Pediatric Palliative Care: A Conceptual Analysis for Pediatric Nursing Practice (original) (raw)
Related papers
Pediatric palliative care nursing
Annals of Palliative Medicine, 2019
Palliative care is patient-and family-centered care that enhances quality of life throughout the illness trajectory and can ease the symptoms, discomfort, and stress for children living with life-threatening conditions and their families. This paper aims to increase nurses' and other healthcare providers' awareness of selected recent research initiatives aimed at enhancing life and decreasing suffering for these children and their families. Topics were selected based on identified gaps in the pediatric palliative care literature. Published articles and authors' ongoing research were used to describe selected components of pediatric palliative nursing care including (I) examples of interventions (legacy and animal-assisted interventions); (II) international studies (parent-sibling bereavement, continuing bonds in Ecuador, and circumstances surrounding deaths in Honduras); (III) recruitment methods; (IV) communication among pediatric patients, their parents, and the healthcare team; (V) training in pediatric palliative care; (VI) nursing education; and (VII) nurses' role in supporting the community. Nurses are in ideal roles to provide pediatric palliative care at the bedside, serve as leaders to advance the science of pediatric palliative care, and support the community.
Research in Advancing Pediatric Palliative Care
Home Healthcare Nurse, 2012
Approximately 53,000 children die each year in the United States and more than 400,000 are living with life-threatening or life-limiting illnesses. Many providers lack the education and resources needed to provide safe, quality pediatric palliative care. Optimally, services should be provided by an interdisciplinary team that would support the medical, psychosocial, spiritual, educational, and emotional needs of families and children with life-limiting illnesses. Below are summaries of 4 published research articles related to pediatric palliative care that describe some of the ongoing barriers in this area and innovative programs working toward reaching more people in need of these services. The 1st article addresses the important role nurses can play by facilitating palliative care communication and supporting the shift to early palliative care. The 2nd research study profiled in this article explores barriers to palliative care experienced by healthcare providers. The 3rd article identifies 4 countries with innovative pediatric palliative care programs and strategies these programs used to overcome some of the challenges they encountered. The 4th article features a successful state-funded pediatric palliative program in Massachusetts. Readers are encouraged to read the full articles to learn more about the studies and the palliative care programs briefly described here.
Paediatric palliative care: a review of needs, obstacles and the future
(2013) Journal of Nursing Management Paediatric palliative care: a review of needs, obstacles and the future Aim This literature review offers a response to the current paediatric palliative care literature that will punctuate the need for a framework (i.e. the three world view) that can serve as an evaluative lens for nurse managers who are in the planning or evaluative stages of paediatric palliative care programmes. Background The complexities in providing paediatric palliative care extend beyond clinical practices to operational policies and financial barriers that exist in the continuum of services for patients. Evaluation This article offers a review of the literature and a framework in order to view best clinical practices, operational/policy standards and financial feasibility when considering the development and sustainability of paediatric palliative care programmes. Key aspects Fifty-four articles were selected as representative of the current state of the literature as it pertains to the three world view (i.e. clinical, operational and financial factors) involved in providing paediatric palliative care. Conclusion In developing efficient paediatric palliative care services, clinical, operational and financial resources and barriers need to be identified and addressed. Implications for nursing management Nursing management plays a crucial role in addressing the clinical, operational and financial needs and concerns that are grounded in paediatric palliative care literature.
Journal of Hospice & Palliative Nursing, 2012
Thousands of children die each year, with the majority of deaths occurring in the hospital setting. However, nurses caring for these children have limited expertise and varying comfort levels regarding palliative and end-of-life care. Nurses are traditionally taught to focus their care on survival, healing, and curing, yet frequently become the primary care providers when the child is dying. National initiatives and incentives support and advocate for palliative and end-of-life care for children, but evidence demonstrates that nurses are both unprepared for this type of care and express confusion regarding palliative and curative care for children. The purpose of this study was to investigate pediatric nurses' knowledge and attitudes about pediatric palliative care. A one-group, pretest-posttest, pre-experimental design was utilized to evaluate the impact of an educational program on the attitudes and knowledge of 25 pediatric and pediatric ICU nurses working at a large urban metropolitan medical center. Statistical significance found that the intervention of an educational program increased pediatric nurses' knowledge (P = .02) and improved attitudes regarding pediatric palliative care (P = .001). Recommendations included offering palliative/end-of-life training as a routine part of staff orientation as well as ongoing clinical programs to all pediatric nurses who may care for dying children. Implications for curricular changes in nursing programs were also discussed. KEY WORDS end of life, palliative care, pediatric H istorically, pediatric palliative care (PPC) evolved from research conducted on dying patients from the early 1950s and was based on adult populations. 1 In the late 1990s and early 2000s, attention focused on the support and management of children at the end of life. Nursing was the first to publish precepts for palliative care in pediatrics. 2 In 1998, the Initiative for Pediatric Palliative Care was established to support research, quality improvement, and educational programs that strengthened and enhanced family-centered care for children with life-threatening illnesses. 3 The American Academy of Pediatrics (AAP) then published a policy statement in 2000, outlining the need for development of palliative and respite programs in pediatrics. 4 In 2001, results of an international venture, the Children's Project on Palliative/Hospice Services, spurred the development of a white paper as well as resources for both families and professionals in the arena of PPC. 5,6 In 2003, the Institute of Medicine created a statement mandating appropriate pediatric palliative and end-of-life (EOL) initiatives. 7 This document identified emotional and psychological issues raised by families and staff and resulted in the development of clinical practice guidelines for dying children and their families. 8,9 Despite these national and international incentives for the inclusion of PPC in nursing and medical practice, barriers to the provision of this type of care continue to exist, especially within the healthcare realm. Nurses, caring for children in the hospital setting, view their primary role as preserving life and are neither prepared nor comfortable supporting the death of a child. 10 Review of the Literature Pediatric death is an unnatural phenomenon, very different from that of an adult or elderly person. Personnel caring for children in the pediatric ICU (PICU) and inpatient pediatric units are extremely competent in their ability to heal and cure illness but have limited expertise and varying comfort levels in the management of EOL situations. 11 Pediatric nurses are educated to promote the
Pediatric Palliative Care in Childhood Cancer Nursing: From Diagnosis to Cure or End of Life
Seminars in Oncology Nursing, 2010
To describe selected components of pediatric palliative care from diagnosis to cure or end of life that combine to help nurses and other clinicians achieve goals of care for children with cancer and their families. DATA SOURCES: Published articles. CONCLUSION: Pediatric palliative care is characterized by diversity of care delivery models; effect of cancer on the family as the central focus of care; and consideration of culture, spirituality, communication, and ethical standards. End-of-life issues that can be anticipated by nurses and other clinicians include symptoms of cancer or its treatment, the importance of hopefulness, the relevance of trying to be a good parent in decision making, the meaning of legacy making of ill children, and family bereavement. IMPLICATIONS FOR NURSING PRACTICE: Direct nursing care strategies to achieve pediatric palliative care goals are vital to reduce child and family suffering from cancer.
Bol Med Hosp Infant …, 2010
In this paper we discuss different aspects of palliative care in pediatrics and how the definition has changed and evolved. We also define what a terminally ill patient is, list the objectives of care, and how to implement care practices. We describe different ways to diminish physical, social, emotional and spiritual suffering. The dying process is described according to the different stages of child development. The spiritual aspects are now considered an important part of the approach with children. We must keep in mind the different barriers that we may encounter when we initiate palliative care. Education and further research is still needed to improve care and to achieve better results.
2018
Allah says " "If ye are grateful, I will add more (favours) unto you"After thanking Allah for his bounty and gratitude and great greatness and generosity of his gift, where he allows me to complete this blessed work is praise and blessings from him. I extend my sincere thanks and appreciation to Dr. Farid Ghrayeb-may Allah bless him-for his generosity in supervising this research and his great effort and for advising me of his advice and guidance and his patience and tolerance mad this study possible. I also extend my thanks and appreciation to the members of the discussion committee for their efforts of teaching and to make wonderful and valuable observations and guidance. I would like to extend my thanks to my first university, which was the foundation of my success and success-An-Najah National University, I will not forget my second university, Al-Quds University, because I found it appreciated and respected by us and for all the doctors and tutors who are working hard in this great distinguished institution who gave me support, progress and development in my field.
Nursing care in palliative care in pediatric oncology
International Journal of Family & Community Medicine
This research has as general theme "Nursing care in palliative care in pediatric oncology", an approach that needs to be further discussed due to the need to prepare nursing professionals working in the pediatric sector with cancer patients who are terminally. Thus, an informative text was produced with information based on authors who have already conducted research on this theme, with a qualitative approach, because this is a Bibliographic research. To guide this research, the general objective was to identify the knowledge and reactions of nursing professionals in pediatric cancer care and as specific objectives to identify the perceptions and feelings that permeate pediatric nursing practice in relation to cancer, treatment, and its implications and to know the care/care activities aimed at children hospitalized in the pediatric oncology sector. It is concluded that the courses directed to nursing need to offer disciplines that prepare these professionals to deal with ...
Pediatric Nurses' Individual and Group Assessments of Palliative, End-of-Life, and Bereavement Care
Journal of Palliative Medicine, 2011
Background: Although pediatric nurses working in children's hospitals often provide care to dying children, little is known about their palliative care beliefs and experiences as individuals or members of groups within the hospital. Objective: To describe pediatric nurses' ratings of palliative care goals and problems, as individuals and members of clusters of nurses with similar views, and nurses' degree of collaboration with an inpatient palliative care team across hospital units. Method: A cross-sectional survey of nurses at a freestanding children's hospital in 2005. Results: Nurses rated the most important goals as managing pain, maintaining the child's quality of life, and improving communication. Commonly cited problems were lack of opportunity to debrief after a patient's death, uncertainty about the goals of care, and the health care team's reluctance to discuss hospice with family. Based on individual views about goals and problems, nurses clustered into 5 groups that differed in terms of the adamancy of their views and the scope of the goals and problems they considered important or significant. The hospital unit was the most important factor in predicting nurses' degree of collaboration with the palliative care team even after accounting for individual characteristics. Conclusions: Pediatric nurses broadly endorse both the importance of palliative care goals and the presence of problems yet perceive the importance of these goals and problems differently. Further, they vary in their level of collaborative practice with a palliative care team in ways that should be accounted for when planning and implementing palliative care programs.