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首页> 外文期刊>Indian journal of palliative care >End-of-life milieu of critically sick children admitted to a pediatric hospital: A comparative study of survivors versus nonsurvivors
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End-of-life milieu of critically sick children admitted to a pediatric hospital: A comparative study of survivors versus nonsurvivors

机译：儿科医院危重病儿童的临终环境：幸存者与非幸存者的比较研究

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Objective: The aim of this study was to describe end-of-life (EOL) milieu among caregivers of children who died in the hospital and to compare their psychosocial, spiritual, and financial concerns with caregivers of children who survived. Materials and Methods: Sixty caregivers of children (30 survivors and 30 nonsurvivors), admitted in the pediatric intensive care unit and general pediatric unit, were recruited over a period of 1 year. Mixed qualitative methods were used to collect information from parents on EOL care perspectives. Results: Demographic, disease, and treatment-related characteristics were not significantly different between nonsurvivor and survivor groups. The caregivers of nonsurvivors versus survivors showed no significant differences as regards optimal care (76.67% vs. 56.67%), social support (76.6% vs. 66.67%), and frequent recitation of scriptures (30.77% vs. 45.83%). Mean medical expenditure among children receiving EOL care was Rs. 40,883 (range: Rs. 800–5 lakhs). Regression results revealed that for every 1 day of increase in hospital stay, cost of hospitalization for dying children increased by Rs. 3000 (P = 0.0001). Medical insurance was reported by only minority of the cases (5%). Several themes emerged in the focus group discussions with care providers which highlighted the importance of communication and need for emotional, social, and financial support. EOL decision was taken in only two of the nonsurviving children. Conclusions: The study offers useful insight about social, financial, and religious “end-of-life” needs among terminally sick children and thereby sensitizes the health-care providers to optimize their care at this niche period.
机译：目的：本研究的目的是描述在医院死亡的儿童看护人的临终环境（EOL），并将他们的心理，精神和经济问题与存活儿童的看护人进行比较。材料和方法：招募了60名儿童，其中30名幸存者和30名非幸存者，他们分别在小儿重症监护室和普通小儿科接受了为期一年的护理。使用混合的定性方法从父母那里收集有关EOL护理观点的信息。结果：非幸存者和幸存者组之间的人口统计学，疾病和治疗相关特征无显着差异。非幸存者与幸存者的照护者在最佳护理（76.67％vs. 56.67％），社会支持（76.6％vs. 66.67％）和经文诵经（30.77％vs. 45.83％）方面没有显着差异。在接受EOL护理的儿童中，平均医疗支出为Rs。 40,883（范围：800–50万卢比）。回归结果显示，住院时间每增加1天，垂死儿童的住院费用就会增加Rs。 3000（P = 0.0001）。只有少数病例报告了医疗保险（5％）。在与护理提供者的焦点小组讨论中出现了几个主题，这些主题突出了沟通的重要性以及对情感，社会和财务支持的需求。只有两个未幸存的孩子才做出停产决定。结论：该研究提供了关于绝症儿童的社会，财务和宗教“生命终结”需求的有用见解，从而使医疗保健提供者在此利基时期提高了他们的护理水平。

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