Defining a “Good Death” in the Pediatric Intensive Care Unit

  • Elizabeth G. Broden
    Elizabeth G. Broden is a doctoral student, University of Pennsylvania School of Nursing, and a registered nurse, Pediatric Intensive Care Unit, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Janet Deatrick
    Janet Deatrick is a professor emerita, Department of Family and Community Health, University of Pennsylvania School of Nursing.
  • Connie Ulrich
    Connie Ulrich is a professor, Department of Biobehavioral Health, School of Nursing, and a professor of bioethics, School of Medicine, University of Pennsylvania.
  • Martha A.Q. Curley
    Martha A.Q. Curley is the Ruth M. Colket Endowed Chair in Pediatric Nursing, Children’s Hospital of Philadelphia, and a professor, Department of Family and Community Health, School of Nursing and Department of Anesthesia and Critical Care, Perelman School of Medicine, University of Pennsylvania.

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<jats:sec><jats:title>Background</jats:title><jats:p>Societal attitudes about end-of-life events are at odds with how, where, and when children die. In addition, parents’ ideas about what constitutes a “good death” in a pediatric intensive care unit vary widely.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To synthesize parents’ perspectives on end-of-life care in the pediatric intensive care unit in order to define the characteristics of a good death in this setting from the perspectives of parents.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A concept analysis was conducted of parents’ views of a good death in the pediatric intensive care unit. Empirical studies of parents who had experienced their child’s death in the inpatient setting were identified through database searches.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The concept analysis allowed the definition of antecedents, attributes, and consequences of a good death. Empirical referents and exemplar cases of care of a dying child in the pediatric intensive care unit serve to further operationalize the concept.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Conceptual knowledge of what constitutes a good death from a parent’s perspective may allow pediatric nurses to care for dying children in a way that promotes parents’ coping with bereavement and continued bonds and memories of the deceased child. The proposed conceptual model synthesizes characteristics of a good death into actionable attributes to guide bedside nursing care of the dying child.</jats:p></jats:sec>

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