Pediatric Concurrent Hospice Care: A Scoping Review and Directions for Future Nursing Research

Area of Science:

• Pediatric Palliative Care
• Health Services Research
• Nursing Research

Background:

• The Patient Protection and Affordable Care Act of 2010 mandated Concurrent Care for Children, removing the need to forgo curative therapies for hospice eligibility.
• Despite being a federally supported option, a comprehensive review of the scientific evidence on concurrent hospice care has not been previously conducted.
• This policy change impacts pediatric end-of-life care, necessitating an understanding of its implications and effectiveness.

Purpose of the Study:

• To systematically gather and critically appraise existing scientific evidence on concurrent hospice care for children.
• To identify gaps in the current research landscape, particularly concerning nursing research.
• To explore the policy, legal, ethical, and implementation aspects of concurrent care.

Main Methods:

• A systematic literature search was performed to identify relevant articles.
• Inclusion and exclusion criteria were applied to select studies for review.
• A total of 186 articles were initially identified, with 14 meeting the final criteria.

Main Results:

• The reviewed literature primarily focused on policy, legal, and ethical perspectives of concurrent hospice care.
• Only one study evaluated the impact of concurrent care on patient outcomes.
• Several articles described clinical and state-level implementation strategies for concurrent care.

Conclusions:

• There is a significant need for research that moves beyond conceptualization to generate baseline and outcomes data on concurrent hospice care.
• Understanding the effectiveness of concurrent care is crucial for informing future nursing research and clinical practice.
• Further investigation into the dissemination and implementation approaches at state, provider, and family levels is warranted.