Health Care Professionals' Awareness of a Child's Impending Death. (July 2020)

• Record Type: Journal Article
• Authors: Kobler, Kathie; Bell, Cynthia; Kavanaugh, Karen; Gallo, Agatha M.; Corte, Colleen; Vincent, Catherine
• Is Part Of: Qualitative health research. Volume 30:Number 9(2020)
• Page Start: 1314
• Page End: 1325
• Publication Date: 2020-07
• Subjects: professional -- end-of-life issues -- decision-making -- children -- theory development -- qualitative -- case study -- Midwest; Health -- Periodicals; Health behavior -- Periodicals; Health -- Research -- Methodology -- Periodicals; Health behavior -- Research -- Methodology -- Periodicals; 610.7205
• DOI: 10.1177/1049732320911627
• Languages: English
• ISSNs: 1049-7323

Abstract

Health care professionals' (HCPs) experiences during early pediatric end-of-life care were explored using a theory-building case study approach. Multiple data collection methods including observation, electronic medical record review, and semi-structured interviews were collected with 15 interdisciplinary HCPs across four cases. Within- and across-case analyses resulted in an emerging theory. HCPs' initial awareness of a child's impending death is fluid, ongoing, and informed through both relational and internal dimensions. Initial cognitive awareness is followed by a deeper focus on the child through time-oriented attention to the past, present, and future. HCPs engage in a "delicate dance of figuring out" key issues. Awareness was exemplified through four themes: professional responsibility, staying connected, grounded uncertainty, and holding in. The emerging theoretical model provides a framework for HCPs to assess their ongoing awareness, identify personal assumptions, and inform gaps in understanding when facilitating early end-of-life care discussions with families.