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  • JPM_Review_Revised_manuscript_10_OCT_2018_Author_Accepted_Manuscript

    Rights statement: Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/10.1089/jpm.2018.0335

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    Available under license: CC BY-NC: Creative Commons Attribution-NonCommercial 4.0 International License

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Perceptions of a Good Death in Children with Life-Shortening Conditions: An Integrative Review

Research output: Contribution to journalJournal article

Published
<mark>Journal publication date</mark>1/06/2019
<mark>Journal</mark>Journal of Palliative Medicine
Issue number6
Volume22
Number of pages10
Pages (from-to)714-723
Publication StatusPublished
Early online date11/12/18
<mark>Original language</mark>English

Abstract

BACKGROUND: For children with life-shortening illness, achieving a "good death" can be a tacit goal. There is little understanding of how different stakeholders perceive what a "good death" might be.

OBJECTIVE: To review empirical literature to construct an understanding of a "good death" for children with life-shortening conditions.

DESIGN: An integrative review approach was followed. This involved searching across Embase, Web of Science, Medline, CINAHL, and PsycINFO (no date limits set), as well as identifying eligible studies tracking reference lists. Appraisal of shortlisted articles in full text was performed, followed by data extraction, synthesis, and interpretation.

RESULTS: Analysis of articles (n = 24) yielded a dynamic and layered narrative about a good death that revolved around three themes. (1) Level of needs: includes both practical support and aspirational goals such as "do everything." (2) The composite experience: whether positive or negative adds to produce a sense of suffering. (3) Control (preservation and letting go): moving from maintaining status quo to acceptance of the child's death, the experience of which also contributes to suffering. Framed using a health care system perspective, a concept map that interprets a good death in children with life-shortening conditions is represented.

CONCLUSIONS: A single yet holistic understanding of a good death experienced in the "real world" is suggested. Pediatric health and social care providers, and even policy makers, can use this new understanding to conceive alternative approaches to enhance support to dying children and their families.

Bibliographic note

Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/10.1089/jpm.2018.0335