Study of Uprooting in Pediatric Cancer Care for Children From the French West Indies and Guiana Treated in Mainland France: A Qualitative Study.

Abstract

Background: A diagnosis of childhood cancer has a profound impact on families, especially when treatment requires relocation. Children from the French West Indies (FWI) and French Guiana (FG) are often treated in specialized centers in mainland France, resulting in physical and cultural uprooting that poses unique psychosocial challenges.

Aims: This study explores the impact of uprooting on the dynamics and well-being of these families.

Methods: This qualitative observational study used semi-structured interviews with parents of pediatric cancer patients from the FWI and FG. Eligible participants were French-speaking primary caregivers with parental authority who accompanied their children for treatment in mainland France. Interviews were conducted between November 2023 and February 2024, recorded, transcribed, and analyzed using Interpretative Phenomenological Analysis with NVivo software.

Results: Among the 10 families interviewed, uprooting significantly disrupted family dynamics and required complex adjustments. Parents reported challenges in accessing resources to manage the stress of their child's diagnosis and treatment, but expressed overall satisfaction with the healthcare received. Psychological support was essential, with many finding comfort in religious practices. Financial and social difficulties were common. Children generally adapted better than expected but struggled with separation from their familiar environment, while siblings often felt abandoned.

Conclusion: This study is the first to examine the impact of uprooting on childhood cancer treatment for families from this region. Providing care closer to home may reduce psychological and financial burdens. Recommendations include establishing regional pediatric oncology units and increased support from social services. Future research should focus on non-accompanying parents, siblings, and schooling to understand the long-term effects on survivors and develop targeted psychological and social interventions.