1 Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada.
2 Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
3 Department of Pediatrics, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
4 Center for Healthcare Delivery Science, Nemours Children's Health, Delaware, DE 19803, USA.
5 Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada.
6 Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1S 5S9, Canada.
7 Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.
8 Department of Psychology, Concordia University, Montreal, QC H3G 1M8, Canada.
9 Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, CA 92697, USA.
10 Department of Pediatric Psychology, Children's Hospital of Orange County, Orange, CA 92868, USA.
11 UCI Center on Stress and Health, School of Medicine, University of California Irvine, Orange, CA 92868, USA.
12 Ontario Parents Advocating for Children with Cancer, Toronto, ON M4G 1R8, Canada.

Background: Pain is a prevalent and distressing symptom for children with cancer, negatively affecting quality of life and family functioning. While most research focuses on hospital-based care, many pain episodes occur at home, where parents act as primary caregivers with limited access to evidence-based symptom management. Young children are particularly vulnerable due to limited self-reporting capacity and reliance on parental assessment. We aimed to explore parent experiences and pediatric oncology clinician perceptions of young children's cancer pain at home, its impact on families, and recommended supports.

Methods: Using an interpretive descriptive qualitative design, we conducted semi-structured interviews with parents of children aged 2-11 years undergoing outpatient cancer treatment and clinicians at two hospitals in Canada and the United States. Data were analyzed using thematic analysis.

Results: In total, 21 parents and 21 clinicians participated. Three themes were developed: (1) the multifaceted experience of young children's cancer pain at home, (2) the ripple effects of a young child's cancer pain on the family unit, and (3) assessing and treating children's cancer pain at home.

Conclusion: Managing cancer pain at home places substantial emotional and practical demands on the families of young children. Our findings highlight that structured supports providing parents and clinicians with education, effective communication pathways, and collaboration opportunities may optimize home-based pain care, reduce caregiving burden, and improve outcomes for children and their families.