Advancing Pediatric Oncology Rehabilitation: Survey Findings of Health Professionals’ Perceptions of Barriers to Care and a Framework for Action

SIMPLE SUMMARY: Children with cancer are at high risk of developing physical impairments, which can be minimized through participation in rehabilitation programs. Unfortunately, the literature suggests that pediatric oncology rehabilitation services are underutilized and that few children are referred to the service. This study aimed to explore referral practices to pediatric rehabilitation in Canada, identify healthcare providers’ perspectives of barriers to service provision, and propose a framework for action to support the advancement of rehabilitation programs for children with cancer. Canadian healthcare providers working in pediatric oncology participated in a web-based survey. Results demonstrated that medical referrals to rehabilitation services occur mostly when the child presents with, or is at risk of, severe deficits due to surgery. Healthcare providers identified a large number of barriers to rehabilitation. A framework for action is proposed, comprising key strategies to enhance rehabilitation services for children with cancer and to inform future research. ABSTRACT: Purpose: To explore pediatric oncology referral practices, gather healthcare providers’ perspectives of barriers to access and provision of rehabilitation service across Canada, and inform a framework for action to optimize rehabilitation care and inform future research. Methods: A cross-sectional survey was conducted with Canadian healthcare professionals (HCPs) working in pediatric oncology. Results: A total of 54 responses were received, and 34 corresponded to HCPs who refer children with cancer to rehabilitation services. Results suggest that approximately 25% of children are referred to rehabilitation services, primarily when the child presents with, or is at risk of, significant functional disability due to surgery. A primary barrier to service provision identified across HCPs included a lack of funding and resources. Medical professionals further identified a lack of specialized pediatric oncology rehabilitation services, whereas rehabilitation professionals identified the lack of pediatric oncology specific space and equipment. Identified themes from open-ended survey questions include the need for (1) dedicated funding and resources, (2) improved access, and (3) the need for specialized pediatric oncology rehabilitation services. Conclusion: Several barriers exist in the Canadian healthcare context that impact the delivery of rehabilitation services for children with cancer. We propose a framework for action to advance clinical care and guide future research.