Perth Children's Hospital, Child and Adolescent Health Service, Nedlands, Western Australia, Australia.
School of Nursing, Midwifery and Paramedicine, Faculty Health Sciences, Curtin University, Bentley, Western Australia, Australia.
Palliat Med. 2021 Jan;35(1):76-96. doi: 10.1177/0269216320967593. Epub 2020 Oct 24.
Provision of paediatric palliative care is complex and optimally covers meeting the individual needs of a heterogenous population of children and their parent caregivers throughout a life-limiting illness. It is unclear whether existing approaches comprehensively address parent caregivers' needs.
To examine support needs of parents caring for children with life limiting illnesses and identify specific approaches used to identify and address needs.
A scoping review.
MEDLINE, EMBASE, PsycINFO, CINAHL and ProQuest Central, were searched for peer reviewed English language full text research published from 2008 to 2019. Study quality appraisal was undertaken. Fourteen quantitative, 18 qualitative and 12 mixed methods studies were synthesised and themed using summative content analysis and mapped to the Parent Supportive Care Needs Framework (PSCNF).
Themes were communication, choice, information, practical, social, psychological, emotional and physical. Communication and choice were central and additional to domains of the PSCNF. Unmet were needs for supporting siblings, for respite care, out of hours, psychological, home and educational support. Six articles reported using instruments to identify parent carer support needs.
Support needs of parent caregivers of children with life limiting illnesses are substantial and heterogenous. While studies report evidence of burden and distress in parent caregivers, this rarely translates into improvements in practice through the development of interventions. A systematic and regular assessment of individual parent caregiver support needs is required by using instruments appropriate to use in clinical practice to move the focus to palliative care interventions and improved services for parents.
儿科姑息治疗的提供较为复杂,最佳做法是在危及生命的疾病过程中,满足具有异质性的儿童及其父母照护者的个体需求。目前尚不清楚现有的方法是否全面涵盖了父母照护者的需求。
调查照顾患有危及生命疾病的儿童的父母的支持需求,并确定用于识别和满足这些需求的具体方法。
范围综述。
检索了 MEDLINE、EMBASE、PsycINFO、CINAHL 和 ProQuest Central 中 2008 年至 2019 年发表的同行评审的英文全文研究。进行了研究质量评估。综合了 14 项定量研究、18 项定性研究和 12 项混合方法研究,并使用总结性内容分析进行了主题分析,并映射到父母支持性护理需求框架(PSCNF)。
主题包括沟通、选择、信息、实际、社会、心理、情感和身体。沟通和选择是核心,并且是 PSCNF 领域之外的附加内容。需要支持兄弟姐妹、临时护理、非工作时间、心理、家庭和教育支持的需求未得到满足。有 6 篇文章报告了使用工具来识别父母照顾者的支持需求。
患有危及生命疾病的儿童的父母照顾者的支持需求是多方面的。尽管研究报告了父母照顾者负担和痛苦的证据,但这很少通过开发干预措施转化为改善实践。需要使用适合临床实践的工具,系统且定期地评估个别父母照顾者的支持需求,将重点转移到姑息治疗干预和改善父母服务上。