Perspective of Indian parents on physiotherapy rehabilitation in pediatric oncology: a qualitative phenomenological study protocol.

Background: Advances in pediatric oncology treatment have had a positive impact on the childhood cancer survival rates across the world. Despite this, children who are receiving treatment can experience treatment related physical impairments such as fatigue, muscle weakness, less mobility, and various day to day functional limitations, and this can quietly harm their quality of life. In this context, the need for physical rehabilitation increases as it supports physical functioning and generally supports well-being throughout the duration of treatment. Despite the increase in evidence showing that rehabilitation matters in pediatric oncology, the use of physiotherapy services stays uneven, especially in low- and middle-income countries, including India. Parents, who act as the main caregivers as key healthcare decision makers, strongly shape whether and how their child can take part in rehabilitation. However, the evidence on how Indian parents experience and make sense of physiotherapy rehabilitation during their child's cancer journey is limited. Therefore, this study is designed to explore and understand the lived experiences and meaning-making of Indian parents regarding physiotherapy rehabilitation during their child's cancer treatment. Methods: A phenomenological qualitative design will be employed in this study to investigate the lived experiences of Indian parents of children with cancer who are receiving physiotherapy rehabilitation. The participants who have a child aged 8-17years diagnosed with cancer and exposed to physiotherapy will be parents or primary caregiver of children will be recruited from a pediatric oncology center at a tertiary care hospital by using a purposive sampling method. Data will be collected from 8-17years old child's parents or primary caregiver of children diagnosed with cancer and exposed to physiotherapy until data and thematic saturation is achieved. Data collection will be carried out through semi-structured in-depth interviews in English or Kannada using an interview schedule. The interview schedule will be validated by experts using the Content Validity Index and the Delphi technique. The interviews will be audio recorded, transcribed and translated in the language used for the interview and analyzed using Braun and Clarke's approach of reflexive thematic analysis. Trustworthiness, credibility, confirmability, dependability, and transferability will be achieved through bracketing, reflexivity, independent coding, and audit trail. Discussion: This phenomenological study will offer valuable insights into the meaning of physiotherapy rehabilitation to Indian parents in the context of pediatric oncology and how it is experienced. An understanding of parental beliefs, expectations, emotions and barriers to physiotherapy rehabilitation will potentially help guide culturally appropriate, family-centered rehabilitation interventions and facilitate the integration of physiotherapy into pediatric oncology care pathways in low- and middle-income settings.