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Abstract O-26: TRANSITIONAL TOGETHERNESS THE CHANGING NATURE OF THE PARENT-HEALTHCARE PROVIDER RELATIONSHIP WHEN A CHILD DIES IN THE PICU

Butler, A.1; Hall, H.1; Copnell, B.2

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 12
doi: 10.1097/01.pcc.0000537368.79763.13
Oral Abstracts
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1Monash University, School of Nursing and Midwifery, Melbourne, Australia

2La Trobe University, School of Nursing and Midwifery, Melbourne, Australia

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Aims & Objectives:

The paediatric intensive care unit (PICU) remains the most common site for paediatric death worldwide. These children are typically accompanied by one or more parents, who must interact and form relationships with healthcare staff in the PICU. The aim of this study was to explore these parent-healthcare provider interactions when a child dies in PICU.

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Methods

Constructivist grounded theory was used. Twenty-six bereaved parents from four Australian PICUs participated in semi-structured, audio-recorded interviews in 2015–2016. Data were analysed using open, focused, and theoretical coding, the constant comparison method, and theoretical memoing, consistent with grounded theory. Ethical approval was provided by the university and participating hospitals.

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Results

Transitional togetherness describes the changing nature of the parent-healthcare provider relationship across the child’s illness trajectory and death, and the parents’ subsequent bereavement journey. Three key phases are explored: Welcoming expertise, focusing on the initial development of the relationship during the child’s admission; Becoming a team, which explores the parents’ need to reconstruct their role and form a team with their child’s healthcare providers; and Gradually disengaging, which demonstrates the parents’ need to continue their relationship with the PICU healthcare providers during the early bereavement period.

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Conclusions

The parent-healthcare provider relationship when a child is dying in the PICU is not static, but rather changes across time based on the changing needs and desires of the parents. Understanding these changes will ensure healthcare providers are able to provide appropriate care to parents across all stages of their journey.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies