PO-0320 Suffering Of Parents Four Years After Picu Admission Of Their Child

Abstract

Results For 72 children (31 girls, 41 boys), 91 decision-making meetings were organised. We identified 27.7% (20/72) disagreements or conflicts: 4 simple disagreements, 12 continuing disagreements and 4 conflicts. Five children had acute disease and 15 children had chronic disease. Source of disagreements was continuing LST in 19 cases (families wanted to continue aggressive treatment). In 1 case, the family wanted to stop treatments despite medical opinion (refusal of tracheotomy). Consequences of theses disagreements were continuation of treatments despite LST decisions in 12 cases. For 3 cases a compromise solution was found. Conclusion Disagreements are frequent in decisions to forgo LST (27,7%) and most of the child undergo treatments that are medically futile. Background and aims In a previous study on suffering of children during admission to a paediatric intensive care unit (PICU), we found that parents described suffering of their child mainly in relation to physical symptoms. In this study we evaluated if these children still have signs of suffering four years after the PICU admission and if the symptoms of suffering, as perceived by the parents, are different compared to the PICU period. Methods A structured audio taped interview with 15 parents of children four years after admission to a 20 bed level III PICU of a university teaching hospital to assess whether their child perceived to suffer and to identify perceived aspects of suffering. Results About 50% of the parents experienced 4 years after PICU admission suffering in their child. Parents of 8 children did not perceive suffering in their child. Parents indicated that the suffering during the PICU admission was due to physical and psychosocial factors. Psychosocial factors were related to the disease causing the admission to the PICU, the treatment and the hospital stay. Four years later the signs of suffering are related to communication, physical and mental retardation and being different from mates. Conclusions A child's admission to a PICU and its suffering not only cause suffering in the child during admission, but often suffering is still present four years after admission. Caregivers in paediatrics need to be aware of these perceived symptoms. In long-term follow up of critically ill children this phenomena needs attention. PO-0319 IS THERE SUFFERING IN CHILDREN FOUR YEARS AFTER

Ethical issues arising in the provision of medical interventions for gender diverse children and adolescents

“…A parent who is very sensitive to their child’s intense distress may express a desire for an immediate medical intervention. We know that seeing suffering in children causes suffering in parents (de Weerd, Brouwer, Sauer, & Mackelbergh, 2014). Parents may also be encouraged by others in their support community to believe that what the child feels is completely intolerable.…”