Descriptions of comfort in the social networks surrounding a dying child.
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BackgroundThe death of a child is considered to be one of the greatest losses a parent can sustain and an extremely stressful experience for nurses. Comfort is needed throughout life, especially when one is suffering. Morse (1) describes comfort as an integral part of nursing, while other researchers use the term consolation. Norberg, Bergsten & Lundman (2) described consolation as occurring when openness, presence and availability create trust. In a trusting relationship suffering can be revealed and shared in a reciprocal presence, i.e. in communion and experience of meaning can emerge. The concepts comfort and consolation are partly overlapping and sometimes used interchangeably (3). As the concept comfort can mean different things (4), it is important to understand the concrete needs for comfort of the individual person who is suffering.Those who suffer can use self-comforting or self soothing strategies, such as taking time for oneself, and focusing on immediate needs (5, 6). According to Horton (7) the need to self-comfort is life-long.
Comfort for comforters in pediatric palliative careThe World Health Organization (8) describes palliative care for children as the active total care of the child's body, mind and spirit, and also involves giving support to the child's family. Children living with and dying from a life-threatening disease and their families suffer. As a child's disease and death often affect many persons, the child and his/her parents, siblings and the extended family need comfort (9). Family members often play a vital role in palliative care, both at home and in hospital, and their suffering can be a multidimensional experience of pain, sorrow, fear and vulnerability (10). Illness and death impact on how relationships are maintained within and outside a family (11,12).The death of a child is a tragic event for all involved, especially parents (12). In pediatric palliative care the focus is on providing palliation and comfort for the child and the child's family (9). Studies show that parents of children with life-threatening diseases valued continuity in the care of their child, a nurse who was there from beginning to end, showing compassion and performing small acts of kindness (11, 13). Nurses, who developed a close relationship with parents and turned their attention to the whole family, comforted parents. Parents were also relieved through practical help, kindness and thoughtfulness from their social network (14). Parents of children treated for cancer spoke about the comfort they received from other families and caregivers on the ward (15). The willingness of others to listen and be present can be comforting. The sense of being connected with others can give hope, and is in itself a ...