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Published on: February 16, 2011
Beyond the Label: How Naming and Framing Impact Pediatric Palliative Care Acceptance
Dahlia A Brasuel1, Madeline L Johnson2, Kathryn A Ritchie1
1Department of Pediatrics (D.A.B., K.A.R., C.B.R.), Medical College of Wisconsin, Milwaukee, Wisconsin, United States.
Context:
Pediatric palliative care (PPC) underutilization persists despite proven benefits. Some barriers stem from the misconception that PPC is exclusively for end-of-life, causing parental distress and reticence to engage. This study explores the origins of these misconceptions to enable smoother introduction of this helpful service line.
Objectives:
This study examines how program naming and the framing of PPC services impacts perceptions of, and receptiveness to, PPC services among community-dwelling parents in the United States.
Methods:
A national sample of 363 U.S. parents recruited via Amazon Mechanical Turk (MTurk). Participants were randomly assigned to one of four vignettes introducing a PPC team. Introductions varied team name ("palliative care" vs. "Pediatric Advanced Care Team [PACT]") and frame (with/without explicit end-of-life mention). Questions assessed demographics, perceptions of, and willingness to engage with, PPC. Analyses included inferential statistics and Exploratory Factor Analysis (EFA).
Results:
There were no significant differences in the reception of PPC based on team name or the inclusion of end-of-life language. EFA identified two latent factors accounting for 76.46% of the variance: 1) Best Interest (parent's perception that the services were beneficial) and 2) Parental Distress (parent's perception of being overwhelmed when considering the service).
Conclusion:
Parental perceptions of PPC are predicated on underlying factors that may constitute referral barriers. In this study, neither renaming the team nor excluding the mention of end-of-life impacted participants' enthusiasm. Future interventions should look beyond name changes to characterize and directly address the latent factors of parental distress and the perceived best interests of the child.
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