End-of-life care in the pediatric intensive care unit: a concept analysis

Abstract

 PURPOSE: In the pediatric intensive care unit (PICU), there are children with life-threatening conditions, which results to end-of-life (EOL) consequences despite the administration of aggressive treatment. A conceptual analysis was conducted to determine the critical elements of EOL care in the PICU and to identify operative definitions. METHODS: The analysis method of Walker & Avant (2018) was used, and the databases searched included PubMed, EMBASE, CINAHL, PsycINFO, and Icyushi Web (Japanese database). A total of 57 references were included in the analysis. RESULTS: Attribute groups were categorized based on six themes: direct care for children, direct care for families, relationships between families and health care professionals, decision support, bereavement with children, and health care professional readiness. CONCLUSIONS: EOL care in the PICU involved child- and family-centered care that continuously supported the best interests of children and families with diverse developmental stages. Additionally, disease trajectories repeated the shared decision-making process and helped in building relationships based on mutual understanding between families and health care providers.