Parents' Perspectives on Hospital Care for Children and Adolescents with Life-Limiting Conditions: A Grounded Theory Analysis of Narrative Interviews.

Abstract:

: Background: Guidelines on pediatric palliative care recommend to provide care for children and adolescents with life-limiting conditions at home. Since 2007, in Germany, palliative home care can be provided by specialized outpatient palliative care teams. However, teams with specific expertise for children are not available all over the country. Families without this support need to use the hospital to get specialists' assistance. Objective: To explore how parents of children and adolescents with life-limiting conditions think about the hospital as place of care. Design: We conducted narrative interviews with parents and analyzed these by using a grounded theory approach. Setting/Subjects: We interviewed 13 parents (4 fathers and 9 mothers) of 9 children with life-limiting conditions receiving or having received pediatric specialized outpatient palliative care (SOPPC) in Germany. Results: Parents reported feelings of vulnerability, heteronomy, and disablement associated with hospital care and were afraid that their children's needs were not adequately addressed. These perceptions resulted from hospitals' standardized care structures and over- and undertreatment, a lack of continuity of care, hospital pathogens, a lack of a palliative mindset, insensitive hospital staff, the exclusion of parents from the treatment and parental care of their children, the hospital stay as a permanent state of emergency, and a waste of limited life time. Conclusion: Pediatric hospital staff needs training in identifying and responding to palliative care needs. SOPPC structures should be expanded all over Germany to meet the needs of families of children with life-limiting conditions.

journal_name

J Palliat Med

authors

Engler J,Gruber D,Engler F,Hach M,Seipp H,Kuss K,Gerlach FM,Ulrich LR,Erler A

doi

10.1089/jpm.2019.0245

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

466-474

issue

4

eissn

1096-6218

issn

1557-7740

journal_volume

23

pub_type

杂志文章
  • "We're Taking Something So Human and Trying to Digitize": Provider Recommendations for mHealth in Palliative Care.

    abstract:: Background: Mobile health (mHealth) is a promising tool for improving health outcomes. However, the benefits of using mHealth in palliative care are under studied. Objective: As a first step to designing meaningful palliative c...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0216

    authors: Dickman Portz J,Ford K,Bekelman DB,Boxer RS,Kutner JS,Czaja S,Elsbernd K,Bull S

    更新日期:2020-02-01 00:00:00

  • Conservative management of end-stage renal disease without dialysis: a systematic review.

    abstract:PURPOSE:To summarize evidence on conservative, nondialytic management of end-stage renal disease regarding 1) prognosis and 2) symptom burden and quality of life (QOL). METHODS:Medline, Cinahl, and Cochrane were searched for records indexed prior to March 1, 2011. Bibliographies of articles and abstracts from recent m...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2011.0207

    authors: O'Connor NR,Kumar P

    更新日期:2012-02-01 00:00:00

  • Communication strategies and cultural issues in the delivery of bad news.

    abstract::Good communication is a fundamental skill for all palliative care clinicians. Patients present with varied desires, beliefs, and cultural practices, and navigating these issues presents clinicians with unique challenges. This article provides an overview of the evidence for communication strategies in delivering bad n...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2007.9929

    authors: Barclay JS,Blackhall LJ,Tulsky JA

    更新日期:2007-08-01 00:00:00

  • Self-reported quality of life in amyotrophic lateral sclerosis.

    abstract:OBJECTIVES:To continuously assess overall quality of life (QOL) and disease progression in patients with amyotrophic lateral sclerosis (ALS) at different stages of the disease and compare the results between these two variables. DESIGN/SUBJECTS:Twenty-six patients with ALS were interviewed with a questionnaire to asse...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2006.9.304

    authors: Nygren I,Askmark H

    更新日期:2006-04-01 00:00:00

  • Addition of methadone to another opioid in the management of moderate to severe cancer pain: a case series.

    abstract:BACKGROUND:Previous research has reported improved pain after adding methadone to another opioid, but did not quantify this benefit using a validated outcome measure. OBJECTIVE:To assess quantitatively the effectiveness of adding methadone to another opioid for moderate to severe cancer-related pain. DESIGN:All outpa...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2012.0335

    authors: Wallace E,Ridley J,Bryson J,Mak E,Zimmermann C

    更新日期:2013-03-01 00:00:00

  • What Children Wished They Had/Had Not Done and Their Coping in the First 13 Months after Their Sibling's Neonatal/Pediatric Intensive Care Unit/Emergency Department Death.

    abstract:: Background: Research on what children wished they had done differently after their sibling's death has not been reported. Objective: Examine what children wished they had/had not done, and their coping after a sibling's neonata...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0538

    authors: Youngblut JM,Brooten D

    更新日期:2020-07-08 00:00:00

  • Prediction of pediatric death in the year after hospitalization: a population-level retrospective cohort study.

    abstract:BACKGROUND:The study of how the quality of pediatric end-of-life care varies across systems of health care delivery and financing is hampered by lack of methods to adjust for the probability of death in populations of ill children. OBJECTIVE:To develop a prognostication models using administratively available data to ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2008.0206

    authors: Feudtner C,Hexem KR,Shabbout M,Feinstein JA,Sochalski J,Silber JH

    更新日期:2009-02-01 00:00:00

  • Family Caregiver Perspectives on End-of-Life Dreams and Visions during Bereavement: A Mixed Methods Approach.

    abstract:: Background: End-of-life dreams and visions (ELDVs) are prevalent experiences that provide comfort and meaning to dying individuals. Limited research has examined the impact of ELDVs on the bereaved. Objective: This study aimed ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0093

    authors: Grant PC,Depner RM,Levy K,LaFever SM,Tenzek KE,Wright ST,Kerr CW

    更新日期:2020-01-01 00:00:00

  • Insights from Bereaved Family Members about End-of-Life Care and Bereavement.

    abstract:: Background: Bereavement programs provide institutions with an avenue for obtaining feedback from family members about their experiences during a patient's illness and end-of-life (EOL) period that can be used to improve both patient care and the care of bereaved individual...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0467

    authors: Morris SE,Nayak MM,Block SD

    更新日期:2020-08-01 00:00:00

  • The Association between Glycemic Control in People with Diabetes and Symptoms at the End of Life: A Prospective Observational Consecutive Cohort Study.

    abstract:: Background: Diabetes is increasingly prevalent globally, including in palliative care. Guidelines vary as to the ideal glycemic goals for patients near the end of life. The relationship between hyperglycemia and attributable symptoms late in life remains ill defined. ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0083

    authors: Kleinig PA,Woodman RJ,Currow DC

    更新日期:2020-03-01 00:00:00

  • Characteristics and correlates of dyspnea in patients with advanced cancer.

    abstract:BACKGROUND:Dyspnea is a very distressing symptom present in the vast majority of patients with advanced cancer. There are limited data on the characteristics and correlates of dyspnea in this population. The purpose of this study was to characterize dyspnea, explore the differences between breakthrough and continuous p...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2008.0158

    authors: Reddy SK,Parsons HA,Elsayem A,Palmer JL,Bruera E

    更新日期:2009-01-01 00:00:00

  • A Self-Check Program Targeting Quality Improvement in a Hospital-Based Palliative Care Consultation Team, Japanese Society for Palliative Medicine: Issues Regarding Team Activities Identified through the Plan-Do-Check-Act Cycle.

    abstract:: Background: The number of hospital-based palliative care consultation teams (PCCTs) has increased in Japan, and quality improvement (QI) of PCCTs is an issue. The Japanese Society for Palliative Medicine is building a framework for continuous QI of PCCT activities. ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0236

    authors: Nakazawa Y,Sakashita A,Kaizu M,Abo H,Ise Y,Shinada Y,Sugano K,Yamashiro A,Akizuki N,Kato M

    更新日期:2020-03-01 00:00:00

  • An educational intervention to improve resident comfort with communication at the end of life.

    abstract:BACKGROUND:Approximately 20% of deaths in the United States occur in the intensive care unit (ICU). Physician trainees lack the practical communication skills required for end-of-life care, including establishing patient preferences, participating in shared decision making, discussing prognosis, and delivering bad news...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1089/jpm.2012.0173

    authors: Smith L,O'Sullivan P,Lo B,Chen H

    更新日期:2013-01-01 00:00:00

  • Humidified high-flow nasal oxygen utilization in patients with cancer at Memorial Sloan-Kettering Cancer Center.

    abstract:BACKGROUND:Respiratory signs and symptoms are commonly encountered by physicians who care for cancer patients. Supplemental oxygen (SOx) has long been used for treatment of hypoxic respiratory insufficiency, but data reveal mixed efficacy results. The use and outcome patterns of technologically advanced oxygen delivery...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2011.0005

    authors: Epstein AS,Hartridge-Lambert SK,Ramaker JS,Voigt LP,Portlock CS

    更新日期:2011-07-01 00:00:00

  • What We Do: Key Activities of an Outpatient Palliative Care Team at an Academic Cancer Center.

    abstract:BACKGROUND:Outpatient palliative care (PC) has been shown to positively impact quality of life and decrease healthcare utilization, but there are limited data describing what activities render these benefits. OBJECTIVE:Describe the topics addressed by an outpatient PC team during scheduled visits. DESIGN:Longitudinal...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2017.0441

    authors: Bischoff K,Yang E,Kojimoto G,Shepard Lopez N,Holland S,Calton B,Adkins SH,Cheng S,Miller BJ,Rabow MW

    更新日期:2018-07-01 00:00:00

  • Evidence-based approach to management of fever in patients with end-stage dementia.

    abstract::Alzheimer's dementia and related dementias are incurable illnesses for which curative treatment currently does not exist, and the efficacy of remittive treatment is extremely limited. Persons with advanced dementia commonly develop fever and are at high risk for death. We preformed a systematic review of outcome follo...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/109662103322144664

    authors: Pinderhughes ST,Morrison RS

    更新日期:2003-06-01 00:00:00

  • Quality of life in advanced ovarian cancer: identifying specific concerns.

    abstract:PURPOSE:To identify issues affecting the quality of life (QoL) in women receiving palliative therapy for ovarian cancer. METHODS:Twenty women with advanced recurrent ovarian cancer were interviewed to establish what issues affect QoL. All patients were receiving palliative chemotherapy or other palliative therapy in t...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.1999.2.397

    authors: Houck K,Avis NE,Gallant JM,Fuller AF Jr,Goodman A

    更新日期:1999-01-01 00:00:00

  • The Impact of Depression on Health Care Utilization in Patients with Cancer.

    abstract:: Background: Depression is common in the oncology patient population. Little data exist on the impact of depression on health care utilization. Objectives: We evaluated the prevalence of depression and the relationship between d...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2020.0329

    authors: Ye S,Williams CP,Gilbert AD,Huang CH,Salter TL,Rocque GB

    更新日期:2021-01-21 00:00:00

  • Development of a cognitive model for advance care planning discussions: results from a quality improvement initiative.

    abstract:BACKGROUND:Residents struggle with advance care planning (ACP) discussions in the inpatient setting, and may not be aware of newer models for ACP that stress the importance of giving prognostic information and making a recommendation about cardiopulmonary resuscitation to patients and families. METHODS:A controlled st...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1089/jpm.2010.0383

    authors: Jacobsen J,Robinson E,Jackson VA,Meigs JB,Billings JA

    更新日期:2011-03-01 00:00:00

  • Minnesota Rural Palliative Care Initiative: building palliative care capacity in rural Minnesota.

    abstract:BACKGROUND:Significant gaps exist in the availability of palliative care in rural hospitals and communities, even though rural populations are often disproportionately elderly and chronically ill. Few studies have examined what models of palliative care would be sustainable in a rural community. METHODS:We studied the...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2012.0324

    authors: Ceronsky L,Shearer J,Weng K,Hopkins M,McKinley D

    更新日期:2013-03-01 00:00:00

  • Research methods priorities in geriatric palliative medicine.

    abstract::Continuing the momentum of geriatric palliative medicine research achieved during the past decade requires a focus on research methods priorities that span the continuum of research from small pilot studies testing new interventions to large multisite studies evaluating implementation of proven interventions and model...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2013.9492

    authors: Aldridge Carlson MD

    更新日期:2013-08-01 00:00:00

  • Impact of Inpatient Palliative Care on Quality of End-of-Life Care and Downstream Acute and Postacute Care Utilization.

    abstract:BACKGROUND:Additional evidence is needed regarding the impact of inpatient palliative care (IPC) on the quality of end-of-life care and downstream utilization. AIM:Examine the effects of IPC on quality of end-of-life care and acute and postacute care use in a large integrated system. DESIGN:Retrospective cohort desig...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2017.0275

    authors: Khang PS,Wang SE,Liu IA,Watson HL,Koyama SY,Huynh DN,Lee JS,Nguyen HQ

    更新日期:2018-07-01 00:00:00

  • Perceptions of lethal fetal abnormality among perinatal professionals and the challenges of neonatal palliative care.

    abstract:BACKGROUND:After prenatal diagnosis of lethal fetal abnormality (LFA), some couples choose to continue the pregnancy rather than opt for termination of the pregnancy. This may result in the requirement for neonatal palliative care, which in France is prescribed by the Leonetti Law. These rare situations raise various q...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1089/jpm.2014.0023

    authors: Tosello B,Dany L,Gire C,Bétrémieux P,Vriet-Ndour ME,Le Coz P,D'Ercole C,Siméoni U,Einaudi MA

    更新日期:2014-08-01 00:00:00

  • Nurses' attitudes and experiences surrounding palliative sedation: components for developing policy for nursing professionals.

    abstract:BACKGROUND:Nurses play an integral role in providing care for patients with end of life (EOL) symptoms refractory to conventional treatments and that may necessitate palliative sedation (PS). A paucity of research on nurses' attitudes, knowledge, and experience with PS exists, despite nurses being instrumental in evalu...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2011.0336

    authors: Patel B,Gorawara-Bhat R,Levine S,Shega JW

    更新日期:2012-04-01 00:00:00

  • Clinical Indicators That Identify Risk of Deteriorating and Dying in People with a Hematological Malignancy: A Case-Control Study with Multivariable Analysis.

    abstract:BACKGROUND:Identifying people who are at risk of deteriorating and dying is essential to inform goals of care, appropriate treatment decisions, patient autonomy, and effective end-of-life care. Limited literature exists on predicting survival near the end of life for people with a hematological malignancy. OBJECTIVE:T...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2018.0033

    authors: Button E,Gavin NC,Chan RJ,Chambers S,Butler J,Yates P

    更新日期:2018-12-01 00:00:00

  • A Chinese version of the Spiritual Needs Assessment for patients survey instrument.

    abstract:CONTEXT:Unmet spiritual needs have been associated with decreased patient ratings of quality of care, satisfaction, and quality of life. Few instruments exist to measure spiritual needs particularly among non-English speaking patients in the U.S. OBJECTIVE:To develop an internally consistent and reliable Chinese versi...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2012.0131

    authors: Astrow AB,Sharma RK,Huang Y,Xu Y,Sulmasy DP

    更新日期:2012-12-01 00:00:00

  • Depression with psychomotor retardation: diagnostic challenges and the use of psychostimulants.

    abstract::A patient with advanced pancreatic cancer is presented to demonstrate the clinical challenge of diagnosing depression in palliative care. The conundrum related to the relative roles of somatic and psychological symptoms in screening or diagnosing depression in these patients is illustrated and discussed. There is no c...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/109662101300051906

    authors: Pereira J,Bruera E

    更新日期:2001-04-01 00:00:00

  • Stakeholder Perspectives on the Use of Community Health Workers To Improve Palliative Care Use by African Americans with Cancer.

    abstract:BACKGROUND:African Americans in the United States have worse end-of-life care and cancer outcomes than whites. Palliative care may improve this disparity. Community Health Workers may provide a means to improve palliative care disparities. METHODS:Semistructured in-depth interviews (five) and stakeholder focus groups ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2018.0366

    authors: Johnston FM,Neiman JH,Parmley LE,Conca-Cheng A,Freund KM,Concannon TW,Smith TJ,Cooper LA

    更新日期:2019-03-01 00:00:00

  • Opportunities and challenges to improving end-of-life care for seriously ill elderly patients: a qualitative study of generalist physicians.

    abstract:BACKGROUND:End-of-life care quality deficiencies have in part been linked to inadequate physician skill in the technical and communication domains of palliative care. Yet few studies have examined physicians' perspectives regarding their experiences caring for patients approaching the end of life. OBJECTIVE:To underst...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2005.8.291

    authors: Winzelberg GS,Patrick DL,Rhodes LA,Deyo RA

    更新日期:2005-04-01 00:00:00

  • Parental bereavement needs in the pediatric intensive care unit: review of available measures.

    abstract:BACKGROUND:Pediatric intensive care units (PICUs) are highly technological settings in which advanced care is used to restore health to critically ill children; however, they are also places where children die. Understanding the needs of parents bereaved in this setting is essential for better family care. OBJECTIVE:T...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2010.0453

    authors: Meert KL,Schim SM,Briller SH

    更新日期:2011-08-01 00:00:00