• Journal of Hospice and Palliative Care
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• v.27 no.2
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• pp.51-63
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• 2024

Purpose: This study aimed to clarify the concept of pediatric hospice and palliative care through conceptual analysis. It also sought to identify the differences between related concepts such as pediatric death care and pediatric spiritual care, in order to provide foundational data for the development of nursing theory and knowledge. Methods: A conceptual analysis of pediatric hospice and palliative care was conducted using Rodgers' evolutionary method. Out of 5,013 papers identified, 28 were selected for detailed reading and analysis. Results: Pediatric hospice and palliative care encompasses physical, psychological, social, mental, spiritual, and family care for children with acute and chronic diseases with uncertain prognoses ahead of death, as well as their families. Effective pediatric hospice and palliative care will require multidisciplinary team nursing, effective communication, and supportive policies. Conclusion: The findings of this study suggest that providing pediatric hospice and palliative care will lead to improvements in pain relief for children and families, the efficiency of responses to death in children, and the quality of life for children and families. The significance of this study is that it clearly clarifies the concept by analyzing pediatric hospice and palliative care using an evolutionary method.

• Perspectives in Nursing Science
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• v.16 no.2
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• pp.55-64
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• 2019

Purpose: This study examined the knowledge and perception of hospice-palliative care and terminal care stress among pediatric nurses, and the relationships among these variables. Methods: In this descriptive research study, 154 pediatric nurses who experienced terminal care at least once were surveyed. This study used three scales, including the Palliative Care Quiz for Nursing (PCQN), Perception of Hospice-Palliative Care, and Terminal care stress. Data analyses using SPSS 22.0 included descriptive statistics, independent t-test, one-way ANOVA, Mann-Whitney U test, Pearson's correlation coefficient, and stepwise multiple linear regression. Results: Terminal care stress experienced by the pediatric nurses was significantly related to the perception of hospice-palliative care; the hospice-palliative care education program enhanced the knowledge and perception of hospice-palliative care. Conclusion: Hospice-palliative care education programs should be developed and provided for pediatric nurses to improve pediatric hospice-palliative care. Additionally, further research on this topic is required because the present results are inconsistent with previous and current researches.

• Journal of Hospice and Palliative Care
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• v.25 no.3
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• pp.121-132
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• 2022

Purpose: This phenomenological analysis was conducted to explore the experiences of college student volunteers in the field of pediatric palliative care. Methods: In-depth interviews were conducted with nine study participants who had experience volunteering with children receiving pediatric palliative care. The study analysis was conducted using the Colaizzi method, a rigorous qualitative research method, to develop "intra-group" comparisons among the study participants. Results: Through an analysis of the data, 51 themes, 18 theme clusters, and five main categories were derived. The results confirmed that the experience of university student volunteers in pediatric palliative care can be summarized as "awareness of the role of a volunteer," "difficulties encountered while volunteering," "efforts to overcome the difficulties of volunteer work," "personal reflection," and "awareness of life and death." Conclusion: The results of this study can be used as a practical guide for the effective management of volunteers in the pediatric palliative care setting.

• Journal of Hospice and Palliative Care
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• v.15 no.3
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• pp.131-140
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• 2012

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.51-59
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• 2023

Purpose: We evaluated the status of patients enrolled in South Korea's pediatric palliative care pilot project based on the experience of a single center. This study examined factors related to end-of-life services and differences in medical costs. Methods: The medical records of 120 patients referred by a pediatric palliative care team were analyzed retrospectively. Data from July 1 to February 28, 2022 were collected and analyzed using the chi-square test and the Mann-Whitney U test. Results: Volunteer programs and psychological support (100%), family support and education (99.2%), and financial support through institutional linkage (62.5%) were provided to the participants. In the deceased group, there were no significant differences in general characteristics, which included age, gender, primary disease, religion, duration of hospitalization in an intensive care unit (ICU) and non-intensive care unit (non-ICU). However, the ICU group had fewer opportunities to access individual pain and physical symptom management than the non-ICU group and there were limitations in linking with external resources. Medical expenses were significantly different for the ICU group, with a 3-times higher average cost than the non-ICU group. Conclusion: Although an individualized approach is needed for each patient in pediatric palliative care, psychosocial care is essential. In addition, if early intervention for end-of-life pediatric patients is available from a palliative care team, the cost burden of medical care for patients and their families should be minimal.

• Journal of Hospice and Palliative Care
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• v.18 no.3
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• pp.235-244
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• 2015

Purpose: The aim of this study was to investigate pediatric nurses' perception and knowledge about pediatric hospice and palliative care. Methods: A cross-sectional descriptive study was conducted with 132 nurses who are stationed in pediatric wards and intensive care units. The participants were requested to fill out a questionnaire comprising 23 items for perception and 20 items for knowledge. Data were collected after obtaining written consent. Data were analyzed using SPSS 21.0. Results: Participants perceived difficulties in pediatric hospice palliative care, especially communication with patients and their families. The differences of perception among participants were observed according to pediatric hospice and palliative care experience, but not general characteristics. Participants' knowledge was $8.83{\pm}2.64$. Nurses who work in a ward showed higher level of knowledge about pediatric hospice/palliative care. Conclusion: An education program should be developed and provided to pediatric nurses to improve their perception and knowledge about pediatric hospice/palliative care.

• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.39-47
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• 2019

Purpose: This study was performed to investigate the current status of pediatric palliative care provision and how it is perceived by the palliative care experts. Methods: A descriptive study was conducted with 61 hospice institutions. From September through October 2017, a questionnaire was completed by experts from the participating institutions. Data were analyzed using SPSS 21.0. Results: Among 61 institutions, palliative care is currently provided for pediatric cancer patients by 11 institutions (18.0%), all of which are concentrated in Seoul, Incheon and Gyeonggi and Gyengsang provinces; 85.2% of all do not plan to provide specialized pediatric palliative care in the future. According to the experts, the main barriers in providing pediatric palliative care were the insufficient number of trained specialists regardless of the delivery type. Experts said that it was appropriate to intervene when children were diagnosed with cancer that was less likely to be cured (33.7%) and to move to palliative care institutions when their conditions worsened (38.2%); and it was necessary to establish a specialized pediatric palliative care system, independent from the existing institutions for adult patients (73.8%). Conclusion: It is necessary to develop an education program to establish a nationwide pediatric palliative care centers. Pediatric palliative care intervention should be provided upon diagnosis rather than at the point of death. Patients should be transferred to palliative care institutions after intervention by their existing pediatric palliative care team at the hospital is started.

• Journal of Hospice and Palliative Care
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• v.25 no.2
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• pp.85-97
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• 2022

Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.289-300
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• 2014

Purpose: The aim of this research was to explore nurses' knowledge of and attitudes toward pediatric palliative care (PPC) in Korea. Methods: A descriptive cross-sectional design was used. A total of 196 participants were recruited from the ELNEC-PPC course held in Seoul, Korea. All participants completed a 20-item survey questionnaire which assessed knowledge of and attitudes toward PPC using a 7-point Likert scale. Results: Nurses' knowledge of PPC correlated with their educational level and work experience in the pediatric unit and hospice care unit. The work experience in the pediatric unit, career length in PPC and completion of palliative education course made differences in the attitudes toward PPC. Married nurses scored significantly higher on the parental rights in determining palliative care service for their child, and nurses with master's degree or higher showed a higher level of understanding of and attitudes toward the differences between PPC and adult palliative care. Conclusion: The factors influencing nurses' knowledge of and attitudes toward PPC need be considered to develop a pediatric palliative training program.

• Journal of Hospice and Palliative Care
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• v.24 no.4
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• pp.235-244
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• 2021

Purpose: This study aimed to provide basic data for developing interventions to relieve the end-of-life care stress experienced by pediatric nurses by examining the relationships of end-of-life care stress with compassionate competence and attitudes toward end-of-life care. Methods: Data were collected via a survey that was conducted from September 10 to September 30, 2018 and administered to 113 nurses who had worked for more than 6 months in a pediatric unit at a tertiary hospital in Seoul, South Korea. The data were analyzed for frequency, percentage, mean, and standard deviation, and the independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 25.0. Results: End-of-life care stress among pediatric nurses had a weak positive correlation (r=0.216, P<0.05) with compassionate competence and had no significant correlation with attitudes toward end-of-life care. Among the sub-factors of end-of-life care stress, psychological difficulties had a weak positive correlation with sensitivity (r=0.309, P<0.01) and communication (r=0.230, P<0.05), which are aspects of compassionate competence. Lack of knowledge about end-of-life care had a weak positive correlation with communication (r=0.209, P<0.05) as an aspect of compassionate competence. Conclusion: To improve the quality of end-of-life care provided by pediatric nurses, it is necessary to improve their compassionate competence and reduce their end-of-life care stress by developing education and support programs tailored to the characteristics of children and specific communication methods.