Shifting Focus In Pediatric Advance Care Planning: From Advance Directives To Family Engagement

Title

Shifting Focus In Pediatric Advance Care Planning: From Advance Directives To Family Engagement

Creator

Siden H; Chavoshi N

Identifier

http://dx.doi.org/10.1016/j.jpainsymman.2016.05.010

Publisher

Journal Of Pain And Symptom Management

Date

2016

Description

The foundational principle of palliative care is to provide comfort, ameliorate symptoms, and offer emotional support when death is inevitable. Advance care planning (ACP) elicits patients' goals for the future. One important result of an ACP discussion may be an advance directive (AD), a written order delineating explicit wishes regarding medical interventions.

Pediatric palliative care (PPC) is a young field and developed many of its approaches as reflections from adult palliative care. ACP has not been well evaluated in children.1 Often ADs are thought to be synonymous with a “do not attempt resuscitation” (DNAR) order, which in turn has been treated as an indicator for a nonintervention-oriented stance and as a proxy for ACP discussions between families and clinicians.2 Another barrier identified in the literature is physician reluctance to undertake ACP discussions. Clinicians report feeling ill prepared and inadequately trained to carry out such conversations.3

Studies involving parents of children with life-threatening conditions showed that parents are interested in ACP, provided there is emotional support available.3 and 4 The literature indicates that ACP discussions likely need to occur more than once over time.

Rights

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).

Citation List Month

July 2016 List

Citation

Siden H; Chavoshi N, “Shifting Focus In Pediatric Advance Care Planning: From Advance Directives To Family Engagement,” Pediatric Palliative Care Library, accessed July 25, 2021, https://pedpalascnetlibrary.omeka.net/items/show/10526.

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