The need for education as a primary vehicle for improving paediatric palliative care (PPC) in a small island developing state (SIDS): Results of a qualitative exploration

The need for education as a primary vehicle for improving paediatric palliative care (PPC) in a small island developing state (SIDS): Results of a qualitative exploration

Morris K; Greaves N; Lashley P M

West Indian Medical Journal

2020

education; pediatric palliative care; Caribbean; Barbados; qualitative exploration

Objective: To explore the perceptions and experiences of paediatric palliative care (PPC) among healthcare providers (HCPs) providing care at the sole tertiary healthcare facility in the SIDS of Barbados. Method(s): Sampling was purposive. Twelve participants (six physicians and six nurses) with 2-28 years of paediatric experience participated in semi-structured, individual, face-to-face interviews conducted by the researcher. The average interview time per participant was 45 minutes. The interviews were audiotaped, transcribed verbatim by the interviewer and subject to thematic analysis with constant comparison via manual data management. Result(s): It was shown that health professionals did not reference an internationally recognized definition or construct in framing their understanding of palliative care. There was consistent framing of palliative care as a terminal and end-of-life care point. This was made without reference to pain and symptom management across the disease trajectory of patients and their families who face life-threatening illnesses. Lack of education regarding what constitutes PPC, in addition to the practicalities of clinical PPC, was perceived as the primary barrier to providing appropriate evidence-based care, compounded by some physical plant resource limitations. Conclusion(s): While provision of PPC is a legal and ethical obligation for SIDS in the Caribbean, provision will not be possible without urgently correcting clinical educational deficits as part of the pathway for culturally acceptable and sustainable PPC service design.

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