Important factors in municipality-based pediatric palliation from healthcare professionals' perspective: A qualitative study

Important factors in municipality-based pediatric palliation from healthcare professionals' perspective: A qualitative study

Skjaerseth K; Preminger N; Hauken MA

Palliative Care and Social Practice

2025

Abstract Background: Municipality-based pediatric palliative care (PPC) is recommended to promote the quality of life for the child and family by enabling them to stay at home as much as possible. However, municipality-based PPC presents complex challenges and places significant demands on healthcare professionals. Yet, it remains an underexplored field. Objectives: Semi-structured and individual interviews with 16 healthcare professionals with experiences from PPC were conducted and transcribed. Data was analyzed using systematic text condensation. Results: To increase the knowledge base and understanding of important factors for municipality-based PPC from healthcare professionals' perspective. Design: A qualitative method with an interpretive descriptive design was applied. Methods: The bridging theme "Establishing a sense of security and predictability for the family and healthcare professionals" emerged from the analysis. This was elaborated by three main themes: (1) "A comprehensive approach to the family," (2) "Establishing and maintaining a dedicated, multidisciplinary pediatric palliative team in the municipality," and (3) "Collaboration and communication between involved services." Each main theme was further elaborated by subthemes. Conclusion: The importance of establishing security and predictability in municipality-based PPC was emphasized. To achieve this, holistic support for the entire family and ensuring sufficient competence in the municipality seem crucial. Establishing municipality PPC teams is proposed, and the need for early referral, routines for collaboration, and a designated coordinator appear to be key systemic factors. Registration and reporting guidelines: The study is registered in the institutional system for research project (RETTE ID: R2082), and the study is reported according to the COREQ checklist for qualitative studies. ---- Plain language summary Enhancing home-based care for children with life-limiting conditions When children face serious health conditions, it’s often best for them to receive care at home, surrounded by family. This type of care, known as pediatric palliative care (PPC), focuses on improving quality of life for both the child and their loved ones. However, providing this care at a municipality level can be challenging and requires skilled healthcare professionals. A study was conducted to better understand what makes municipality-based PPC effective from the viewpoint of these professionals. We interviewed 16 healthcare workers experienced in PPC, analyzing their insights to identify key factors for successful care. The study found that creating a secure and predictable environment is essential for both families and healthcare workers. This involves a holistic approach that considers the family’s overall needs, forming a specialized team that can address the complex aspects of care, and ensuring clear communication between different services involved in the child’s care. In conclusion, the study highlights the need for a well-coordinated team and support system within the municipality to provide effective PPC. This includes having a team dedicated to PPC, early involvement of care services, established routines for working together, and a coordinator to oversee the process. By focusing on these areas, municipality-based PPC can offer meaningful support to families during challenging times.

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