{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:05:05Z","timestamp":1789571105498,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine how healthcare provider communication shapes referral, acceptance and ongoing integration of specialist pediatric palliative care (SPPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative study was conducted across four pediatric cancer centers in Canada. Sixty\u2010six healthcare providers working in oncology and palliative care settings participated in in\u2010depth interviews. Participants included physicians, nurses, psycho\u2010social clinicians and other members of the interprofessional health team. Transcripts were analyzed using iterative, inductive coding based on the Grounded Theory method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Communication barriers to referral and acceptance included inadequate explanations for SPPC involvement, incomplete or misleading descriptions of services, and framing SPPC solely as end\u2010of\u2010life care. Oncologist discomfort, avoidance, and use of ambiguous \u201ccoded\u201d language further hindered referral conversations. Facilitators included strong communication skills, clear and comprehensive explanations of SPPC, and age\u2010appropriate engagement with patients. For ongoing integration of SPPC, poor interprofessional communication and unclear role and responsibilities among team members created risks for fragmented care. In contrast, structured collaboration such as joint meetings, shared care planning, and proactive information exchange, supported effective integration of SPPC and consistent messaging to patients and families.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Communication is central to successful SPPC referral, acceptance, and integration in pediatric oncology settings. Both clinician\u2010family and interprofessional communication practices directly shaped understanding and engagement with SPPC services. Interventions should prioritize communication training, clearer framing of SPPC, and enhanced collaboration between teams. Early involvement of the psychosocial provider along with an SPPC specialist may further improve communication and uptake, ultimately strengthening care for children with serious illness and their families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70568","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T11:51:01Z","timestamp":1786103461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Communication Barriers and Facilitators to Specialist Pediatric Palliative Care Involvement in Pediatric Oncology Settings Across Canada"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9936-2826","authenticated-orcid":false,"given":"Leeat","family":"Granek","sequence":"first","affiliation":[{"name":"School of Health Policy and Management York University  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9803-9434","authenticated-orcid":false,"given":"Stephanie","family":"Veldhuijzen van Zanten","sequence":"additional","affiliation":[{"name":"Palliative Care Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8132-061X","authenticated-orcid":false,"given":"Kimberley","family":"Widger","sequence":"additional","affiliation":[{"name":"Lawrence Bloomberg Faculty of Nursing University of Toronto  Toronto Ontario Canada"},{"name":"Paediatric Advanced Care Team Hospital for Sick Children  Toronto Ontario 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"}]},{"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 Ontario 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 Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathasha","family":"Datoo","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology BC Children's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Fergus","sequence":"additional","affiliation":[{"name":"Psychology Department York University  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1551-3995","authenticated-orcid":false,"given":"Anthony K. 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