Pediatric intensive care nurses' perspectives on the quality of dying and death among hospitalized children: A Cross-Sectional Study

Background: Nurses are continuously present at the bedside and work closely with both children and families; therefore, their perspectives can provide a detailed understanding of end-of-life care. This study examined the quality of dying and death among hospitalized children from the perspective of Pediatric Intensive Care Unit (PICU) nurses and explored nurse-related factors associated with their evaluations. Methods: In this cross-sectional study, ۱۷۶ nurses working in the PICUs of four teaching hospitals (۶ PICU wards) in Tehran, Iran, participated. Inclusion criteria were at least a bachelor's degree in nursing, at least ۱۲ months of PICU experience, experience caring for terminally ill children, and no personal history of losing a child. A census sampling method was used. Data were collected by self-report using the PICU-QODD (Quality of dying and death) questionnaire. Independent t-tests, one-way ANOVA, Pearson correlations, and multiple linear regression were performed using SPSS version ۲۴. Results: The overall QODD score was ۶۸.۴۴ ± ۱۵.۶, suggesting a moderate to favorable perceived quality. The highest domain scores were observed for continuity and coordination of care (۸۴.۴ ± ۱۸.۱), fulfillment of the parental role (۷۷.۰۴ ± ۲۱.۹), emotional support for the family (۷۶.۹۱ ± ۱۹.۳), and pain and symptom management (۷۶.۸۱ ± ۱۵.۵), whereas the physical and instrumental needs of the family (۴۹.۱ ± ۲۹.۲) and spirituality and religious‑cultural issues (۳۳.۴۶ ± ۲۴.۱) had the lowest scores. In the multivariable analysis, only fixed work shift remained independently associated with higher QODD scores (B = ۷.۰۱, ۹۵% CI (۰.۳۴۳,۱۳.۶۸۸)). Conclusion: PICU nurses rated children's quality of dying and death as generally acceptable but identified shortcomings in spiritual and practical support for families. Promoting continuity of care and providing targeted education on holistic, family-centered end-of-life care may be beneficial.

کلیدواژه ها:

Palliative care ، Death ، Nursing ، Children