Improving the quality of end-of-life care in the pediatric intensive care unit: parents' priorities and recommendations

Pediatrics. 2006 Mar;117(3):649-57. doi: 10.1542/peds.2005-0144.

Abstract

Objective: Despite recognition that dying children and their families have unique palliative care needs, there has been little empirical inquiry of parent perspectives to improve the quality of end-of-life care and communication. The purpose of this study was to identify and describe the priorities and recommendations for end-of-life care and communication from the parents' perspective.

Methods: This was a qualitative study based on parental responses to open-ended questions on anonymous, self-administered questionnaires, conducted at 3 pediatric ICUs in Boston, Massachusetts. Fifty-six parents whose children had died in PICUs after withdrawal of life support participated in this study. We measured parent-identified priorities for end-of-life care and communication.

Results: Parents identified 6 priorities for pediatric end-of-life care including honest and complete information, ready access to staff, communication and care coordination, emotional expression and support by staff, preservation of the integrity of the parent-child relationship, and faith.

Conclusions: Parental priorities and recommendations offer simple yet compelling guidance to improve pediatric end-of-life clinical practice and research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Communication
  • Decision Making
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Pediatric*
  • Palliative Care / psychology*
  • Parent-Child Relations
  • Parents / psychology*
  • Professional-Family Relations
  • Surveys and Questionnaires
  • Terminal Care / psychology*