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A qualitative study of health care professionals' views and experiences of paediatric advance care planning

Jack, BA, Mitchell, TK, O'Brien, MR, Silverio, SA and Knighting, K (2018) A qualitative study of health care professionals' views and experiences of paediatric advance care planning. BMC Palliative Care, 17 (1). p. 93. ISSN 1472-684X

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Open Access URL: https://doi.org/10.1186/s12904-018-0347-8 (Published version)


Background: Good end-of-life care planning is vital to ensure optimal care is provided for patients and their families. Two key factors are open and honest advance care planning conversations between the patient (where possible), family, and health care professionals, focusing on exploring what their future wishes are; and the development of an advance care plan document. However, in paediatric and neonatal settings, there has been little research to demonstrate how advance care planning conversations take place. This study explored health care professionals' views and experiences of paediatric advance care planning in hospitals, community settings and hospices. Methods: A qualitative methodology was employed using purposive sampling of health care professionals involved in the end-of-life care for children aged 0-18 years known to the hospital palliative care team, and had died at least three months before, but less than 18 months prior to the study. Ethics committee approval was obtained for the study. Located in the North of England, the study involved three hospitals, a children's hospice, and community services. Data were collected using semi-structured, digitally recorded, telephone interviews. All interviews were transcribed verbatim and subjected to thematic analysis. Results: Twenty-one health care professionals participated, including generalist paediatric staff as well as specialist palliative care staff. Two themes were generated from the study: The timing of planning conversations, including waiting for the relationship with the family to form; the introduction of parallel planning; avoiding a crisis situation. Secondly, supporting effective conversations around advance care planning, including where to have the conversation; introducing the conversation; and how to approach the topic encompassing the value of advance care planning and documentation for families. Conclusion: The timing of when to start the advance care planning conversations remains an issue for health care professionals. The value of doing it in stages and considering the environment where the conversations are held was noted. Timely planning was seen as vital to avoid difficult conversations at a crisis point and for co-ordination of care. Good advance care planning is to provide the best person-centred care for the child and experience for the family.

Item Type: Article
Uncontrolled Keywords: Humans; Palliative Care; Attitude of Health Personnel; Pediatrics; Qualitative Research; Adult; Middle Aged; Health Personnel; Advance Care Planning; England; Female; Male; Interviews as Topic; Advance care planning; End-of-life care; Interviews; Paediatrics; Palliative care; Qualitative research; Terminal care; Thematic analysis; Adult; Advance Care Planning; Attitude of Health Personnel; England; Female; Health Personnel; Humans; Interviews as Topic; Male; Middle Aged; Palliative Care; Pediatrics; Qualitative Research; 1110 Nursing; 1117 Public Health and Health Services; Gerontology
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > R Medicine (General)
R Medicine > RJ Pediatrics
Divisions: Psychology (from Sep 2019)
Publisher: BioMed central
SWORD Depositor: A Symplectic
Date Deposited: 02 Dec 2022 13:19
Last Modified: 02 Dec 2022 13:30
DOI or ID number: 10.1186/s12904-018-0347-8
URI: https://researchonline.ljmu.ac.uk/id/eprint/18256
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