Psychosocial and supportive care in radiation therapy: a qualitative comparison of Norway and Canada

PURPOSE: Radiation therapy technologists (RTTs) are well positioned to address psychosocial and supportive care (PSSC) needs through daily patient contact. However, PSSC remains inconsistently integrated in practice. Building on prior cross-national survey findings, this study aimed to deepen understanding of how Norwegian and Canadian RTTs' perceptions and practices in providing PSSC, and identify barriers and opportunities to improve PSSC delivery. METHODS: A qualitative comparative study using semi-structured interviews was conducted with RTTs practicing in Norway and Canada. Participants were recruited through convenience and snowball sampling. The interview guide explored four categories: 1) demographics; 2) perceptions and current practices related to PSSC; 3) barriers and enablers of PSSC; and 4) opportunities to improve PSSC delivery. Interviews were transcribed and analyzed using inductive thematic analysis to identify themes and compare patterns across both countries. RESULTS: A total of 26 RTTs were interviewed (Norway: n = 13; Canada: n = 13). RTTs in both countries recognized the importance of providing psychosocial support and care to patients undergoing radiation therapy. Norwegian RTTs described protecting relational care through scheduling flexibility and supportive environments. Canadian RTTs described delivering PSSC through structured assessments and integrating tasks within time- and staffing-constrained environment. Shared barriers included limited time and variable awareness of resources. CONCLUSION: Norwegian and Canadian RTTs described a strong commitment to PSSC, but organizational conditions shaped how care was delivered. Norwegian RTTs used a flexible patient-centered approach, while Canadian RTTs relied on a structured approach. Effective PSSC delivery requires alignment between RTTs' roles, targeted education, and institutional structures that support quality care.