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Pediatric Resident Perception and Participation in End-of-Life Care
Jason Z Niehaus1, Megan Palmer2, Michelle LaPradd3
1Division of Neonatal-Perinatal Medicine, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.
Insights
Pediatric residents lack comfort and training in end-of-life care. Enhanced education is crucial to improve their skills in communicating with families and providing support during pediatric palliative care.
Area of Science:
- Pediatric Medicine
- Palliative Care
- Medical Education
Background:
- Pediatric deaths are a reality, often occurring in hospitals.
- End-of-life care is vital for children with serious illnesses.
- Pediatric providers report discomfort with end-of-life care.
Purpose of the Study:
- To assess pediatric residents' perceptions of end-of-life care.
- To evaluate pediatric residents' participation in end-of-life care for children and families.
Main Methods:
- A survey-based, descriptive, mixed-methods study.
- Surveys were distributed to 100 pediatric residents at Indiana University School of Medicine.
- A 68% response rate provided quantitative and qualitative data.
Main Results:
- Residents across all training levels reported limited comfort and participation in end-of-life care.
- Only 32% felt adequately prepared by their education for end-of-life care.
- 19.5% of residents reported no participation in any aspect of end-of-life care.
Conclusions:
- Formalized education and training are necessary to enhance resident comfort and participation in pediatric end-of-life care.
- Future interventions should prioritize communication skills for difficult conversations.
- Training should also focus on providing guidance and support to families during end-of-life care.
Background:
Despite advances in medical care, pediatric deaths are still an unfortunate reality. Most of these deaths occur within a hospital setting. End-of-life care is an important part of medical care for children with serious illnesses. Despite the importance, pediatric providers report a lack of comfort surrounding end-of-life care.
Objective:
To assess categorical pediatric residents' perceptions and participation in providing end-of-life care to dying children and their families.
Study Design:
This is a survey-based, descriptive, mixed-methods study. Survey was sent to categorical pediatric residents at Indiana University School of Medicine in June 2018 to obtain both quantitative and qualitative information on resident perception and participation in end-of-life care. Surveys were sent to 100 residents with a response rate of 68%.
Setting/Participants:
Pediatric residents at Indiana University School of Medicine.
Results:
The comfort and participation in end-of-life care are limited in all levels of pediatric training. Residents do not feel comfortable with 19 of 22 questions related to end-of-life care. Only 32% of residents felt their education prepared them to participate in end-of-life care. Almost one-fifth (19.5%) of residents report participating in zero aspect of end-of-life care. Themes discussed by residents include education, experience, communication, social norms, emotions, self-care, comfort, and family.
Conclusion:
More formalized education and training is needed to increase resident comfort with and participation in end-of-life care. Such future interventions should focus on communication surrounding difficult conversations and providing guidance for families.
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