Abstract
Brain tumors are a common form of solid tumors in children and, unfortunately, they are characterized by a very uncertain prognosis. The treatment of this pathology often includes one or more very invasive surgical procedures, quite often in the very first steps of the treatment. Cases of brain tumors in children represent one of the greatest challenges for health care professionals in the domain of pediatric neurosurgery. This is clearly due to the complexity of the therapeutic plan, but also to the nature of the bond that is established between the child, the parents, and the members of the staff during the often-dramatic initial phase of the illness. In this phenomenological-hermeneutic study, we explore both the emotional and organizational needs, as well as the available professional and personal resources of the staff in the Neurosurgery ward of the Meyer Children’s Hospital in Florence (Italy). The ward staff, composed of 7 surgeons, a pediatric neuro-oncologist, 12 nurses, and 4 auxiliary health care professionals, underwent in-depth interviews that were recorded (with the consensus of the participants). The recordings were then transcribed and submitted to content analysis according to COREQ standards. A complex picture of emotional as well as organizational demands emerged from the data. Shared experiences were pointed out, together with more specific and idiosyncratic contents characteristic of different professional roles. The focus of the present paper was twofold, first, we considered the needs that are overtly expressed by the staff, and then we discussed the main sources of their motivational drives. We found that the latter is mainly found in the quality of the therapeutic bond that is established with the children and the family members, together with the deep interest in one’s own professional activity and the effective complementarity and integration of the personal and professional qualities of the staff members within the multidisciplinary caring group.
Highlights
Tumors of the Central Nervous System are the most common form of solid tumors in childhood, and the second most common form of cancer in the pediatric age, with a mean incidence of 3.3 cases over 100,000 children (Sinzig et al, 2008; Crawford, 2013)
The areas to be explored included the motivations to work in a pediatric neurosurgery ward, first contact with the patient and family members, the communication with patients and families, the emotional burden on the individual and group level, the staff dynamics, significant difficulties, and the major resources when facing a multitude of challenges in taking care of children with brain tumors, the memories of relevant episodes
We will focus on themes concerning needs that are overtly expressed by the staff and on the sources of their motivational drives
Summary
Tumors of the Central Nervous System are the most common form of solid tumors in childhood, and the second most common form of cancer in the pediatric age (after leukemia), with a mean incidence of 3.3 cases over 100,000 children (Sinzig et al, 2008; Crawford, 2013). The child is taken to the clinical observation due to very mild symptoms including motor system dysfunctions such as abnormalities of gait and coordination, weight loss, behavioral problems, school difficulties, and sometimes, minimal and transient facial nerves paresis (Wilne et al, 2007). While in adult patients’ symptoms of a focal encephalic lesion are mainly determined by its localization, in the case of children the symptomatology can be aggravated with the presence of general and a-specific behavioral disturbances, found in many different pediatric pathologies
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