“WE HAVE LEARNED TO SPEAK WITH OUR EYES”: REFLECTIONS OF THE PEDIATRIC PALLIATIVE CARE PROCESS ON FAMILY LIFE
Yıl 2024,
, 69 - 76, 23.08.2024
İpen Ünlü
,
Cennet Ulucan Şahin
,
Mustafa Karataş
,
Ömer Faruk Cantekin
Öz
Objective: This study was conducted to examine in detail the experiences regarding the care process of family members providing pediatric palliative care.
Method: A qualitative research method was adopted for the study. The reason for choosing this method was to understand the phenomenon of the reflections of the experiences of family members who care for children (0-18 years old) in the palliative care process in family life. Data were collected using a semi-structured interview form from the primary caregivers of 10 pediatric patients hospitalized in the pediatric palliative care unit of a children's hospital in Ankara. The data obtained was subjected to descriptive analysis through the "Maxqda 2020 Analytics Pro" analysis software.
Results: Themes created regarding the reflections of the palliative care process on family life are examined and grouped under four headings. These are: "Perception of Palliative Care", "Difficulties in the Palliative Care Process", "Coping Mechanisms of Families" and "Effects of the Palliative Care Process on Family Life". Regarding their socio-demographic characteristics, the caregivers' education levels were low and their income levels were moderate. In terms of the characteristics of the caregiving process, the families were primarily aware of what palliative care is, spent much time during the day for care, and experienced various difficulties (psychological, social, economic) with the care process, causing changes in family ties.
Conclusion: Multidisciplinary teamwork is needed to manage the many difficulties that the palliative care process brings to the lives of caregivers and to increase the coping capacity of caregivers and their quality of life by taking into account all psychosocial and economic contexts of their lives.
Kaynakça
- Radbruch L, De Lima L, Knaul F, et al. Redefining palliative care—a new consensus-based definition. Journal of pain and symptom management. 2020; 60(4):754-764.
- Report of a World Health Organization (WHO) Expert Committee, WHO Technical Report Series 804, Cancer pain relief, Geneva: WHO, 1990, p.11.
- Ryan S, Wong J, Chow R , Zimmermann C. Evolving definitions of palliative care: upstream migration or confusion?. Current treatment options in oncology. 2020; 21(3): 1-17.
- World Health Organisation. Integrating palliative care and symptom relief into paediatrics: a WHO guide for health-care planners, implementers and managers;[May;2024].2018. https://apps.who.int/iris/bitstream/handle/10665/274561/9789241514453- eng.pdf?ua =1.
- Connor SR, Downing J, Marston J. Estimating the global need for palliative care for children: A cross-sectional analysis. Journal of Pain and Symptom Management,S0885392416304936–.2016.08.020. 2017;53 (2):171-177.
- Kabalak A, Öztürk H, Erdem AT, Akın S. Comprehensive Palliative Care Center Application at SB Ulus State Hospital. Journal of Contemporary Medicine. 2012; 2(2):122-126.
- Swami M, Case AA. Effective palliative care: what is involved?. Oncology (08909091), 2018; 32(4). 180-184.
- Erol S, Ergün A. Geriatric Palliative Care: Why, Where, When, How and By Whom Should It Be Provided? Journal Of Public Health Nursing. 2019;1(2):38-48.
- Kangalgil Balta G, Bekiroğlu, S. The Importance of Psychosocial Support Services in Palliative Care. Work and Society. 2021(4), 2797-2812.
- Tekindal M, Uğuz Arsu Ş. A review of the scope and process of the phenomenological approach as a qualitative research method. Beyond the Horizon Science Journal. 2020; 20(1):153-182.
- Neuman LW. Social Research Methods: Qualitative and Quantitative Approaches (Seventh Ed.). Essex: Pearson Education Limited. 2014.
- Baltacı A. A Conceptual Review on Sampling Methods and Sample Size Issues in Qualitative Research. BEÜ SBE Journal. 2018;7(1):231-74.
- Braun, V. and Clarke, V. The use of thematic analysis in psychology. Journal of Qualitative Research in Education – Journal of Qualitative Research in Education. 2019; 7(2), 873-98.
- Winger A, Kvarme LG, Løyland B, Kristiansen C, Helseth S, Ravn IH. (2020). Family experiences with palliative care for children at home: a systematic literature review. BMC Palliative Care. 2020; 19(1): 165.
- Cengiz Z, Turan M, Olmaz D, Erce Ç. Care burden and quality of life in family caregivers of palliative care patients. Journal of Social Work in End-of-Life & Palliative Care. 2021; 17(1): 50-63.
- Sağlam Z, Koç Z, Çınarlı T, Korkmaz M. Determining the Caregiving Burden and Factors Affecting Patients' Relatives Giving Care to Individuals Sixty-five Years of Age and Over. Samsun Health Sciences Journal. 2016;1(2): 40-60.
- Egici MT, Kök Can M., Toprak D, et al. Care Burden and Burnout Situations of Individuals Giving Care to Patients Being Treated in Palliative Care Centers. Journal of Academic Research In Nursing. 2019; 5 (1): 1-8.
- Franchini L, Ercolani G, Ostan R, et al. Caregivers in home palliative care: gender, psychological aspects, and patient's functional status as main predictors for their quality of life. Supportive Care in Cancer. 2020; 28(7): 3227-3235.
- Robinson J, Gott M, Ingleton C. Patient and family experiences of palliative care in hospital: what do we know? An integrative review. Palliative medicine. 2014; 28(1):18-33.
- Lin SC, Chang KL & Huang MC. When and how do healthcare professionals introduce specialist palliative care to the families of children with life-threatening conditions in Taiwan? A qualitative study. Journal of Pediatric Nursing, 2021.
- Özhan, E. Evaluation of Psycho-Social Situations of Relatives of Cancer Patients: Eyüpsultan State Hospital Palliative Care Center Example. Sakarya University, Unpublished Master's Thesis. 2019.
- Boyden JY, Hill DL, Nye RT, et al. Pediatric palliative care parents' distress, financial difficulty, and child symptoms. Journal of pain and symptom management, 2022;63(2):271-282.
- Rocío, L., Rojas, E. A., González, M. C., Carreño, S., Diana, C., & Gómez, O. Experiences of patient-family caregiver dyads in palliative care during hospital-to-home transition process. International Journal of Palliative Nursing, 2017; 23(7): 332-339.
- Nipp RD, El-Jawahri A, Moran SM, D'Arpino SM, Johnson PC, Lage DE, Wong RL, Pirl WF, Traeger L, Lennes IT, Cashavelly BJ, Jackson VA, Greer JA, Ryan DP, Hochberg EP, Temel JS. The relationship between physical and psychological symptoms and healthcare utilization in hospitalized patients with advanced cancer diagnosis. Cancer. 2017;123(23):4720–7.
- Lee G, Kim HS, Lee SW, Park YR, Kim EH, Lee B, Hu YJ, Kim KA, Kim D, Cho HY, Kang B, Choi HJ. Preliminary screening of patient-reported symptoms using the Edmonton Symptom Assessment System in outpatient palliative cancer care. Eur J Cancer Care. 2020; 29(6):e13305.
- Valero-Cantero, I., Casals, C., Carrión-Velasco, Y., Barón-López, F.J., Martínez-Valero, F.J., & Vázquez-Sánchez, M. Á. The influence of symptom severity of palliative care patients on their family caregivers. BMC Palliative Care, 2022; 21(1): 1-7.
- Darlington AS, Randall D, Leppard L, Koh M. Palliative and end of life care for a child: understanding parentsâ coping strategies. Acta Paediatrica. 2021;110(2):673-681.
- Verberne LM, Kars MC, Schouten-van Meeteren AYN, van den Bergh EMM, Bosman DK, Colenbrander DA, Grootenhuis MA, van Delden JJM. Parental experiences and coping strategies when caring for a child receiving paediatric palliative care: a qualitative study. Eur J Pediatr. 2019; 178(7):1075-1085.
- Özdemir, F. Examining the relationship between the psychosocial problems experienced by the relatives of patients receiving palliative care and their religious coping styles, Hacettepe University Faculty of Health Sciences, Master's Thesis, Ankara. 2016.
- Çetin Ö. The Effect of Psychoeducation on Palliative Care Providers' Coping with Stress and Quality of Life. Celal Bayar University Health Sciences Institute, Master's Thesis, Manisa. 2018.
- Gün S. Evaluation of Burnout and Stress Coping Situations of Relative Caregivers of Stroke Patients. Ondokuz Mayıs University, Institute of Health Sciences, Master's Thesis, Samsun. 2017.
- Kopuz E. Determining the Work-Related Tension Level of Nurses and Examining Their Attitudes to Cope with Stress: A Private Hospital Example. Haliç University, Institute of Health Sciences, Master's Thesis, Istanbul.2013.
- Adelman, R., Tmanova, L., and Delgado, D. Caregiver Burden: A Clinical Review. JAM, 2014; 311 (10): 1052-1060.
- Azevedo C, Pessalacia JDR, Mata LRFD, Zoboli ELCP, Pereira MDG. Interface between social support, quality of life and depression in users eligible for palliative care. Rev Esc Enferm USP. 2017; 51:e03245. English, Portuguese, Spanish.
- Rutkowski NA, Lebel S, Richardson K, Mutsaers B, Chasen M, Feldstain A. A little help from my friends: social support in palliative rehabilitation. Current Oncology, 2018; 25(6): 358-365.
- Veloso, V.I., & Tripodoro, V.A.Caregivers burden in palliative care patients: a problem to tackle. Current opinion in supportive and palliative care. 2016; 10(4): 330-335.
- Karakartal D. Examination of the Problems Experienced by the Relatives of the Patient Giving Care to the Cancer Patient During the Treatment Process. International Journal of Humanities and Education. 2017; 3(2): 96-109.
- Perpiñá-Galvañ J, Orts-Beneito N, Fernández-Alcántara M, García-Sanjuán S, García-Caro MP, Cabañero-Martínez MJ. Level of burden and health-related quality of life in caregivers of palliative care patients. International journal of environmental research and public health. 2019; 16(23): 4806.
- Başdinç ŞE. Caregiving Burden and Psychosocial Needs of Relatives of Patients in Palliative Care. Istanbul University, Unpublished Master's Thesis. İstanbul. 2019.
Yıl 2024,
, 69 - 76, 23.08.2024
İpen Ünlü
,
Cennet Ulucan Şahin
,
Mustafa Karataş
,
Ömer Faruk Cantekin
Kaynakça
- Radbruch L, De Lima L, Knaul F, et al. Redefining palliative care—a new consensus-based definition. Journal of pain and symptom management. 2020; 60(4):754-764.
- Report of a World Health Organization (WHO) Expert Committee, WHO Technical Report Series 804, Cancer pain relief, Geneva: WHO, 1990, p.11.
- Ryan S, Wong J, Chow R , Zimmermann C. Evolving definitions of palliative care: upstream migration or confusion?. Current treatment options in oncology. 2020; 21(3): 1-17.
- World Health Organisation. Integrating palliative care and symptom relief into paediatrics: a WHO guide for health-care planners, implementers and managers;[May;2024].2018. https://apps.who.int/iris/bitstream/handle/10665/274561/9789241514453- eng.pdf?ua =1.
- Connor SR, Downing J, Marston J. Estimating the global need for palliative care for children: A cross-sectional analysis. Journal of Pain and Symptom Management,S0885392416304936–.2016.08.020. 2017;53 (2):171-177.
- Kabalak A, Öztürk H, Erdem AT, Akın S. Comprehensive Palliative Care Center Application at SB Ulus State Hospital. Journal of Contemporary Medicine. 2012; 2(2):122-126.
- Swami M, Case AA. Effective palliative care: what is involved?. Oncology (08909091), 2018; 32(4). 180-184.
- Erol S, Ergün A. Geriatric Palliative Care: Why, Where, When, How and By Whom Should It Be Provided? Journal Of Public Health Nursing. 2019;1(2):38-48.
- Kangalgil Balta G, Bekiroğlu, S. The Importance of Psychosocial Support Services in Palliative Care. Work and Society. 2021(4), 2797-2812.
- Tekindal M, Uğuz Arsu Ş. A review of the scope and process of the phenomenological approach as a qualitative research method. Beyond the Horizon Science Journal. 2020; 20(1):153-182.
- Neuman LW. Social Research Methods: Qualitative and Quantitative Approaches (Seventh Ed.). Essex: Pearson Education Limited. 2014.
- Baltacı A. A Conceptual Review on Sampling Methods and Sample Size Issues in Qualitative Research. BEÜ SBE Journal. 2018;7(1):231-74.
- Braun, V. and Clarke, V. The use of thematic analysis in psychology. Journal of Qualitative Research in Education – Journal of Qualitative Research in Education. 2019; 7(2), 873-98.
- Winger A, Kvarme LG, Løyland B, Kristiansen C, Helseth S, Ravn IH. (2020). Family experiences with palliative care for children at home: a systematic literature review. BMC Palliative Care. 2020; 19(1): 165.
- Cengiz Z, Turan M, Olmaz D, Erce Ç. Care burden and quality of life in family caregivers of palliative care patients. Journal of Social Work in End-of-Life & Palliative Care. 2021; 17(1): 50-63.
- Sağlam Z, Koç Z, Çınarlı T, Korkmaz M. Determining the Caregiving Burden and Factors Affecting Patients' Relatives Giving Care to Individuals Sixty-five Years of Age and Over. Samsun Health Sciences Journal. 2016;1(2): 40-60.
- Egici MT, Kök Can M., Toprak D, et al. Care Burden and Burnout Situations of Individuals Giving Care to Patients Being Treated in Palliative Care Centers. Journal of Academic Research In Nursing. 2019; 5 (1): 1-8.
- Franchini L, Ercolani G, Ostan R, et al. Caregivers in home palliative care: gender, psychological aspects, and patient's functional status as main predictors for their quality of life. Supportive Care in Cancer. 2020; 28(7): 3227-3235.
- Robinson J, Gott M, Ingleton C. Patient and family experiences of palliative care in hospital: what do we know? An integrative review. Palliative medicine. 2014; 28(1):18-33.
- Lin SC, Chang KL & Huang MC. When and how do healthcare professionals introduce specialist palliative care to the families of children with life-threatening conditions in Taiwan? A qualitative study. Journal of Pediatric Nursing, 2021.
- Özhan, E. Evaluation of Psycho-Social Situations of Relatives of Cancer Patients: Eyüpsultan State Hospital Palliative Care Center Example. Sakarya University, Unpublished Master's Thesis. 2019.
- Boyden JY, Hill DL, Nye RT, et al. Pediatric palliative care parents' distress, financial difficulty, and child symptoms. Journal of pain and symptom management, 2022;63(2):271-282.
- Rocío, L., Rojas, E. A., González, M. C., Carreño, S., Diana, C., & Gómez, O. Experiences of patient-family caregiver dyads in palliative care during hospital-to-home transition process. International Journal of Palliative Nursing, 2017; 23(7): 332-339.
- Nipp RD, El-Jawahri A, Moran SM, D'Arpino SM, Johnson PC, Lage DE, Wong RL, Pirl WF, Traeger L, Lennes IT, Cashavelly BJ, Jackson VA, Greer JA, Ryan DP, Hochberg EP, Temel JS. The relationship between physical and psychological symptoms and healthcare utilization in hospitalized patients with advanced cancer diagnosis. Cancer. 2017;123(23):4720–7.
- Lee G, Kim HS, Lee SW, Park YR, Kim EH, Lee B, Hu YJ, Kim KA, Kim D, Cho HY, Kang B, Choi HJ. Preliminary screening of patient-reported symptoms using the Edmonton Symptom Assessment System in outpatient palliative cancer care. Eur J Cancer Care. 2020; 29(6):e13305.
- Valero-Cantero, I., Casals, C., Carrión-Velasco, Y., Barón-López, F.J., Martínez-Valero, F.J., & Vázquez-Sánchez, M. Á. The influence of symptom severity of palliative care patients on their family caregivers. BMC Palliative Care, 2022; 21(1): 1-7.
- Darlington AS, Randall D, Leppard L, Koh M. Palliative and end of life care for a child: understanding parentsâ coping strategies. Acta Paediatrica. 2021;110(2):673-681.
- Verberne LM, Kars MC, Schouten-van Meeteren AYN, van den Bergh EMM, Bosman DK, Colenbrander DA, Grootenhuis MA, van Delden JJM. Parental experiences and coping strategies when caring for a child receiving paediatric palliative care: a qualitative study. Eur J Pediatr. 2019; 178(7):1075-1085.
- Özdemir, F. Examining the relationship between the psychosocial problems experienced by the relatives of patients receiving palliative care and their religious coping styles, Hacettepe University Faculty of Health Sciences, Master's Thesis, Ankara. 2016.
- Çetin Ö. The Effect of Psychoeducation on Palliative Care Providers' Coping with Stress and Quality of Life. Celal Bayar University Health Sciences Institute, Master's Thesis, Manisa. 2018.
- Gün S. Evaluation of Burnout and Stress Coping Situations of Relative Caregivers of Stroke Patients. Ondokuz Mayıs University, Institute of Health Sciences, Master's Thesis, Samsun. 2017.
- Kopuz E. Determining the Work-Related Tension Level of Nurses and Examining Their Attitudes to Cope with Stress: A Private Hospital Example. Haliç University, Institute of Health Sciences, Master's Thesis, Istanbul.2013.
- Adelman, R., Tmanova, L., and Delgado, D. Caregiver Burden: A Clinical Review. JAM, 2014; 311 (10): 1052-1060.
- Azevedo C, Pessalacia JDR, Mata LRFD, Zoboli ELCP, Pereira MDG. Interface between social support, quality of life and depression in users eligible for palliative care. Rev Esc Enferm USP. 2017; 51:e03245. English, Portuguese, Spanish.
- Rutkowski NA, Lebel S, Richardson K, Mutsaers B, Chasen M, Feldstain A. A little help from my friends: social support in palliative rehabilitation. Current Oncology, 2018; 25(6): 358-365.
- Veloso, V.I., & Tripodoro, V.A.Caregivers burden in palliative care patients: a problem to tackle. Current opinion in supportive and palliative care. 2016; 10(4): 330-335.
- Karakartal D. Examination of the Problems Experienced by the Relatives of the Patient Giving Care to the Cancer Patient During the Treatment Process. International Journal of Humanities and Education. 2017; 3(2): 96-109.
- Perpiñá-Galvañ J, Orts-Beneito N, Fernández-Alcántara M, García-Sanjuán S, García-Caro MP, Cabañero-Martínez MJ. Level of burden and health-related quality of life in caregivers of palliative care patients. International journal of environmental research and public health. 2019; 16(23): 4806.
- Başdinç ŞE. Caregiving Burden and Psychosocial Needs of Relatives of Patients in Palliative Care. Istanbul University, Unpublished Master's Thesis. İstanbul. 2019.