Paediatric end-of-life care–symptoms and problems: parent assessment

C Lykke, O Ekholm, M Olsen… - BMJ Supportive & Palliative …, 2023 - spcare.bmj.com
C Lykke, O Ekholm, M Olsen, P Sjøgren
BMJ Supportive & Palliative Care, 2023spcare.bmj.com
Objective Symptoms and problems (S&P) are under-reported in children in end-of-life care.
To target future interventions, the primary aim was to examine S&P in children in end-of-life
care. Methods All parents, who lost a child under the age of 18 years due to life-limiting
diagnoses in the period 2012–2014 in Denmark, were invited to complete a self-
administered questionnaire in 2017. In all, 152 (38%) children were represented by 136
mothers and 57 fathers. In the present study, parents' assessments of S&P during the last …
Objective
Symptoms and problems (S&P) are under-reported in children in end-of-life care.
To target future interventions, the primary aim was to examine S&P in children in end-of-life care.
Methods
All parents, who lost a child under the age of 18 years due to life-limiting diagnoses in the period 2012–2014 in Denmark, were invited to complete a self-administered questionnaire in 2017. In all, 152 (38%) children were represented by 136 mothers and 57 fathers. In the present study, parents’ assessments of S&P during the last month of life were restricted to children aged 3–18 years. Data were analyses by means of descriptive statistics.
Results
Children ≥3 years at the time of death were represented by 71 parents (48 mothers and 23 fathers) representing 56 out of the 152 children. Physical fatigue (93%), sleepiness (90%), poor appetite (87%), pain (84%) and nausea (84%) were the five most frequent symptoms reported by the parents. In all, 65% of the parents reported that satisfactory pain relief was obtained and 64% of the parents reported that the healthcare services to a large extent reacted quickly, when the child and/or family needed help. However, 46% of the parents experienced ‘mess-ups’ or sloppy services in the primary ward and 27% experienced that the children suffered from fear of death.
Conclusion
According to the parents, children with life-limiting diagnosis are highly symptomatic and have substantial problems during end-of-life care. Our findings indicate that systematic screening of S&P in children should be considered.
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