Home > Research > Publications & Outputs > A good death in the child with life shortening ...

Electronic data

  • Manuscript_28_May_2021

    Rights statement: The final, definitive version of this article has been published in the Journal, Palliative Medicine, ? (?), 2021, © SAGE Publications Ltd, 2021 by SAGE Publications Ltd at the Palliative Medicine page: https://journals.sagepub.com/home/PMJ on SAGE Journals Online: http://journals.sagepub.com/

    Accepted author manuscript, 436 KB, PDF document

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

Links

Text available via DOI:

View graph of relations

A good death in the child with life shortening illness: A qualitative multiple-case study

Research output: Contribution to journalJournal articlepeer-review

E-pub ahead of print
<mark>Journal publication date</mark>5/07/2021
<mark>Journal</mark>Palliative Medicine
Number of pages11
Publication StatusE-pub ahead of print
Early online date5/07/21
<mark>Original language</mark>English

Abstract

Background:
Understanding what makes a ‘good death’ in the child with life shortening illness is important, as it informs appropriate and effective end-of-life care. Above play, peer contact and opportunities for assent, prior literature review found meeting needs and managing control were critical. The influence of disease types, location of death and palliative care support remains unclear.

Aim:
Explore how a good death for children can occur in the real-world context and identify factors influencing it.

Design:
A qualitative multiple-case study. The case was defined as family and professional caregivers of children who died, stratified across disease categories (cancer or non-cancer) and palliative care contact. Data collection included (1) interviews, (2) artefacts, (3) clinical notes. Framework Analysis facilitated in-depth within and cross-case analysis.

Setting/participants:
Singapore health-care context. Respondents included bereaved parents, health and social care providers from hospital, and a community palliative care service.

Results:
Five cases were constituted, with eight parents and 14 professionals as respondents. Eight common themes were identified, sub-categorised under three domains and interpreted theoretically: (1) Antecedents: Letting go, Acknowledging the child, Closure (2) Determinants: Suffering, Control, Systems and processes (3) Attributes: Comfort, Dying not prolonged. These factors were consistent across all cases, regardless of individual diagnoses, place of care and palliative care access.

Conclusions:
Elements that universally influence a good death are revealed within an ecologically sound and holistic conceptual framework. The impact of attitudes among healthcare professionals, and service delivery at systems level highlighted in this study have immediate applications in practice and policy.

Bibliographic note

The final, definitive version of this article has been published in the Journal, Palliative Medicine, ? (?), 2021, © SAGE Publications Ltd, 2021 by SAGE Publications Ltd at the Palliative Medicine page: https://journals.sagepub.com/home/PMJ on SAGE Journals Online: http://journals.sagepub.com/