PhD Scientific Days 2024

Poster Session S - Health Sciences 2.

“Breaking bad news is more difficult…”: Healthcare professionals’ perspectives on challenges in providing end-of-life care in paediatric intensive care units in Indonesia

Text of the abstract

Introduction
Despite the paediatric intensive care unit (PICU) primary focus on curative or life-sustaining treatments for seriously ill children, death in this setting also occurs. The high expectation of a child’s survival in PICU might cause a devastating feeling for parents/family when the child dies and presents unique challenges for healthcare professionals (HCPs).
Aims
This study aims to delve into the nuanced experiences and challenges HCPs face in delivering end-of-life care to paediatric patients within PICU settings.
Method
A qualitative study using constructivist grounded theory was employed. Semi-structured interviews were conducted with 25 HCPs (physicians, nurses, pharmacists, and nutritionist) in four PICUs in Indonesia. A constant comparative method was used to analyse the data.
Results
Seven categories emerged: (1) Breaking bad news; (2) Involvement of palliative care team; (3) Socio-cultural and religious aspects; (4) Parent/family expectations; (5) Parent/family decision-making; (6) Illness trajectory of PICU patients; and (7) Healthcare system.
Conclusion
Through a more profound understanding of the multifaceted challenges HCPs encounter when providing end-of-life care in PICU, the following recommendations could reduce challenges experienced by HCPs during end-of-life care in PICU: (1) Improving HCPs' communication skills; (2) Supporting shared decision-making; (3) Consideration of Indonesian socio-cultural and religious context; and (4) Involving palliative care specialists in PICUs.
Funding
This study is funded by the Indonesia Endowment Fund for Education (LPDP).