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Impact of Caring for Terminally Ill Children on Physicians: A Systematic Scoping Review
Lisa Xin Ling Ngiam1,2, Yun Ting Ong1,2, Jun Xuan Ng1,2
163751Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Insights
Caring for terminally ill children impacts physicians' professional identity, decision-making, and well-being. Understanding these effects, guided by the Ring Theory of Personhood (RToP), is crucial for providing holistic support to physicians.
Area of Science:
- Medical Ethics
- Psychology
- Pediatric Palliative Care
Background:
- Caring for terminally ill children significantly affects healthcare providers' quality of life and care delivery.
- Existing data is limited regarding the impact on physicians' personhood.
- The Ring Theory of Personhood (RToP) provides a framework to evaluate these effects.
Purpose of the Study:
- To evaluate how caring for terminally ill children impacts a physician's concept of personhood.
- To identify factors influencing the magnitude of these effects.
- To inform holistic support strategies for physicians.
Main Methods:
- Systematic literature review following PRISMA Guidelines (2000-2019).
- Searches conducted across PubMed, CINAHL, PsycINFO, Cochrane Library, and gray literature.
- Content and thematic analysis using a concurrent, independent Split Approach.
Main Results:
- Analysis of 39 articles revealed impacts on physicians' professional identity, clinical decision-making, personal well-being, and relationships.
- The magnitude of these impacts is influenced by protective and risk factors.
- Identified themes provide insight into the physician's experience in pediatric palliative care.
Conclusions:
- This review offers a novel approach to understanding physician personhood changes in pediatric palliative care.
- Further research is needed to explore these shifts in personhood.
- Development of an RToP-based assessment tool could guide personalized support for physicians.
Introduction:
Caring for terminally ill children influences nurses' and allied health provider's quality of life, ability to provide personalized, dignified and empathetic care and even their concepts of personhood. In the absence of data this review utilizes the Ring Theory of Personhood (RToP) to evaluate how a physician's concept of personhood is affected caring for terminally ill children in order to better support them holistically.
Methods:
Using PRISMA Guidelines, 14 researchers carried out independent searches of PubMed, CINAHL, PsycINFO, Cochrane Library and gray literature databases for articles published between 2000 to 2019. Concurrent and independent employment of content and thematic analysis (Split Approach) was used to enhance the trustworthiness of the analysis.
Results:
13,424 titles and abstracts were retrieved, 188 full texts were evaluated, and 39 articles were included and analyzed. Identical categories and themes identified using the Split Approach suggest that caring for dying children in PPC impacts the physician's professional identity, clinical decision making, personal well-being and relationships. The data also suggests that the magnitude of these effects depends on the presence of protective and risk factors.
Conclusion:
Aside from providing a novel insight into the upon the physician, this review proffers a unique approach to accounting for the presence, magnitude and influence of incoming catalysts, resultant conflicts, and protective and risk factors upon the physician's personhood. Further studies into the changes in personhood are required. Design of a personalized assessment tool based on the RToP will help direct timely, appropriate and personalized support to these physicians.
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