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Questions about the optimal setting for delivering pediatric palliative care are often raised and factors such as the proximity to family, the availability of resources and support and patient comfort are considered. While adult palliative care is widely acknowledged in healthcare, there is limited literature on the importance of place in pediatric palliative care.
This scoping review study, conducted by Walker (2023) and colleagues, aimed to highlight the importance and the meaning of place in pediatric palliative care. Twenty-five articles were identified and included in a detailed review. These articles emphasized the importance of pediatric palliative care in three different places: hospitals, homes and hospices.
The first finding is the preferences of the children and their families for where pediatric palliative care should be provided and, importantly, where the place of death should take place, with most preferring that the death occurs at home. This helps to underline the importance of understanding and respecting the preferences of the affected families in these difficult times and shaping the delivery of pediatric palliative care towards this.
Furthermore, the scoping review discussed the factors that can influence the choice of preferring to have the death at home. A crucial determinant is that comfort is provided, both for the child and the family. Grief processes, cultural and spiritual practices, as well as socioeconomic status were all additional factors influencing these preferences. These findings demonstrate the complexity of the decision-making process in pediatric palliative care and highlights the need for a personalized approach.
The significance of these results holds an implication in the decision making process and overall experiences of families in pediatric palliative care. Not only can a place of care help the patient, but can also help the family understand their roles in the situation and help with the grieving process. Acknowledging that these decisions impact multiple facets is crucial for healthcare providers and policymakers to meet the needs of each family.
This scoping review demonstrates that further research in this domain could be beneficial. Gaps were identified in the literature towards the need for more detailed investigations into the importance of the place of death in pediatric palliative care. By further exploring these complexities, researchers can help develop practices based on evidence that prioritize the preferences and well-being of children and their families dealing with these challenges. In the end, a detailed understanding of the significance of place in pediatric palliative care is crucial for improving the care quality and making sure it meets the needs and preferences of patients and their families.
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Source: Walker, M., Nicolardi, D., Christopoulos, T., & Ross, T. (2023). Hospital, hospice, or home: A scoping review of the importance of place in pediatric palliative care. Palliative & Supportive Care, 1-10.
