Provider perceptions of child deaths

Area of Science:

• Pediatric Palliative Care
• Healthcare Provider Perceptions
• End-of-Life Studies

Background:

• End-of-life care quality in children is understudied compared to adults.
• Key components of quality pediatric end-of-life care remain unclear.
• Provider perceptions of end-of-life care quality are not well understood.

Purpose of the Study:

• To compare nurse and physician perceptions of end-of-life care quality for pediatric patients.
• To assess agreement on events surrounding the death of children between physicians and nurses.

Main Methods:

• Utilized self-administered surveys following child deaths in an academic, tertiary care, faith-based children's hospital.
• Included 71 matched sets of physicians and nurses who cared for the same child.
• Employed closed-ended questions on quality of care derived from focus groups.

Main Results:

• High agreement (>75%) between physicians and nurses on events surrounding pediatric care, with exceptions for self-reported behaviors or expectations.
• Physicians generally held more positive perceptions of the quality of death compared to nurses.
• Despite role-based differences, positive reports on the quality of death were common among all providers.

Conclusions:

• Providers reported good quality of end-of-life care for most pediatric patients, with minimal reported pain and suffering.
• Role differences (physician vs. nurse) contributed to variations in perception.
• Further research is recommended to explore differences based on provider experience and in diverse care settings.