Related Experiment Video
Updated: May 21, 2025

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Quality Measure Considerations for Pediatric Palliative and End-of-Life Care
Hannah Hommes1, Diane Forsyth1, April Rowe Neal1
1Winona State University, Winona, MN, USA.
Insights
High-quality pediatric palliative care needs standardized quality measures. This review identified 7 domains for improving comfort, equity, and access in pediatric end-of-life care.
Area of Science:
- Pediatric Palliative Care
- End-of-Life Care Research
- Quality Measurement in Healthcare
Background:
- Growing need for high-quality pediatric palliative and end-of-life care for children with life-limiting illnesses.
- Lack of standardized quality measures for pediatric palliative and end-of-life care patient outcomes.
- Importance of Comfort Theory in guiding care for pediatric patients.
Purpose of the Study:
- To explore current quality measures in pediatric palliative and end-of-life care.
- To evaluate these measures within the Comfort Theory framework.
- To identify areas for improvement in pediatric end-of-life care quality.
Main Methods:
- Literature review of 15 relevant articles.
- Focus on pediatric patients with life-limiting illnesses receiving palliative or end-of-life care.
- Exclusion of studies on acute illness, trauma, or accidental death.
Main Results:
- Identified 7 emergent domains for quality measures: symptom alleviation, care structures/processes, healthcare utilization, place of death/bereavement, patient/family experiences, psychosocial/spiritual care, and cultural/ethical/legal aspects.
- These domains align with the physical, psychospiritual, sociocultural, and environmental contexts of Comfort Theory.
- Current quality measures are not standardized.
Conclusions:
- The 7 identified domains provide a framework for developing and standardizing quality measures in pediatric palliative and end-of-life care.
- Focusing on these domains can promote comfort, equity, and accessible care for pediatric patients.
- Further research and development of standardized quality measures are recommended.
Abstract:
There is an emerging need to provide high-quality pediatric palliative care and end-of-life care to children, adolescents, and young adults with life-limiting illnesses. Currently, there are no standardized quality measures supporting pediatric palliative care and end-of-life care patient outcomes. The aim of this literature review was to explore current quality measures utilized in pediatric palliative care and end-of-life care among pediatric patients with life-limiting illnesses within the conceptual framework of Comfort Theory. A comprehensive review of relevant articles resulted in 15 articles that met criteria and were evaluated. Included studies focused on pediatric patients with life-limiting illnesses receiving palliative care or end-of-life care. Articles related to children with acute illness, trauma, or accidental death were excluded. Emergent themes among quality measures were categorized into 7 domains: (a) Alleviation of distressing symptoms, (b) Structures and processes of care, (c) Health care utilization, (d) Location of death and bereavement care, (e) Patient and family experiences, (f) Psychological and spiritual care, and (g) Cultural, ethical, and legal considerations. These domains support the physical, psychospiritual, sociocultural, and environmental contexts of Comfort Theory. Quality measure research, development, and standardization should focus within the 7 domains identified for the promotion of comfort, equity, and accessible care.
Related Concept Videos
Ethical Issues
Ethical Concerns in Healthcare:
Continuing Care
Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
Ethical Dilemmas II
Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
Patient-centered Care

