When a child cannot be cured - reflections of health professionals
- 1 May 2005
- journal article
- Published by Hindawi Limited in European Journal of Cancer Care
- Vol. 14 (2), 132-140
- https://doi.org/10.1111/j.1365-2354.2005.00520.x
Abstract
This article reports on a study exploring the challenges and complexities of caring for a child with cancer no longer responding to curative therapy. The difficulties that health professionals face when initiating and providing palliative care to children with cancer is largely unexplored. A greater understanding of these challenges is needed to inform the development of effective models of care. Participatory group discussions and in-depth interviews were used to explore how health professionals from three disciplines - nursing, medicine and social work - view their role during the shift from cure to palliation. Interviews were tape-recorded and transcribed verbatim. Content and thematic analysis was used to identify themes and important messages in the transcripts. This study illustrates how the trajectory of childhood cancer is characterized by uncertainty, especially following relapse where there is reduced clarity surrounding the child's outcome. Prognostic uncertainty and continued hope for survival make the shift to palliation difficult, raising questions about the applicability of traditional palliative care models for these children and their families. Decision making in this context is complicated by a lack of clarity, uncertainty and continued hope. Shifting the focus of care from cure to palliation is not experienced as a discrete event but rather, as an awareness and acceptance that slowly develops. New models of care that incorporate palliative care throughout the disease trajectory are recommended.Keywords
This publication has 20 references indexed in Scilit:
- Symptoms and Suffering at the End of Life in Children with CancerNew England Journal of Medicine, 2000
- The Meaning of Peak and Nadir Experiences of Pediatric Oncology Nurses: Secondary AnalysisJournal of Pediatric Oncology Nursing, 1998
- TRAINING HEALTH PROFESSIONALS IN CARING FOR DYING CHILDREN AND GRIEVING FAMILIESDeath Studies, 1997
- How to read a paper: Papers that go beyond numbers (qualitative research)BMJ, 1997
- Now I lay me down to sleepAmerican Journal of Hospice and Palliative Medicine®, 1997
- Parents' Emotional Reactions Related to Different Prospects for the Survival of Their Children with CancerJournal of Psychosocial Oncology, 1997
- specialty UPDATE96Nursing2021, 1996
- Coming to Terms: Parents' Response to a First Cancer Recurrence in Their ChildNursing Research, 1996
- Pass Me the BlueJournal of Pediatric Oncology Nursing, 1994
- Cancer Recurrence as a Traumatic EventBehavioral Medicine, 1990