mainland centers to receive vital treatment. This study was conducted to explore the experiences of children with cancer and their families in Tasmania from the perspective of healthcare professionals (HCPs). Using interpretive description, as described by Thorne, this qualitative study involved semi-structured interviews with six HCPs who worked in the area of pediatric oncology. HCPs' identification of the need for individualized care for each child and family was notable. The overarching theme identified was "How a family copes with having a child with cancer is individual… but it's also very hard." The five key themes that informed the overarching theme are: (1) The child living with cancer; (2) separation and isolation; (3) financial impact; (4) navigating care systems; and (5) emotional and psychosocial wellbeing. A process of normalization of cancer was described by participants and reflects how children's cancer treatment becomes a routine experience for a child. Our findings show that children living in rural, remote, and regional settings may have different experiences in comparison to those living in large centers. The impact the geographic location has on children with cancer affects the child and their family and needs to be explored further.