{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:22:00Z","timestamp":1792030920195,"version":"4.4.0"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["#PDI\u2010185639"],"award-info":[{"award-number":["#PDI\u2010185639"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early integration of pediatric palliative care (PPC) is associated with improved symptom management, quality of life, and healthcare utilization for children with cancer. Despite this, variation persists in how PPC is understood, operationalized, and integrated within pediatric oncology programs. In particular, ambiguity surrounding the roles of oncology teams providing generalist palliative care and specialist PPC teams may contribute to delayed or inconsistent involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a qualitative study using a grounded theory approach as part of a larger multi\u2010site project examining barriers and facilitators to early PPC integration in pediatric oncology. Semi\u2010structured interviews were conducted with healthcare professionals from four Canadian pediatric centers, including oncologists, PPC physicians, nurses, social workers, and other interprofessional team members. Interviews explored definitions of PPC and perceived roles and responsibilities of oncology and PPC teams. Transcripts were coded iteratively using constant comparative analysis until thematic saturation was reached.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants from both oncology and PPC teams demonstrated substantial concordance in defining PPC as holistic, family\u2010centered care focused on quality of life, symptom management, psychosocial support, and goal\u2010concordant decision\u2010making. Both groups described overlapping responsibilities, particularly in symptom control and psychosocial care. However, specialist PPC teams identified additional roles including complex serious illness communication, bereavement support, funeral planning, and 24\/7 availability that oncology teams did not consistently recognize as part of their role. Participants emphasized that PPC roles are fluid and context\u2010dependent, shifting across disease trajectory, care setting, family needs and goals, and institutional resources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In pediatric oncology settings, overlap between generalist and specialist PPC reflects collaborative care rather than duplication. However, a lack of shared role clarity may impede timely specialist PPC involvement. Developing shared frameworks, institutional definitions, and ongoing interdisciplinary communication may support earlier, coordinated, and family\u2010centered PPC integration for children with cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70376","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T11:56:08Z","timestamp":1777982168000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Defining Roles in Pediatric Palliative Care: Perspectives From Oncology and Palliative Care Teams"],"prefix":"10.1002","volume":"73","author":[{"given":"Leeat","family":"Granek","sequence":"first","affiliation":[{"name":"School of Health Policy and Management York University  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9573-8870","authenticated-orcid":false,"given":"Lori","family":"Wiener","sequence":"additional","affiliation":[{"name":"Center for Cancer Research National Cancer Institute, NIH Bethesda  Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Veldhuijzen","family":"van Zanten","sequence":"additional","affiliation":[{"name":"Palliative Care Children's Hospital of Eastern Ontario  Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6145-9809","authenticated-orcid":false,"given":"Donna","family":"Johnston","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology Children's Hospital of Eastern Ontario  Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5594-5528","authenticated-orcid":false,"given":"Fyeza","family":"Hasan","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology Hospital for Sick Children  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Rapoport","sequence":"additional","affiliation":[{"name":"Pediatric Advanced Care Team Hospital for Sick Children  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathasha","family":"Datoo","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology BC Children's Hospital  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberley","family":"Widger","sequence":"additional","affiliation":[{"name":"Lawrence Bloomberg Faculty of\u00a0Nursing University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1334-3670","authenticated-orcid":false,"given":"Sumit","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology Hospital for Sick Children  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Fergus","sequence":"additional","affiliation":[{"name":"Psychology Department York University  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony K. C.","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology Department of Pediatrics McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisha","family":"Kassam","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Southlake Health  Newmarket Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"McCullogh","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management York University  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave","family":"Lysecki","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, Department of Pediatrics McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.12.003"},{"key":"e_1_2_9_3_1","volume-title":"When Children Die: Improving Palliative and End\u2010of\u2010Life Care for Children and Their Families","author":"Field M. 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