Defining Legacy: The Perceptions of Pediatric Health Care Providers
Child; Female; Humans; Male; Adaptation Psychological; Attitude to Death; Child Hospitalized/psychology; Terminal Care/psychology; pediatrics; Parents/psychology; Physician's Role; Social Support; Pediatrics/standards; Terminally Ill/psychology; health care; legacy; perceptions; providers
Legacy building interventions like plaster hand molds are offered in most children's hospitals, yet little is known about how the concept of legacy is understood and described by pediatric health care providers. Therefore, this study explored pediatric health care providers' perceptions of legacy at an academic medical center to ensure that future legacy interventions are evidence-informed and theoretically grounded. An electronic survey featuring three open-ended questions and two multiple-choice questions with an option for free text response was completed by 172 medical and psychosocial health care providers. Analysis yielded four themes: (1) legacy is intergenerational, enduring, and typically associated with end-of-life; (2) legacies articulate the impacts on others for which one is known and remembered; (3) legacies can be expressed through tangible items or intangible qualities; and (4) legacies are informed and generated by family relationships and work experiences. By understanding legacy as a personally and professionally contextualized experience, health care providers can better assess and meet the legacy needs of hospitalized pediatric patients and families.
Boles J; Jones M; Dunbar J; Cook J
Clinical Pediatrics
2020
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0009922820940808" target="_blank" rel="noreferrer noopener">10.1177/0009922820940808</a>
Grief reactions and coping strategies of trainee doctors working in paediatric intensive care
Attitude of Health Personnel; pediatrics; Intensive Care Units; grief; Adaptation Psychological; attitude to death; physicians - psychosocial factors
Background: The death of a child can have significant emotional effects on doctors responsible for their care. Trainee doctors working in the paediatric intensive care unit (PICU) may be particularly vulnerable. The aim of this study was to examine the emotional impact of, and grief reactions to, a child's death in PICU trainee doctors, along with coping strategies they used.Methods: In a prospective, cross-sectional, observational study, qualitative and quantitative data were recorded on anonymised, written questionnaires. Grief severity was assessed using the Texas Revised Inventory of Grief. Emotional impact was assessed using the shortened Impact of Event Scale. The BriefCOPE tool was used to assess coping strategies. Qualitative data was analysed using conventional content analysis. Data are presented as median (inter-quartile range) or number (%).Results: All invited trainee doctors (23 anaesthetists; 5 paediatricians) completed the questionnaire (age, 30 [29-34] yr; 13/28 [46%] female). Two (7%) doctors experienced severe grief (Texas Revised Inventory of Grief score <39), with five (18%) doctors severely affected by the deaths as measured by the Impact of Event Scale. Qualitative analysis revealed prominent themes of sadness, helplessness, guilt, shock, and concern for the bereaved family. There was limited use of coping strategies. Speaking with another trainee doctor was the principal coping strategy. Requests for debriefing sessions, greater psychological support and follow-up with the patient's family were frequently suggested.Conclusions: Paediatric deaths evoke significant grief and emotional reactions in a subset of PICU trainee doctors. Trainee PICU doctors highlighted a lack of professional support and tailored debriefs.
ffrench-O'Carroll R; Feeley T; Crowe S; Doherty E M
BJA: The British Journal of Anaesthesia
2019
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.bja.2019.01.034" target="_blank" rel="noreferrer noopener">10.1016/j.bja.2019.01.034</a>
Associated Factors of Psychological Distress among Japanese NICU Nurses in Supporting Bereaved Families Who Have Lost Children
Adaptation Psychological; Male; Infant Newborn; Bereavement; Surveys and Questionnaires; Humans; Adult; Stress Psychological; Female; psychological distress; Intensive Care Neonatal; nurses; bereavement care; Intensive Care Units Neonatal; Nicu; children's deaths; Hospice Care/psychology; Neonatal Nursing/education; Nurses Neonatal/education/psychology; Pediatricians/psychology
PURPOSE: This study aimed (1) to examine the current status of psychological distress experienced by neonatal intensive care unit (NICU) nurses in supporting bereaved families, (2) to identify the factors associated with psychological distress, and (3) to understand the professional characteristics of nurses experiencing high psychological distress by comparing the study results with those of pediatricians. METHODS: We sent questionnaires to 64 NICUs. The psychological distress of nurses was classified into two groups based on the frequency of psychological distress experienced and analyzed using the chi2 test and Fisher's exact test. A multiple logistic regression analysis was used to investigate the factors related to psychological distress. RESULTS: Of the 384 nurse respondents, 190 (49.5%) reported having supported bereaved families, 169 of who were included in the analysis. A total of 123 nurses (72.8%) reported high levels of psychological distress. Our study revealed that the use of coping methods is associated with high psychological distress. The comparison with pediatricians revealed that nurses were significantly more likely to be female and had fewer years of working experience. Nurses were also significantly more likely to use coping methods and to experience high psychological distress. CONCLUSION: Clarifying the coping methods for psychological distress in supporting bereaved families may be necessary, and nurses need to identify appropriate coping methods. In nursing education, information on psychological distress related to children's deaths and bereavement care should be conveyed from the early stage and nurses must obtain preliminary knowledge. The creation of a bereavement follow-up system is recommended.
Kitao M; Setou N; Yamamoto A; Takada S
Kobe Journal of Medical Sciences
2018
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Identifying domains of quality of life in children with cancer undergoing palliative care: A qualitative study with professionals
Adaptation Psychological; Middle Aged; Male; Humans; Palliative Care/mt [Methods]; Adult; Qualitative Research; Neoplasms/px [Psychology]; Female; Quality of Life/px [Psychology]; Palliative Care/px [Psychology]; Quebec; Pediatrics/st [Standards]; Health Personnel/px [Psychology]; Perception; Pediatrics/ma [Manpower]
OBJECTIVE: The goal of pediatric palliative care (PPC) is to maintain the quality of life (QoL) of children whose lives are threatened. However, there are sparse scientific data on the domains of QoL in this particular context, and no measurement strategies are available. The present study aims to describe the domains of QoL in the context of PPC in oncology, according to the perceptions of professional caregivers. METHOD: Semistructured interviews were conducted with a random sample of 20 professional caregivers from the Division of Hematology/Oncology at Le Centre Hospitalier Universitaire Sainte-Justine (Montreal, Canada). The caregivers were asked about their perceptions about the QoL of the children they have cared for in this context. The data were analyzed using inductive thematic content analysis. RESULTS: The analysis allowed us to identify seven domains of QoL: "physical comfort," "alleviation of psychological suffering," "fun and the present moment," "sense of control," "feeling valued and appreciated," "feeling that life goes on," and "meaningful social relationships." SIGNIFICANCE OF RESULTS: Caregivers recount the regard that should be accorded to maintaining well-being and a sense of fun, as well as fostering the child's abilities, taking account of the progression of the disease, and to fulfilling his or her needs, especially social ones. Our results also demonstrate that all domains were positively referred to by professional caregivers. The data from our study will lead to better assessment of QoL according to the trajectory of a child with advanced cancer while undergoing PPC.
Avoine-Blondin J; Parent V; Lahaye M; Humbert N; Duval M; Sultan S
Palliative & Supportive Care
2017
<a href="http://doi.org/%2010.1017/S1478951516001048" target="_blank" rel="noreferrer noopener">10.1017/S1478951516001048</a>
"They Say I Should not Think About It:": A Qualitative Study Exploring the Experience of Infant Loss for Bereaved Mothers in Kumasi, Ghana
death and dying; bereavement; Male; Infant Newborn; Young Adult; Humans; Adult; Female; Infant; Interviews as Topic; Infant Mortality; Adaptation Psychological; Mothers/ psychology; Ghana; perinatal death; qualitative research; infant mortality; Grief; infant loss; low-resource country; Medically Underserved Area
Meyer AC; Opoku C; Gold K J
Omega (Westport)
2018
<a href="http://doi.org/10.1177/0030222816629165" target="_blank" rel="noreferrer noopener">10.1177/0030222816629165</a>