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An exploration of the experience of caring for children with non-malignant life-limiting conditions including, accessing services and decision-making surrounding the child’s care

Hurley, Fiona (2020) An exploration of the experience of caring for children with non-malignant life-limiting conditions including, accessing services and decision-making surrounding the child’s care. PhD thesis, Dublin City University.

Abstract
Children with non-malignant life-limiting conditions (NMLLCs) constitute the largest proportion of children requiring palliative care. Partly due to technological advances, growing numbers of these children are experiencing improved survival. Care is mostly provided at home by the family, with significant input from a range of health and social care providers at different points in the life trajectory. Little is known about parental experiences of caring for a child with a NMLLC including their experiences of accessing services and decision-making. Similarly, a dearth of information exists regarding the experiences of healthcare professionals caring for this cohort of children. This study aimed to explore the experience of caring for children with NMLLCs including, the experience of accessing services and decision-making. Participants were twenty-three parents (eighteen mothers and five fathers) and twelve healthcare professionals’ recruited from five organisations with a wide geographical remit. A concurrent mixed methods design was adopted. Qualitative data were collected from parents and healthcare professionals through semi-structured interviews. Two standardised measures and a demographic questionnaire collected quantitative data from parents. The measures were the Decisional Conflict Scale (DCS) and the Measure of Processes of Care-20 Scale (MPOC-20). The qualitative data took precedence within this concurrent embedded mixed methods design. Three key themes which emerged from the interviews with the parents were ‘Starting out in haziness’, ‘Managing an unexpected life’ and ‘The ship is going to go down’. Parents reported a generally low level of decisional conflict in the study. In addition, parents reported a generally positive perception of family-centred care provided. Three key themes which emerged from the interviews with the healthcare professionals were ‘Being there’, ‘Being focused’ and ‘Being strong’. Although commonalities across parents’ and professionals’ accounts were noted, key differences were also apparent. Parents and healthcare professionals equally demonstrated an extraordinary level of commitment to the child, focusing on providing expert care. Whilst aspects of good service provision were highlighted, both participant groupings identified that overall current services seemed under-resourced and insufficient to meet child and family needs. However, the perceived need to fight for services and the need to make complex decisions were more apparent in the parents’ accounts. This study is unique as no other study has explored the palliative care needs of children with NMLLCs and their families in an Irish context.
Metadata
Item Type:Thesis (PhD)
Date of Award:March 2020
Refereed:No
Supervisor(s):Kiernan, Gemma and Price, Jayne
Uncontrolled Keywords:children's nursing
Subjects:Medical Sciences > Nursing
DCU Faculties and Centres:DCU Faculties and Schools > Faculty of Science and Health > School of Nursing and Human Sciences
Use License:This item is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 License. View License
Funders:All-Ireland Institute of Hospice and Palliative Care and the Health Research Board, HRB
ID Code:23979
Deposited On:08 Apr 2020 16:36 by Gemma Kiernan . Last Modified 08 Apr 2020 16:36
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