Introduction: Research has routinely been conducted into the experiences and well-being of children and young people with cancer and their families. However, there is little research that directly involves those with learning disabilities (LD) and or who are autistic. This is despite some cancers being more far more prevalent in some syndromes associated with learning disabilities, for example Downs Syndrome. More generally paediatric hospital care, recent research has highlighted inequity for children with LD, compared with children and young people without LD. Staff often feel less capable and confident to deliver care to those with learning disabilities, as well as having less capacity. Still less is known about cancer care for autistic children and young people, for example relating to symptom management. We aim to explore how inequity might present in cancer care for children and young people aged 5-15 years with and without LD and or who are autistic to see what inequities exist, for whom, why and in what circumstances. Methods and analysis: A transformative mixed methods design will be used, comprising an individual staff and organisational level survey, retrospective case note review, ethnographic observations of clinical care, family and staff interviews, and participatory workshops. The ethnographer will follow and observe individual children and their families. A 'toolbox' of creative participatory methods will be employed, including providing a co-designed research data collection journal to support elicitation of the child's perspective. Ethics and Dissemination: The study will run from September 2024 to January 2026. Health Research Authority approval is granted (REC Reference no. 24/LO/0410 \| IRAS Project ID: 335623) for work package 2 and 3 involving the ethnography, with interviews and workshops.
Study Type
OBSERVATIONAL
Enrollment
50
Cross-sectional Staff Survey
Purpose designed survey to provide staff perspectives around capacity, capability and confidence in delivering cancer care to children and young people with and without learning disabilities and or who are autistic.
Time frame: 6 months
Length of hospital stay
Relevant to retrospective electronic case note review
Time frame: 2017-2023
Mortality
Relevant to retrospective electronic case note review
Time frame: 2017-2023
Symptom management profiles: e.g. pain, constipation, nausea and vomiting
Relevant to retrospective electronic case note review
Time frame: 2017-2023
Cross-sectional Organisational Survey
Purpose designed survey to explore organisational level policies, training and implementation of interventions including making reasonable adjustments.
Time frame: 6 months
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