Pediatric Hematology-Oncology Provider Attitudes and Beliefs About the Use of Integrative Modalities for Their Patients: A Cross-Sectional Survey.

Purpose: Children with cancer suffer from physical and psychological symptoms. Integrative medicine modalities (IMMs) for symptom management are increasingly popular, but whether these are acceptable to pediatric hematology-oncology (PHO) providers remains unknown. To address this knowledge gap and guide integrative medicine (IM) program development, a needs assessment was conducted to understand PHO provider knowledge, attitudes, and beliefs regarding IMMs for symptom management in children with hematologic or oncologic disorders. Methods: A detailed survey instrument was crafted using primary literature and expert opinion, iteratively reviewed for validity, and piloted tested by health care providers (HCPs). The survey was distributed electronically to patient-facing staff and stratified by clinical role. Survey response data from physicians and advanced practice providers (APPs) underwent descriptive analysis using SAS v.9.4 (Cary, NC). Results: A total of 78 PHO physicians and APPs completed this survey (response rate 29.5%). While most PHO physicians and APPs do not feel confident discussing incorporation of IMMs into the care of PHO patients, they are willing to (1) receive additional education in IM and (2) refer to a trusted IM provider. Providers do not believe that families typically disclose use of IMM to HCPs, and many worry about the use of entities such as high-dose vitamins and chiropractic care. Conclusions: PHO providers are concerned about the use of specific IMMs in their patients' care but support massage and mindfulness almost universally. Most PHO clinicians are willing to engage trained IM providers and support strategies that may contribute to improved quality of life for their patients and families.