The elements of end-of-life care provision in paediatric intensive care units: a systematic integrative review

Title

The elements of end-of-life care provision in paediatric intensive care units: a systematic integrative review

Creator

Adistie F; Neilson S; Shaw KL; Bay B; Efstathiou N

Publisher

BMC Palliative Care

Date

2024

Subject

PsycINFO; Web of Science; palliative therapy; life sustaining treatment; health care personnel; pediatric intensive care unit; systematic review; time of death; intensive care; human; article; child; terminal care; Cinahl; therapy; ritual; constant comparative method; information service

Description

Background: Deaths in paediatric intensive care units (PICUs) are not uncommon. End-of-life care in PICUs is generally considered more challenging than other settings since it is framed within a context where care is focused on curative or life-sustaining treatments for children who are seriously ill. This review aimed to identify and synthesise literature related to the essential elements in the provision of end-of-life care in the PICU from the perspectives of both healthcare professionals (HCPs) and families. Methods: A systematic integrative review was conducted by searching EMBASE, CINAHL, MEDLINE, Nursing and Allied Health Database, PsycINFO, Scopus, Web of Science, and Google Scholar databases. Grey literature was searched via Electronic Theses Online Service (EthOS), OpenGrey, Grey literature report. Additionally, hand searches were performed by checking the reference lists of all included papers. Inclusion and exclusion criteria were used to screen retrieved papers by two reviewers independently. The findings were analysed using a constant comparative method. Results: Twenty-one studies met the inclusion criteria. Three elements in end-of-life care provision for children in the PICUs were identified: 1) Assessment of entering the end-of-life stage; 2) Discussion with parents and decision making; 3) End of life care processes, including care provided during the dying phase, care provided at the time of death, and care provided after death. Conclusion: The focus of end-of-life care in PICUs varies depending on HCPs' and families' preferences, at different stages such as during the dying phase, at the time of death, and after the child died. Tailoring end-of-life care to families' beliefs and rituals was acknowledged as important by PICU HCPs. This review also emphasises the importance of HCPs collaborating to provide the optimum end-of-life care in the PICU and involving a palliative care team in end-of-life care.

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

September List 2024

Collection

Citation

Adistie F; Neilson S; Shaw KL; Bay B; Efstathiou N, “The elements of end-of-life care provision in paediatric intensive care units: a systematic integrative review,” Pediatric Palliative Care Library, accessed February 17, 2025, https://pedpalascnetlibrary.omeka.net/items/show/19711.