Taiwanese parents' experience of making a "do not resuscitate" decision for their child in pediatric intensive care unit
Journal
Asian Nursing Research
Journal Volume
8
Journal Issue
1
Pages
29-35
Date Issued
2014
Author(s)
Abstract
Purpose The purpose of this project was to explore the parental experience of making a "do not resuscitate" (DNR) decision for their child who is or was cared for in a pediatric intensive care unit in Taiwan. Methods A descriptive qualitative study was conducted following parental signing of a standard hospital DNR form on behalf of their critically ill child. Sixteen Taiwanese parents of 11 children aged 1 month to 18 years were interviewed. Interviews were recorded, transcribed, analyzed and sorted into themes by the sole interviewer plus other researchers. Results Three major themes were identified: (a) "convincing points to sign", (b) "feelings immediately after signing", and (c) "postsigning relief or regret". Feelings following signing the DNR form were mixed and included "frustration", "guilt", and "conflicting hope". Parents adjusted their attitudes to thoughts such as "I have done my best," and "the child's life is beyond my control." Some parents whose child had died before the time of the interview expressed among other things "regret not having enough time to be with and talk to my child". Conclusion Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process. ? 2013, Korean Society of Nursing Science. Published by Elsevier. All rights reserved.
Subjects
intensive care units; parents; pediatrics; resuscitation orders; terminal care
SDGs
Other Subjects
adult; article; attitude; cardiovascular disease; clinical article; communication skill; critically ill patient; decision making; descriptive research; do not resuscitate; emotion; Enterovirus infection; experience; female; frustration; guilt; hope; human; intensive care unit; male; medical order; parental attitude; priority journal; qualitative analysis; qualitative research; resuscitation; Taiwan; thinking; adolescent; child; human relation; infant; middle aged; palliative therapy; parent; preschool child; psychology; resuscitation; young adult; Adolescent; Adult; Child; Child, Preschool; Decision Making; Female; Humans; Infant; Intensive Care Units, Pediatric; Male; Middle Aged; Palliative Care; Parents; Professional-Family Relations; Qualitative Research; Resuscitation Orders; Taiwan; Young Adult
Publisher
Elsevier (Singapore) Pte Ltd
Type
journal article