Kai-Ling Chang1
1) Taiwan
Background and aims: Pain usually impacts the children on end-of-life (EOL), and creates significant distress for caregivers. The quality of EOL pediatric pain control was impacted directly by the nursing competency to handle the parents grieving. This case report was to investigate how a pain control care plan was affected by parental grieving care of an EOL child.
Methods: This is a case study. A 5-year-old girl was diagnosed with Hepatoblastoma. She lost follow-up after chemotherapy because her parents were afraid that the surgery would hurt their child. 8 months later, she re-admitted due to hypoglycemia, pain and hyperbilirubinemia. The PICU and palliative team began to provide hospice care.
Results: We suggested to use alternative opioid at home. However, the parents couldn’t make any pain control decision because of grief. Through in-deep conversation, we could understand may be the parents choose to do nothing for ‘inaction’ provide self-preservation. They had to face the fact that their daughter death and they believe there was a principle in the infinity nature that they had to obey. We narrated their love story to provided parents grief support. Finally, all good memories encourage the father decide to take his girl home, and want to discuss what kind of pain control method in home was better for them.
Conclusions: It’s very complex to do EOL pediatric pain care effectively, includes the skills related to control physical, emotional, spiritual and culture components. Safe and suitable Opioid delivering for EOL children is necessary, and developing the ability to understand the meaning from suffering of parents and child. We recommended to develop specific policies for suitable and safety available analgesics for EOL children, and to create the ability for holistic pain control care.
Acknowledgments/Disclosures: Thanks, the patient and her parents. There were no conflicts of interest to disclose.
