Savannah Neurology, Evelina London Children's Hospital, London, UK
Health Sciences, University of Southampton, Southampton, UK.
Arch Dis Child. 2021 Oct;106(10):981-986. doi: 10.1136/archdischild-2020-320975. Epub 2021 Feb 16.
Conflict in paediatric healthcare is becoming increasingly prevalent, in particular relation to paediatric end of life. This is damaging to patients, families, professionals and healthcare resources. Current research has begun to explore perspectives of healthcare professionals (HCPs), but the parental views on conflict are lacking.
This scoping review explores parental views on conflict during a child's end of life. In addition, parental views are mapped onto HCPs' views.
A search was completed of the databases CINAHL, PubMed, Web of Science, Embase and Medline between 1997 and 2019, focused on parents of children with involvement with palliative or end-of-life care referring to conflict or disagreements.
The review found 10 papers that included parental views on conflict. Data on conflict were categorised into the following seven themes: communication breakdown, trust, suffering, different understanding of 'best interest', disagreements over treatment, spirituality and types of decision-making. In particular, parental expertise, perspectives on suffering and ways of making decisions were significant themes. A subset of themes mirror those of HCPs. However, parents identified views of conflict unique to their perspective.
Parents identified important themes, in particular their perspective of what constitutes suffering and 'best interest'. In addition, parents highlight the importance of being recognised as an expert.
儿科医疗保健中的冲突越来越普遍，特别是在儿科临终关怀方面。这对患者、家庭、专业人员和医疗资源都造成了损害。目前的研究已经开始探索医疗保健专业人员（HCPs）的观点，但缺乏父母对冲突的看法。
本范围综述探讨了父母在孩子临终时对冲突的看法。此外，还将父母的观点映射到 HCPs 的观点上。
对 CINAHL、PubMed、Web of Science、Embase 和 Medline 数据库进行了 1997 年至 2019 年的搜索，重点是关注参与姑息治疗或临终关怀的儿童的父母，涉及冲突或分歧。
综述发现了 10 篇包含父母对冲突看法的论文。关于冲突的数据被分为以下七个主题：沟通失败、信任、痛苦、对“最佳利益”的不同理解、治疗分歧、精神信仰和决策类型。特别是，父母的专业知识、对痛苦的看法和决策方式是重要主题。一部分主题反映了 HCPs 的观点。然而，父母也确定了他们观点中独特的冲突观点。
父母确定了一些重要的主题，特别是他们对痛苦和“最佳利益”的看法。此外，父母强调了被认可为专家的重要性。
