Parents’ perspectives on conflict in paediatric healthcare: a scoping review

Abstract

BackgroundConflict in paediatric healthcare is becoming increasingly prevalent, in particular relation to paediatric end of life. This is damaging to patients, families, professionals and healthcare resources. Current research has begun to explore perspectives of healthcare professionals (HCPs), but the parental views on conflict are lacking.ObjectivesThis scoping review explores parental views on conflict during a child’s end of life. In addition, parental views are mapped onto HCPs’ views.MethodsA search was completed of the databases CINAHL, PubMed, Web of Science, Embase and Medline between 1997 and 2019, focused on parents of children with involvement with palliative or end-of-life care referring to conflict or disagreements.ResultsThe review found 10 papers that included parental views on conflict. Data on conflict were categorised into the following seven themes: communication breakdown, trust, suffering, different understanding of ‘best interest’, disagreements over treatment, spirituality and types of decision-making. In particular, parental expertise, perspectives on suffering and ways of making decisions were significant themes. A subset of themes mirror those of HCPs. However, parents identified views of conflict unique to their perspective.ConclusionsParents identified important themes, in particular their perspective of what constitutes suffering and ‘best interest’. In addition, parents highlight the importance of being recognised as an expert.