Karen Carr1, Felicity Hasson1, Sonja McIlfatrick1, Julia Downing2. 1. Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK. 2. International Children's Palliative Care Network, UK & Makerere University, Kampala, Uganda.
Abstract
BACKGROUND: Advance care planning for children with palliative care needs is an emotionally, legally and complex aspect of care, advocated as beneficial to children, families and health professionals. Evidence suggests healthcare professionals often avoid or delay initiation. An overview of evidence on the factors that influence and impact on the health care professional's initiation of paediatric advance care planning process is lacking. AIM: To review and synthesise evidence on the factors associated with health care professional's decision to initiate paediatric advance care planning. DESIGN: Systematic integrative review using constant comparison method. DATA SOURCES: Electronic databases (CINAHL, PubMed, PsycINFO, Ovid MEDLINE, EMBASE, Web of Science and Cochrane) using MeSH terms and word searches in Oct 2019. No limit set on year of publication or country. Grey literature searches were also completed. RESULTS: The search yielded 4153 citations from which 90 full text articles were reviewed. Twenty-one met inclusion criteria consisting of quantitative (n = 8), qualitative (n = 6) and theoretical (n = 7) studies.Findings revealed overarching and interrelated themes 'The timing of initiation', 'What makes an initiator, 'Professionals' perceptions' and 'Prerequisites to initiation'. CONCLUSIONS: This review provides insights into the complexities and factors surrounding the initiation of advance care planning in paediatric practice. Uncertainty regarding prognosis, responsibility and unpredictable parental reactions result in inconsistent practice. Future research is required to inform intervention to assist health care professionals when initiating paediatric advance care planning conversations.
BACKGROUND: Advance care planning for children with palliative care needs is an emotionally, legally and complex aspect of care, advocated as beneficial to children, families and health professionals. Evidence suggests healthcare professionals often avoid or delay initiation. An overview of evidence on the factors that influence and impact on the health care professional's initiation of paediatric advance care planning process is lacking. AIM: To review and synthesise evidence on the factors associated with health care professional's decision to initiate paediatric advance care planning. DESIGN: Systematic integrative review using constant comparison method. DATA SOURCES: Electronic databases (CINAHL, PubMed, PsycINFO, Ovid MEDLINE, EMBASE, Web of Science and Cochrane) using MeSH terms and word searches in Oct 2019. No limit set on year of publication or country. Grey literature searches were also completed. RESULTS: The search yielded 4153 citations from which 90 full text articles were reviewed. Twenty-one met inclusion criteria consisting of quantitative (n = 8), qualitative (n = 6) and theoretical (n = 7) studies.Findings revealed overarching and interrelated themes 'The timing of initiation', 'What makes an initiator, 'Professionals' perceptions' and 'Prerequisites to initiation'. CONCLUSIONS: This review provides insights into the complexities and factors surrounding the initiation of advance care planning in paediatric practice. Uncertainty regarding prognosis, responsibility and unpredictable parental reactions result in inconsistent practice. Future research is required to inform intervention to assist health care professionals when initiating paediatric advance care planning conversations.
Entities:
Keywords:
Child; adolescent; advance care planning; decision making; infant; paediatric; palliative care; terminal care
Authors: Maureen E Lyon; Lawrence J D'Angelo; Ronald H Dallas; Pamela S Hinds; Patricia A Garvie; Megan L Wilkins; Ana Garcia; Linda Briggs; Patricia M Flynn; Sohail R Rana; Yao Iris Cheng; Jichuan Wang Journal: AIDS Care Date: 2017-03-30
Authors: Jane Noyes; Richard P Hastings; Mary Lewis; Richard Hain; Virginia Bennett; Lucie Hobson; Llinos Haf Spencer Journal: BMC Palliat Care Date: 2013-02-05 Impact factor: 3.234
Authors: Emma Beecham; Linda Oostendorp; Joanna Crocker; Paula Kelly; Andrew Dinsdale; June Hemsley; Jessica Russell; Louise Jones; Myra Bluebond-Langner Journal: Health Expect Date: 2016-09-26 Impact factor: 3.377
Authors: Sima Z Bedoya; Abigail Fry; Mallorie L Gordon; Maureen E Lyon; Jessica Thompkins; Karen Fasciano; Paige Malinowski; Corey Heath; Leonard Sender; Keri Zabokrtsky; Maryland Pao; Lori Wiener Journal: Front Psychol Date: 2022-06-08