Caring for dying children in the paediatric intensive care unit [PICU]


Caring for dying children in the paediatric intensive care unit [PICU]


Mattsson J


Pediatric Critical Care Medicine




Pediatric intensive care unit;Child;child parent relation;clinical article;conference abstract;critically ill patient;Female;human;intimacy;Male;medical examination;nurse;palliative therapy;practice guideline;Sweden;terminal care


Aims & Objectives: Caring for dying children is complex and requires coordination of all resources. In PICU the main objective is to save lives and ensure vital functions in critically ill children. However due to the child's critical and life threatening condition, there is always the possibility the child will not survive. The acuity and technical nature of the intensive care context can provide an obstacle in the transition to palliative care and furthermore conflict with the affected families' needs. The study aim was to enlightening caring as it is represented in caring situations of dying children at PICU. Methods An Interpretative Phenomenological design was applied. The data collection was performed at three PICU in Sweden at 2011 and 2016. Caring situations of a total of 18 children were observed, six cases were estimated as end of life care or life threatening conditions. Nurses and parents were interviewed in direct connection to the observation. Results findings showed that for nurses, it was a challenge to change perspective from curative to palliative care. Medical examinations and treatment was experienced to disturb the dying child thus causing unnecessary suffering. Parents found it difficult to leave their dying children even just for a moment and the space in PICU did not support closeness and parenting but rather separated the dying child from her/his family. Conclusions In conclusion, these findings illuminates the importance of guidelines and training in palliative care in PICU. Children and their family ought to have the best care possibly when affected by life-limiting or life-threatening illness.


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November 2018 List



Mattsson J, “Caring for dying children in the paediatric intensive care unit [PICU],” Pediatric Palliative Care Library, accessed December 3, 2023,