JOPHON NCPD (2022 Mar/Apr) - Nursing Presence in Pediatric Oncology: A Scoping Review-Nursing Presence in Pediatric Oncology: A Scoping Review

Nursing Presence in Pediatric Oncology: A Scoping Review

Pdf Summary

This scoping review examined how “nursing presence” is understood and expressed in pediatric oncology, a setting where children and families face intense physical, emotional, and psychological stress. Although nursing presence is associated with improved outcomes in chronic and end-of-life care, the authors found limited pediatric oncology–specific evidence. Using Arksey and O’Malley’s scoping review framework and thematic analysis, the authors searched CINAHL, MEDLINE, and PsycINFO (1999–July 2020). From 4,357 records, only nine qualitative-dominant studies met inclusion criteria; none directly studied nursing presence as a primary phenomenon in pediatric oncology, though several addressed related concepts (e.g., compassion, caring, empathy) and implied presence.

Five themes captured how nursing presence appears in the pediatric oncology literature:

1) <strong>Being With/Being There</strong>: Presence is portrayed as calm, attentive availability—physical and emotional—often emphasizing “being” rather than only “doing.” It includes gentleness, empathic listening, reassurance, small acts of kindness, touch, and allowing feelings to be expressed.

2) <strong>Therapeutic Relationships</strong>: Authentic, trusting relationships between nurses, children, and families are central. Adolescents described nurses as a “second family,” though one caution noted the risk of clinicians becoming overly attached.

3) <strong>Communication</strong>: Both nonverbal (silence, touch, attentive listening) and verbal communication (open, honest, comprehensive discussions) support trust, decision-making, and coping—especially near end of life.

4) <strong>Family-Centered Approach</strong>: Presence extends beyond the child to parents and siblings, recognizing parents as experts and partners in care and valuing their perspectives, support needs, and follow-up after a child’s death.

5) <strong>Perceived Outcomes</strong>: Reported benefits include comfort, reduced isolation, hope, improved coping, and easier difficult conversations. A potential negative outcome for adolescents was feeling loss/abandonment as care intensity decreases during recovery.

The review concludes that pediatric oncology nurses are well-positioned to provide nursing presence, but stronger, direct evidence (qualitative and quantitative) is needed to define, differentiate, and apply the construct in practice and research.

Keywords

nursing presence

pediatric oncology nursing

scoping review

qualitative studies

therapeutic relationships

compassionate care

empathic communication

family-centered care

end-of-life care pediatrics

psychosocial support