OBJECTIVE: To broaden existing knowledge of pediatric end-of-life decision making by exploring factors described by parents of patients in the pediatric intensive care unit (PICU) as important/influential if they were to consider withdrawing life-sustaining therapies. DESIGN: Quantitative and qualitative analysis of semi-structured one-on-one interviews. SETTING: The PICUs at 2 tertiary care hospitals. PARTICIPANTS: English- or Spanish-speaking parents who were older than 17 years and whose child was admitted to the PICU for more than 24 hours to up to 1 week. INTERVENTION: Semi-structured one-on-one interviews. RESULTS: Forty of 70 parents (57%) interviewed said they could imagine a situation in which they would consider withdrawing life-sustaining therapies. When asked if specific factors might influence their decision making, 64% of parents said they would consider withdrawing life-sustaining therapies if their child were suffering; 51% would make such a decision based on quality-of-life considerations; 43% acknowledged the influence of physician-estimated prognosis in their decision; and 7% said financial burden would affect their consideration. Qualitative analysis of their subsequent comments identified 9 factors influential to parents when considering withdrawing life-sustaining therapies: quality of life, suffering, ineffective treatments, faith, time, financial considerations, general rejection of withdrawing life-sustaining therapies, mistrust/doubt toward physicians, and reliance on self/intuition. CONCLUSION: Parents describe a broad range of views regarding possible consideration of withdrawing life-sustaining therapies for their children and what factors might influence such a decision.
OBJECTIVE: To broaden existing knowledge of pediatric end-of-life decision making by exploring factors described by parents of patients in the pediatric intensive care unit (PICU) as important/influential if they were to consider withdrawing life-sustaining therapies. DESIGN: Quantitative and qualitative analysis of semi-structured one-on-one interviews. SETTING: The PICUs at 2 tertiary care hospitals. PARTICIPANTS: English- or Spanish-speaking parents who were older than 17 years and whose child was admitted to the PICU for more than 24 hours to up to 1 week. INTERVENTION: Semi-structured one-on-one interviews. RESULTS: Forty of 70 parents (57%) interviewed said they could imagine a situation in which they would consider withdrawing life-sustaining therapies. When asked if specific factors might influence their decision making, 64% of parents said they would consider withdrawing life-sustaining therapies if their child were suffering; 51% would make such a decision based on quality-of-life considerations; 43% acknowledged the influence of physician-estimated prognosis in their decision; and 7% said financial burden would affect their consideration. Qualitative analysis of their subsequent comments identified 9 factors influential to parents when considering withdrawing life-sustaining therapies: quality of life, suffering, ineffective treatments, faith, time, financial considerations, general rejection of withdrawing life-sustaining therapies, mistrust/doubt toward physicians, and reliance on self/intuition. CONCLUSION: Parents describe a broad range of views regarding possible consideration of withdrawing life-sustaining therapies for their children and what factors might influence such a decision.
Authors: Dorothy Brooten; Joanne M Youngblut; Lynn Seagrave; Carmen Caicedo; Dawn Hawthorne; Ivette Hidalgo; Rosa Roche Journal: Am J Hosp Palliat Care Date: 2012-04-24 Impact factor: 2.500
Authors: Kelly Nicole Michelson; Rachna Patel; Natalie Haber-Barker; Linda Emanuel; Joel Frader Journal: Pediatr Crit Care Med Date: 2013-01 Impact factor: 3.624