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Clinician and carer moral concerns when caring for children who tube-feed
Ann Dadich1, Kaitlyn Hockey1, Cathy Kaplun2
1School of Business, Western Sydney University, Penrith South, NSW, Australia.
Insights
Moral concerns in child healthcare, particularly for tube-feeding, arise from differing beliefs and emotions. Improving dialogue between clinicians and carers is key to optimizing care and outcomes for children who tube-feed.
Area of Science:
- Pediatric Healthcare Ethics
- Family-Centered Care
- Clinical Communication
Background:
- Tube-feeding in children presents complex moral challenges for both clinicians and family carers.
- Disparate values, beliefs, and experiences among healthcare providers and families can influence decision-making processes.
- Understanding these diverse perspectives is crucial for effective and ethical child healthcare.
Purpose of the Study:
- To explore the moral concerns of clinicians and carers involved in the tube-feeding care of children.
- To identify challenges in decision-making and relationships within pediatric tube-feeding care.
- To establish how an ethic of care can improve outcomes for children and their carers.
Main Methods:
- Qualitative study involving semi-structured interviews.
- Conducted interviews with 9 clinicians and 9 carers of children who tube-feed.
- Thematic analysis of interview data to identify key findings.
Main Results:
- Identified disparate beliefs regarding the necessity of tube-feeding.
- Tube-feeding practices can evoke strong emotional responses in both clinicians and carers.
- Normalizing tube-feeding for children presents significant challenges within the caregiving environment.
Conclusions:
- Divergent relationships between clinicians and carers can create challenges in pediatric tube-feeding care.
- An ethic of care approach can reconcile differing interests to improve relationships and optimize feeding care.
- Enhanced dialogue is essential for creating shared understandings to benefit children who tube-feed and their families.
Abstract:
Child healthcare can be vexed by moral concerns - this extends to the care of children who tube-feed. Children who tube-feed often receive care from family members and clinicians of various disciplines. Each brings expertise, experiences, values, and views to a situation, prioritising the child's needs while attending to those they deem important in potentially disparate ways. Their understanding of a situation is shaped by beliefs, feelings, and perceptions. How then are key decisions made about the care of a child who tube-feeds? This article explores clinicians' and carers' moral concerns when caring for children who tube-feed. Interviews with clinicians (n = 9) and carers (n = 9) clarified three findings: first, there are often disparate beliefs about the need for tube-feeding; second, tube-feeding can evoke strong emotions; and third, it can be difficult to normalise tube-feeding. This article demonstrates how challenges can emerge when relationships between clinicians and carers diverge. Furthermore, it establishes how an ethic of care can bring different interests together to bolster the relationships required to optimise feeding care and promote health outcomes among children who tube-feed and their carers. This requires improved dialogue between and among clinicians and carers to create shared understandings of what is, what should be, and how to benefit children who tube-feed.
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