DOI QR코드

DOI QR Code

Needs for Pediatric Palliative Care among Parents of Children with Complex Chronic Conditions

복합만성질환을 가진 자녀를 둔 부모의 소아청소년 완화의료 요구도

  • Yun, Hyeseon (College of Nursing, Yonsei University) ;
  • Hwang, Ae Ran (Palliative Care Center, Yonsei Cancer Center, Severance Hospital, Yonsei University) ;
  • Kim, Sanghee (College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University) ;
  • Choi, Eun Kyoung (College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University)
  • 윤혜선 (연세대학교 간호대학) ;
  • 황애란 (연세대학교 세브란스병원 연세암병원 완화의료센터) ;
  • 김상희 (연세대학교 간호대학.김모임간호학연구소) ;
  • 최은경 (연세대학교 간호대학.김모임간호학연구소)
  • Received : 2018.09.05
  • Accepted : 2018.10.12
  • Published : 2018.10.31

Abstract

Purpose: The purpose of this study was to investigate the needs for pediatric palliative care (PPC) among parents of children with complex chronic conditions (CCCs) and to investigate differences in the needs for PPC according to their general characteristics. Methods: A cross-sectional survey was conducted between March 28 and May 18, 2018. Parents (N=96) who had a child under 18 years with a CCC were recruited. Data were analyzed using descriptive statistics, independent t-test, and one-way ANOVA. Results: The overall average need for PPC was $3.58{\pm}0.33$ out of 4.00. In terms of care for the subjects' children, the highest need was physical care, followed by psychosocial and spiritual care. In the sub-dimensions, preservation of physical function received the highest score. Of the items, the highest need was for seizure control. In terms of care for the subjects themselves, the highest need was for psychosocial care, followed by bereavement and spiritual care. In the sub-dimensions, communication received the highest score. Of the items, the highest need was for smooth communication with medical staff. Differences in needs for PPC according to participants' general characteristics were not statistically significant. Conclusion: Medical staff should provide PPC according to the priorities of parents' perceived needs.

Keywords

References

  1. Chambers L, Dodd W, McCulloch R, McNamara-Goodger K, Thompson A, Widdas D. A guide to the development of children's palliative care services [Internet]. Bristol: Association for Children's Palliative Care; 2009 [cited 2018 Jun 1]. Available from: https://www.togetherforshortlives.org.uk/resource/a-guide-tochildrens-palliative-care.
  2. World Health Organization. WHO definition of palliative care [Internet]. Geneva; World Health Organization; 1998 [cited 2018 Jun 1]. Available from: http://www.who.int/cancer/palliative/definition/en.
  3. Committee on Bioethics and Committee on Hospital Care. Palliative care for children. Pediatrics. 2000;106(2):351-357. https://doi.org/10.1542/peds.106.2.351
  4. Feudtner C, Christakis DA, Connell FA. Pediatric deaths attributable to complex chronic conditions: a population-based study of Washington State, 1980-1997. Pediatrics. 2000;106(1 Pt 2):205-209.
  5. Kim MS, Lim NG, Kim HJ, Kim C, Lee JY. Pediatric deaths attributed to complex chronic conditions over 10 years in Korea: Evidence for the need to provide pediatric palliative care. Journal of Korean Medical Science. 2018;33(1):e1. https://doi.org/10.3346/jkms.2018.33.e1
  6. National Cancer Center Hospice and Palliative Care. Introduction map of hospice and palliative care institution [Internet]. Goyang: National Cancer Center Hospice and Palliative Care; [cited 2018 Jun 1]. Available from: http://hospice.cancer.go.kr/organ/organMap.do?menu_no=473&brd_mgrno=.
  7. Davies B, Brenner P, Orloff S, Sumner L, Worden W. Addressing spirituality in pediatric hospice and palliative care. Journal of Palliative Care. 2002;18(1):59-67.
  8. Kang KA, Hwang AR. Pediatric hospice and palliative care. The Korean Journal of Hospice and Palliative Care. 2012;15(3):131-140.
  9. Himelstein BP, Hilden JM, Boldt AM, Weissman D. Pediatric palliative care. The New England Journal of Medicine. 2004;350(17): 1752-1762. https://doi.org/10.1056/nejmra030334Boston
  10. Jung GG. Pediatric hospice and palliative care. The Korean Journal of Hospice and Palliative Care. 2002;5(1):10-16.
  11. Kang KA, Kim SJ. The present and future of children's hospice care in Korea. Korean Journal of Child Health Nursing. 2003;9(2):190-197.
  12. Section on Hospice and Palliative Medicine and Committee on Hospital Care. Pediatric palliative care and hospice care commitments, guidelines, and recommendations. Pediatrics. 2013;132(5): 966-972. https://doi.org/10.1542/peds.2013-2731
  13. National Cancer Center Hospice and Palliative Care. Information on pilot projects for children and adolescents [Internet]. Goyangsi: National Cancer Center Hospice and Palliative Care; 2018 [cited 2018 July 27]. Available from: http://hospice.cancer.go.kr/hospice/front/boardView.do?keykind=&keyword=&page_now&returl=/hospice/front/boardList.do&listurl=/hospice/front/boardList.do&brd_mgrno=181&menu_no=442&brd_no=89077
  14. Drake R, Frost J, Collins JJ. The symptoms of dying children. Journal of Pain and Symptom Management. 2003;26(1):594-603. https://doi.org/10.1016/S0885-3924(03)00202-1
  15. Kang KA, Shim S, Kim SJ. Development of a tool to measure the need for child hospice care in families of children with cancer. Journal of Korean Academy of Child Health Nursing. 2005;11(1):72-82.
  16. Kang T, Hoehn KS, Licht DJ, Mayer OH, Santucci G, Carroll JM, et al. Pediatric palliative, end-of-life, and bereavement care. Pediatric Clinics of North America. 2005;52(4):1029-1046. https://doi.org/10.1016/j.pcl.2005.04.004
  17. Canadian Hospice Palliative Care Association. Pediatric hospice palliative care guiding principles and norms of practice [Internet]. Ottawa: Canadian Hospice Palliative Care Association; 2006 [cited 2018 May 31]. Available from: http://www.chpca.net/media/7841/Pediatric_Norms_of_Practice_March_31_2006_English.pdf
  18. Meert KL, Thurston CS, Briller SH. The spiritual needs of parents at the time of their child's death in the pediatric intensive care unit and during bereavement: A qualitative study. Pediatric Critical Care Medicine. 2005;6(4):420-427. https://doi.org/10.1097/01.PCC.0000163679.87749.CA
  19. Lynn MR. Determination and quantification of content validity. Nursing Research. 1986;35(6):382-386. https://doi.org/10.1097/00006199-198611000-00017
  20. Polit DF, Beck CT, Owen SV. Focus on research methods: Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health. 2007;30(4):459-467. https://doi.org/10.1002/nur.20199
  21. Polit DF, Beck CT. The content validity index: Are you sure you know what's being reported? critique and recommendations. Research in Nursing and Health. 2006;29(5):489-497. https://doi.org/10.1002/nur.20147
  22. Korean Society for Hospice and Palliative Care. Textbook of hospice and palliative care. 1st ed. Seoul: Koonja; 2018. p. 398-415.
  23. Siden H. Pediatric palliative care for children with progressive nonmalignant diseases. Children. 2018;5(2):E28. https://doi.org/10.3390/children5020028
  24. National Cancer Center. Annual report of cancer statistics in Korea in 2015. Annual Report. Goyang: National Cancer Center; 2017 December. Report No.: 11-1352000-000145-10.
  25. Kang KA, Kim SJ, Kim YS. The need for child hospice care in families of children with cancer. Korean Journal of Hospice and Palliative Care. 2004;7(2):221-231.
  26. Koo HY, Choi SH, Park HR. Cognition and needs for hospice care among parents of children with cancer. Journal of Korean Academy of Child Health Nursing. 2009;15(3):325-333. https://doi.org/10.4094/jkachn.2009.15.3.325
  27. Chung YS, Park SY. Needs for hospice care among families of children with cancer for outpatients. Journal of the Korea Academia-Industrial cooperation Society. 2012;13(4):1706-1713. https://doi.org/10.5762/kais.2012.13.4.1706
  28. Quin S, Clarke J, Murphy-Lawless J. A palliative care needs assessment for children [Internet]. Dublin: Department of Health, Irish Hospice Foundation; 2005 [cited 2018 July 27]. Available from: http://hospicefoundation.ie/wp-content/uploads/2012/04/Palliative-care-needs-assessment-for-children-2005.pdf.
  29. Verberne LM, Kars MC, Schepers SA, Schouten-van Meeteren AYN, Grootenhuis MA, van Delden JJM. Barriers and facilitators to the implementation of a paediatric palliative care team. BMC Palliative Care. 2018;17(1):23. https://doi.org/10.1186/s12904-018-0274-8
  30. Korea Ministry of Government Legislation. Act on hospice and palliative care and decisions on life-sustaining treatment for patients at the end of life [Internet]. Sejong: Korea Ministry of Government Legislation; 2016 [cited 2018 Jun 1]. Available from: http://www.law.go.kr/법령/호스피스.완화의료및임종과정에있는 환자의연명의료결정에관한법률/(14013,20160203).