Cuidados al final de la vida en la unidad de cuidados intensivos pediátricos. Empleo de técnicas de investigación cualitativa para el análisis del afrontamiento de la muerte y situaciones críticas

Casanueva-Mateos, Lidia; Ruiz-López, Pedro; Sánchez-Díaz, Juan Ignacio; Ramos-Casado, Victoria; Belda-Holfheinz, S.; Fuente, Ana Llorente-de la; Mar-Molinero, Fernando

doi:10.1016/s1134-282x(07)71189-2

Cited by 5 publications

(21 citation statements)

References 21 publications

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“…Twenty-four used semi-structured or in-depth interviews and group discussions, with a large variety in their topic of interest and quality of methods: three for Portugal [189,198,199], four for Italy [92,97,152,200], sixteen for Spain [81,84,117,120,140,187,192,[201][202][203][204][205][206][207][208][209], and one international study that includes data from Spain and Italy [210]. Finally, six articles (using data from four different studies) included long-term participant observation.…”

Section: Qualitative Researchmentioning

confidence: 99%

End-of-life care across Southern Europe: A critical review of cultural similarities and differences between Italy, Spain and Portugal

Meñaca

Evans

Andrew

et al. 2012

Critical Reviews in Oncology/Hematology

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Evidence from a range of sources demonstrates that end-of-life (EoL) care practices and preferences vary across countries; culture is consistently one of the main explanations given for this. In order to understand how cultural factors are used to explain similarities and differences in EoL care between Spain, Italy and Portugal, database and hand searches were performed and cross-cutting core themes identified. Similarities included higher proportions of people who wished to die at home than actually died at home, a persistent trend for partial disclosure in Italy and Spain, low use of advance directives, and low incidence of all medical EoL decisions (with the exception of terminal sedation) compared to northern European countries. The role of religion and the importance of family ties were the two main cultural factors used to explain the similarities. Further research is needed in order to interpret the important differences that were also found.

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Section: Qualitative Researchmentioning

confidence: 99%

End-of-life care across Southern Europe: A critical review of cultural similarities and differences between Italy, Spain and Portugal

Meñaca

Evans

Andrew

et al. 2012

Critical Reviews in Oncology/Hematology

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“…Por otra parte, la literatura plantea la existencia de lagunas de conocimientos sobre aspectos difíciles de investigar, como lo es la muerte (27). Es de imperiosa necesidad conocer la realidad acerca de esta temática, en concordancia se plantea una investigación cualitativa con enfoque fenomenológico para responder a la pregunta: ¿Cómo es la experiencia de enfermeras(os) de Cuidados Intensivos Pediátricos, en la muerte de un niño, en cuanto a sus vivencias, duelo y aspectos bioéticos?, el objetivo principal es explorar dicha experiencia, concerniente a un grupo de enfermeras(os) intensivistas pediátricas(os) pertenecientes a un hospital Tipo 4, en la ciudad de Temuco, Chile, durante el año 2011.…”

Section: Aspectos Bioéticos Relacionados Con La Muerte De Un Niño En unclassified

Experiencia De Enfermeras Intensivistas Pediátricas en La Muerte De Un Niño: Vivencias, Duelo, Aspectos Bioéticos

S¹,

Riveros

2013

Cienc. enferm.

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RESUMENExperimentar la muerte de un niño es una situación compleja, donde las(os) enfermeras(os) enfrentan posturas contrapuestas y evasivas, como indiferencia y aprensión. Objetivo: Explorar la experiencia de enfermeras(os) de Cuidados Intensivos Pediátricos, en la muerte de un niño, en su significado o vivencia, duelo y aspectos bioéticos. Hospital Tipo 4, Temuco Chile, 2011. Metodología: Estudio cualitativo descriptivo, enfoque fenomenológico, referente hermenéutico de Schütz. Muestra intencional de 7 participantes. Información recolectada mediante entrevista no estructurada. Resultados: Se describen las siguientes metacategorías A: Vivencia y subcategorías: a) Tragedia que impacta y afecta emocionalmente, b) Impotencia ante las expresiones de dolor de la familia; B: Duelo y subcategorías: a) Tiempo para vivir el duelo, b) trato humanizado (respeto); C: Aspectos Bioéticos, subcategorías a) Autonomía, b) Justicia, c) No Maleficencia. Conclusión: La experiencia estresante develada en el estudio se manifiesta en sentimientos que impactan en la percepción, cognición y comportamiento. Como resultado coexisten posturas contrapuestas y evasivas, como la indiferencia que impide sufrir y la aprensión que desgasta y agota. Se concluye con la necesidad de contar con formación que fortalezca mecanismos de autodefensa y herramientas para la contención e incrementar la formación en bioética. Al mismo tiempo continuar la línea de investigación para documentar con mayor profundidad el proceso experiencial.Palabras clave: Enfermería pediátrica, unidades de cuidado intensivo pediátrico, niño hospitalizado, bioética. ABSTRACTExperiencing the death of a child is a complex situation, where (I) nurses (I) face opposite positions and evasive, as indifference and apprehension. Objective: To explore the experiences of nurses (I) Pediatric Intensive Care, in the death of a child, in meaning or sense, grief and bioethical issues. Hospital Type 4, Temuco, Chile, 2011. Methodology: Qualitative descriptive phenomenological, hermeneutical reference Schütz. Purposive sample of 7 participants. Information collected through unstructured interview. Results: We describe the metacategories A: Experience and subcategories: a) Tragedy emotionally impacting and affecting, b) Impotence expressions of grief to the family. B: Metacategory Mourning and subcategories: a) Time to grieve, b) humane treatment (respect), C: Bioethical Issues, sub categories a) autonomy, b) justice, c) nonmaleficence. Conclusions: A stressful experience is unveiled in the study revealing that feelings impact on perception, cognition and behavior. Conflicting and evasive positions coexist, as indifference that prevents from suffering and apprehension that wears and exhausts. The need for training that supports self-defense mechanisms and tools for containment and increase bioethics training, is concluded. At the same time continue the research line, to document in greater deph the experiential process.

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“…Previous studies on paediatric palliative care units have studied their critical issues and the way to improve them. Among the findings, they remarked the coordination issues between paediatrics and other professionals such as social workers or the rest of the medical team [ 33 , 34 ], the lack of emotional support (during and after de illness [ 34 , 35 , 36 ], the need of maintaining continuity in the medical team, the constant of attention by paediatrics (24-h attention) due to the special bond and trust created with families [ 34 ] and the difficulties related to the transition from paediatric palliative to adult palliative [ 36 ], which can suggest the idea of the establishment of transition units.…”

Section: Discussionmentioning

confidence: 99%

Enhancing the Adult and Paediatric Palliative Care System: Spanish Professionals’ and Family Caregivers’ Suggestions for Comprehensive Improvement

Llop-Medina,

García-Muñoz,

Ródenas-Rigla

et al. 2023

Healthcare

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This research critically explores deficiencies in the palliative care system, focusing on evaluation and treatment aspects for both adult and paediatric patients. Using a qualitative methodology, the study engages healthcare professionals and family caregivers to uncover perspectives on the existing state of palliative care. Conducted through three focus groups and a semi-structured in-depth interview with participants recruited from Virgen de la Arrixaca University Clinical Hospital, this research illustrates critical issues, highlighting the insufficient healthcare workforce and resources to meet the comprehensive needs of patients and their families. Recommendations include holistic care addressing social, emotional, psychological, socio-familiar, and economic dimensions, supported by embedded support groups and the enforcement of relationships with palliative associations. This study also advocates for improved health institutional coordination, social worker support, and ongoing health professional satisfaction monitoring. In paediatric care, specific demands involve specialised units, medical team continuity, 24 h paediatrician care, and a more professional paediatric approach. Beyond problem identification, this study offers valuable insights for shaping health policies and tools, incorporating new indicators and introducing grief bereavement support in clinical reports, contributing to the advancement of patient evaluation in palliative care.

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Cuidados al final de la vida en la unidad de cuidados intensivos pediátricos. Empleo de técnicas de investigación cualitativa para el análisis del afrontamiento de la muerte y situaciones críticas

Cited by 5 publications

References 21 publications

End-of-life care across Southern Europe: A critical review of cultural similarities and differences between Italy, Spain and Portugal

End-of-life care across Southern Europe: A critical review of cultural similarities and differences between Italy, Spain and Portugal

Experiencia De Enfermeras Intensivistas Pediátricas en La Muerte De Un Niño: Vivencias, Duelo, Aspectos Bioéticos

Enhancing the Adult and Paediatric Palliative Care System: Spanish Professionals’ and Family Caregivers’ Suggestions for Comprehensive Improvement

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