Oncologist conceptualizations of pediatric palliative care: challenges and definitions

2014 Jan 7
01/07/2014
By Anat Laronne , Leeat Granek , Lori Wiener , Paula Feder-Bubis , Hana Golan

Purpose: Pediatric palliative care (PC) is an evolving field and involves a comprehensive approach to care of children with cancer. The goal of this paper was to explore how pediatric oncologists define, interpret, and practice pediatric palliative care in their clinical settings.

Methods: The study used the grounded theory approach to data collection and analysis. Twenty-one pediatric oncologists from six pediatric cancer centers across Israel were interviewed. Data was analyzed using line-by-line coding.

Results: The analysis resulted in a four-tiered conceptual model. This model included the following categories: (1) ill-defined concept; (2) philosophies of palliative care; (3) trajectory of palliative care; and (4) palliative care treatment goals.

Conclusion: The findings illustrate the current conceptualizations of pediatric palliative care among the pediatric oncology community in Israel. The conceptual model documents their understanding of pediatric palliative care as a philosophical approach and the challenges they face in differentiating between palliative care and standard pediatric oncology care. Pediatric palliative care is a highly needed and valued sub-specialty. The findings from this study highlight the importance for its continued development in Israel, as it can reduce the suffering of children and their families. Concurrently, pediatric oncologists need to have more resources and access to explicit knowledge of the conceptual and practical aspects of both primary and specialized pediatric palliative care.

Keywords: Cancer; Oncology; Palliative care; Pediatric oncology; Qualitative research.

More publications on the subject

The cultural context of patient’s autonomy and doctor’s duty: passive euthanasia and advance directives in Germany and Israel
01/11/2010
Abstract The moral discourse surrounding end-of-life (EoL) decisions is highly complex, and a comparison of Germany and Israel can highlight the impact of cultural
Selected issues in palliative care among East Jerusalem Arab residents
01/01/2010
Abstract Understanding of cultural context is important when working with Palestinian patients, particularly in Israeli hospitals. Cultural competence includes individual assessment of communication needs
End-of-life needs as perceived by terminally ill older adult patients, family and staff
01/09/2010
Abstract Purpose of the study: A comparison of inpatient end-of-life needs as perceived by terminally ill older adult patients, family, physicians and nurses, is lacking.
The cultural context of end-of-life ethics: a comparison of Germany and Israel
01/07/2010
No abstract available
Family caregiving to hospitalized end-of-life and acutely ill geriatric patients
01/08/2010
Abstract The article examines family caregiving to hospitalized older adults at the end of life (EOL). The stress stress process model was used to
Blaming the messenger and not the message
01/06/2010
No abstract available