Pediatric Oncology Palliative Care: Experiences of General Practitioners and Bereaved Parents

Article English OPEN
Neilson, Sue J. ; Gibson, Faith ; Greenfield, Sheila M (2015)
  • Publisher: OMICS International
  • Journal: Journal of palliative care & medicine, volume 5, issue 2 (eissn: 2165-7386)
  • Related identifiers: doi: 10.4172/2165-7386.1000214, pmc: PMC4765076
  • Subject: RT | Children | Qualitative | General practitioners | RJ | Cancer | Palliative care | Article | Oncology | R1

Objective: This qualitative study set in the West Midlands region of the United Kingdom, aimed to examine the\ud role of the general practitioner (GP) in children's oncology palliative care from the perspective of GPs who had cared for a child with cancer receiving palliative care at home and bereaved parents.\ud Methods: One-to-one semi-structured interviews were undertaken with 18 GPs and 11 bereaved parents\ud following the death. A grounded theory data analysis was undertaken; identifying generated themes through\ud chronological comparative data analysis.\ud Results: Similarity in GP and parent viewpoints was found, the GPs role seen as one of providing medication and\ud support. Time pressures GPs faced influenced their level of engagement with the family during palliative and\ud bereavement care and their ability to address their identified learning deficits. Lack of familiarity with the family, coupled with an acknowledgment that it was a rare and could be a frightening experience, also influenced their level of interaction. There was no consistency in GP practice nor evidence of practice being guided by local or national policies. Parents lack of clarity of their GPs role resulted in missed opportunities for support.\ud Conclusions: Time pressures influence GP working practices. Enhanced communication and collaboration\ud between the GP and regional childhood cancer centre may help address identified GP challenges, such as learning\ud deficits, and promote more time-efficient working practices through role clarity. Parents need greater awareness of\ud their GP's wide-ranging role; one that transcends palliative care incorporating bereavement support and on-going medical care for family members
  • References (21)
    21 references, page 1 of 3

    Mitchell GK (2002) How well do general practitioners deliver palliative care? A systematic review. Palliat Med 16: 457-464.

    Royal College of Paediatric and Child Health (RCPCH) (2012) Paediatric Palliative Medicine. Higher Specialist trainees Handbook. [Accessed October 24th 2014].

    Neilson SJ, Kai J, Macarthur C, Greenfield SM (2011) Caring for children dying from cancer at home: a qualitative study of the experience of primary care practitioners. Fam Pract 28: 545-553.

    10. Charlton R, Dolman E (1995) Bereavement: a protocol for primary care. Br J Gen Pract 45: 427-430.

    (2008) Parents' perspective on symptoms, quality of life, characteristics of death and end-of-life decisions for children dying from cancer. Klin Padiatr 220: 166-174.

    Monterosso L, Kristjanson LJ (2008) Supportive and palliative care needs of families of children who die from cancer: an Australian study. Palliat Med 22: 59-69.

    13. Jalmsell L, Kreicbergs U, Onelöv E, Steineck G, Henter JI (2006) Symptoms affecting children with malignancies during the last month of life: a nationwide follow-up. Pediatrics 117: 1314-1320.

    Mack JW, Hilden JM, Watterson J, Moore C, Turner B, et al. (2005) Parent and physician perspectives on quality of care at the end of life in children with cancer. J Clin Oncol 23: 9155-9161.

    Hain R, Heckford E, McCulloch R (2012) Paediatric palliative medicine in the UK: past, present, future. Arch Dis Child 97: 381-384.

    Department of Health (2012) The NHS Outcomes Framework 2013-14.

  • Metrics
    No metrics available
Share - Bookmark