The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards—A National Survey

Author:

Salamon Eszter1,Fodor Éva1,Földesi Enikő2,Hauser Peter34,Kriván Gergely5,Csanádi Krisztina6,Garami Miklós3ORCID,Kovacs Gabor3,Csóka Monika3,Tiszlavicz Lilla Györgyi7,Kiss Csongor8ORCID,Dergez Tímea9,Ottóffy Gábor1ORCID

Affiliation:

1. Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Pécs Medical School, József A. Street 7, 7623 Pécs, Hungary

2. Institute of Behavioural Sciences, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary

3. Pediatric Center, Semmelweis University, Tűzoltó utca 7–9, 1094 Budapest, Hungary

4. Velkey László Child’s Health Center, Borsod-Abaúj-Zemplén County Central Hospital and University Teaching Hospital, Szentpéteri kapu 72–76, 3526 Miskolc, Hungary

5. Department for Pediatric Hematology and Hemopoietic Stem Cell Transplantation, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary

6. Hemato-Oncology Unit, Heim Pál National Pediatric Institute, 1089 Budapest, Hungary

7. Department of Pediatrics, University of Szeged, 6720 Szeged, Hungary

8. Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary

9. Institute of Bioanalysis, University of Pécs, 7624 Pécs, Hungary

Abstract

Background: Our knowledge about the attitudes of healthcare staff to palliative care in pediatric oncology is scarce. We aimed to assess their perceptions of palliative care in Hungary and find answers to the question of how to provide good palliative care for children. Method: Physicians (n = 30) and nurses (n = 43) working in the field of pediatric oncology (12 of them specialized in hospice care) were interviewed. Palliative care practice (communication, integration of palliative care, professionals’ feelings and attitudes, and opportunities for improvement) was assessed by semi-structured interviews evaluated in a mixed quantitative and qualitative way by narrative categorical content analysis and thematic analysis. Results: All providers displayed high negative emotions, positive evaluations, and used many active verbs. Nurses showed higher levels of denial, more self-references, and were more likely to highlight loss. Physicians emphasized the importance of communication regarding adequate or inadequate palliative care. Hospice specialists showed a higher passive verb rate, a lower self-reference, a lower need for psychological support, and a greater emphasis on teamwork and professional aspects. Conclusion: Our results show that nurses are more emotionally stressed than doctors in palliative care in pediatric oncology. To our knowledge, a study comparing doctors and nurses in this field has yet to be carried out. Our results suggest that pediatric oncological staff can positively evaluate a child’s palliative care despite the emotional strain. Regarding hospices, professional practice in palliative care may be a protective factor in reducing emotional distress and achieving professional well-being.

Funder

Eurakvilo Pediatric Oncological and Hospice Foundation

Publisher

MDPI AG

Subject

Pediatrics, Perinatology and Child Health

Reference55 articles.

1. Radbruch. A matter of definition—Key elements identified in a discourse analysis of definitions of palliative care;Pastrana;Palliat. Med.,2008

2. World Health Organization (2002). National Cancer Control Programmes: Policies and Managerial Guidelines, World Health Organization. [2nd ed.].

3. World Health Organization (1998). Cancer Pain Relief and Palliative Care in Children, WHO.

4. Child death in high-income countries;Petrou;Lancet,2014

5. IMPaCCT (2007). Standards for Paediatric Palliative Care in Europe. Eur. J. Palliat. Care, 14, 109–114.

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