Parental Perspectives on Roles in End-of-Life Decision Making in the Pediatric Intensive Care Unit: An Integrative Review

Bennett, Rachel; LeBaron, Virginia

doi:10.1016/j.pedn.2019.02.029

Cited by 28 publications

(25 citation statements)

References 30 publications

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“…Factors that influence a parent’s decision-making include the child’s clinical status, parental emotions and support systems, and the parent–clinician encounter. Recent evidence reports a role conflict in regard to health care decision-making between parents and clinicians specifically at EOL (Bennett & LeBaron, 2019). Data are lacking on how parents arrive at their decision-making style preference regardless of where on the autonomous-passive-continuum they may be.…”

Section: Discussionmentioning

confidence: 99%

“…Critical to respecting the family’s preferences and goals and providing preference-consistent care, it is important to identify the decision-making style of parents of critically ill children and factors influencing their decision-making process. A recent review of parental decision-making specifically at the end-of-life (EOL) highlights parental needs for a trusting relationship and good communication with health care providers and that making these decisions falls under the domain of the parental role (Bennett & LeBaron, 2019). Although Bennett and LeBaron’s (2019) review focused on EOL decision-making, some of their studies included children who were already receiving palliative care.…”

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confidence: 99%

“…A recent review of parental decision-making specifically at the end-of-life (EOL) highlights parental needs for a trusting relationship and good communication with health care providers and that making these decisions falls under the domain of the parental role (Bennett & LeBaron, 2019). Although Bennett and LeBaron’s (2019) review focused on EOL decision-making, some of their studies included children who were already receiving palliative care. In addition, one of their studies asked parents hypothetical questions on withdrawal of life support for their children in the PICU instead of interviewing those who were facing EOL.…”

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confidence: 99%

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Parental Decision-Making in the Pediatric Intensive Care Unit: An Integrative Review

et al. 2021

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Parents are commonly responsible for making health care decisions for their seriously ill children in the pediatric intensive care unit (PICU); however, the factors influencing their decisions may vary. This integrative review examined the empirical literature between 2013 and 2018 to understand factors pertaining to parents’ decision-making about serious illness care of their children in the PICU. Seventeen studies met the inclusion criteria with three key findings. First, parent–clinician communication in the PICU is critical; second, most parents want to be the final decision-maker for their critically ill child; and third, parents’ emotions, support systems, and the child’s clinical status impact decision-making. Parental perspectives are important to consider when discussing serious illness care decisions for critically ill children. Further inquiry is needed into how the parent–clinician encounter impacts the decision-making process and subsequent outcomes in this population.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Parental Decision-Making in the Pediatric Intensive Care Unit: An Integrative Review

et al. 2021

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“…Three qualitative studies used both interviews and observations to collect evidence. 46,48,49 In the remaining 14 studies, 5 -45 including 2 mixed-methodology articles 47,50 and a secondary data analysis report 51 , data were collected only through interviews. Five common themes about family’s experience of EOLC in the ICU were identified. (1) Distressing emotions …”

Section: Resultsmentioning

confidence: 99%

“…This review focused on adult population because the death of children in the ICU usually involves parents, and their experiences and emotions are different from adult ICU patients’ family members. 24 Due to language restriction of the review team, this review was limited to English-language studies. The search is depicted in a PRISMA diagram (see Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Family Outcomes and Perceptions of End-of-Life Care in the Intensive Care Unit: A Mixed-Methods Review

2019

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The purpose of this review was to evaluate end-of-life care (EOLC) in the intensive care unit (ICU) from the perspective of family members. Sandelowski’s segregated approach from Joanna Briggs Institute (JBI) Mixed-Methods Systematic Reviews guided this review. A search was conducted in PubMed, CINAHL, PsycINFO, EMBASE, and ProQuest databases and identified 50 papers (33 quantitative, 15 qualitative, and 2 mixed-methodology studies). Five synthesized themes (distressing emotions, shared decision-making, proactive communication, personalized end-of- life care, and valuing of nursing care) were identified. For quantitative results, study methodologies and interventions were heterogeneous and did not always improve family members’ perceived quality of care and family members’ psychological distress. Configuration of qualitative and quantitative data revealed ICU end-of-life interventions were ineffective because they were not guided by family members’ reported needs and perceptions. To fulfill the family members’ needs for the patients’ EOLC in the ICU, researchers should develop a theory to explicitly explain how the family members experience ICU EOLC and implement a theory-based intervention to improve family psychological outcomes.

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Rellensmann¹

2021

Pädiatrische Palliativversorgung – Grundlagen

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Parental Perspectives on Roles in End-of-Life Decision Making in the Pediatric Intensive Care Unit: An Integrative Review

Cited by 28 publications

References 30 publications

Parental Decision-Making in the Pediatric Intensive Care Unit: An Integrative Review

Parental Decision-Making in the Pediatric Intensive Care Unit: An Integrative Review

Family Outcomes and Perceptions of End-of-Life Care in the Intensive Care Unit: A Mixed-Methods Review

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