PhD Scientific Days 2024

Budapest, 9-10 July 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

Author(s)

Fanny Adistie1,2, Susan Neilson1, Karen Shaw3, Henny Suzana Mediani2, Nikolaos Efstathiou1,4
1: School of Nursing and Midwifery, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
2: Faculty of Nursing, Universitas Padjadjaran, Paediatric Nursing, Sumedang, Indonesia
3: Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
4: School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada

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).