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Healthcare Professionals’ Experiences of the Barriers and Facilitators to Pediatric Pain Management in the Community at End-of-Life: A Qualitative Interview Study

Healthcare Professionals’ Experiences of the Barriers and Facilitators to Pediatric Pain Management in the Community at End-of-Life: A Qualitative Interview Study
Healthcare Professionals’ Experiences of the Barriers and Facilitators to Pediatric Pain Management in the Community at End-of-Life: A Qualitative Interview Study

Contexts: Inadequate pain management in community pediatric palliative care is common. Evidence to inform improved pain management in this population is limited. Objectives: To explore the barriers and facilitators to pediatric community-based pain management for infants, children and young people at end-of-life as perceived by healthcare professionals. Methods: A qualitative interview study was conducted. Semi-structured interviews were undertaken with 29 healthcare professionals; 12 nurses, five GPs, five consultants and registrar doctors, two pharmacists and five support therapists working in primary, secondary or tertiary care in the United Kingdom and involved in community end-of life care of 0 to 18-year-olds. Results: The data corpus was analyzed using an inductive thematic analysis and seven themes emerged: parents’ abilities, beliefs and wellbeing; working relationships between families and healthcare professionals, and between healthcare teams; healthcare professionals’ knowledge, education and experience; health services delivery; nature of pain treatment; and pediatric-specific factors. Across themes, the concepts of partnership working between families and healthcare professionals, and within healthcare teams, and sharing expertise were prevalent. Conclusion: Partnership working and trust between healthcare professionals and parents, and within healthcare teams, is needed for effective at-home pediatric palliative pain management. Community healthcare professionals require more education from experienced multidisciplinary teams to effectively manage pediatric pain at end-of-life and prevent emergency hospice or hospital admissions, particularly during the COVID-19 pandemic.

Caregivers, paediatrics, pain management, palliative care, parents, qualitative research
0885-3924
98-105
Greenfield, Dr Katie
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Carter, Bernie
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Harrop, Dr Emily
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Jassal, Dr Sabtir
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Bayliss, Ms Julie
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Renton, Dr Kate
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Holley, Dr Simone
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Howard, Dr Richard F.
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Johnson, Ms Margaret
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Liossi, Christina
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Greenfield, Dr Katie
070c2fb7-b7f1-4842-a9a5-db04252a7ed1
Carter, Bernie
f7008227-46f4-4521-90e9-34188ed628db
Harrop, Dr Emily
a4b29888-be35-4f76-93fc-bb0b437d54e0
Jassal, Dr Sabtir
644ff4cc-1bb4-444a-9a4a-330dc4437f2b
Bayliss, Ms Julie
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Renton, Dr Kate
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Holley, Dr Simone
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Howard, Dr Richard F.
52880f05-4da3-4554-9e40-22c3e98b9a2d
Johnson, Ms Margaret
a6a124f3-678a-4136-88e6-f67fccde7934
Liossi, Christina
fd401ad6-581a-4a31-a60b-f8671ffd3558

Greenfield, Dr Katie, Carter, Bernie, Harrop, Dr Emily, Jassal, Dr Sabtir, Bayliss, Ms Julie, Renton, Dr Kate, Holley, Dr Simone, Howard, Dr Richard F., Johnson, Ms Margaret and Liossi, Christina (2022) Healthcare Professionals’ Experiences of the Barriers and Facilitators to Pediatric Pain Management in the Community at End-of-Life: A Qualitative Interview Study. Journal of Pain and Symptom Management, 63 (1), 98-105. (doi:10.1016/j.jpainsymman.2021.06.026).

Record type: Article

Abstract

Contexts: Inadequate pain management in community pediatric palliative care is common. Evidence to inform improved pain management in this population is limited. Objectives: To explore the barriers and facilitators to pediatric community-based pain management for infants, children and young people at end-of-life as perceived by healthcare professionals. Methods: A qualitative interview study was conducted. Semi-structured interviews were undertaken with 29 healthcare professionals; 12 nurses, five GPs, five consultants and registrar doctors, two pharmacists and five support therapists working in primary, secondary or tertiary care in the United Kingdom and involved in community end-of life care of 0 to 18-year-olds. Results: The data corpus was analyzed using an inductive thematic analysis and seven themes emerged: parents’ abilities, beliefs and wellbeing; working relationships between families and healthcare professionals, and between healthcare teams; healthcare professionals’ knowledge, education and experience; health services delivery; nature of pain treatment; and pediatric-specific factors. Across themes, the concepts of partnership working between families and healthcare professionals, and within healthcare teams, and sharing expertise were prevalent. Conclusion: Partnership working and trust between healthcare professionals and parents, and within healthcare teams, is needed for effective at-home pediatric palliative pain management. Community healthcare professionals require more education from experienced multidisciplinary teams to effectively manage pediatric pain at end-of-life and prevent emergency hospice or hospital admissions, particularly during the COVID-19 pandemic.

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JPSM-D-21-00308_R1 - Accepted Manuscript
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More information

Accepted/In Press date: 26 June 2021
e-pub ahead of print date: 14 July 2021
Published date: January 2022
Keywords: Caregivers, paediatrics, pain management, palliative care, parents, qualitative research

Identifiers

Local EPrints ID: 453790
URI: http://eprints.soton.ac.uk/id/eprint/453790
ISSN: 0885-3924
PURE UUID: 313e4031-0223-4682-8d7c-36a33a90c680
ORCID for Dr Katie Greenfield: ORCID iD orcid.org/0000-0001-8827-6543
ORCID for Christina Liossi: ORCID iD orcid.org/0000-0003-0627-6377

Catalogue record

Date deposited: 24 Jan 2022 17:49
Last modified: 17 Mar 2024 06:49

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Contributors

Author: Bernie Carter
Author: Dr Emily Harrop
Author: Dr Sabtir Jassal
Author: Ms Julie Bayliss
Author: Dr Kate Renton
Author: Dr Simone Holley
Author: Dr Richard F. Howard
Author: Ms Margaret Johnson

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